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Shi, Lynn, AB*,†; Chang, Jonathan S., MD*,‡; Suh, Leejee H., MD*; Chang, Stanley, MD*

doi: 10.1097/IAE.0000000000002153
Original Study: PDF Only

Purpose: To determine whether preoperative adjustments are required for intraocular lens calculations in combined phacovitrectomy surgery.

Methods: A single-center, retrospective study of 50 eyes that underwent combined phacovitrectomy and a control group of 50 eyes after cataract surgery over a 3-year period by a single anterior segment surgeon and a single posterior segment surgeon. Main outcome measures were predicted refractive error (RE), as determined by SRK/T and Holladay 1 formulas, change compared with actual RE, surgically induced astigmatism, and the relationships between preoperative central foveal thickness or change in central foveal thickness and final RE.

Results: The differences in predicted and final RE between groups were not statistically significant between groups when both SRK/T and Holladay 1 formulas were used (P > 0.05). Regardless of the formula used, final RE was neither significantly hyperopic nor myopic as compared to the target. There was no difference in surgically induced astigmatism between the two groups. Increased preoperative central foveal thickness was correlated with greater difference between predicted and actual RE. No relationship was noted between change in central foveal thickness and RE.

Conclusion: Combined phacovitrectomy for concurrent cataract epiretinal membrane by experienced cataract and vitreoretinal surgeons seems to deliver as predictable refractive results as cataract surgery alone.

Combining vitrectomy and cataract surgery is effective for treating coexisting pathologies, and provides patients with rapid visual rehabilitation. It is unclear if and how intraocular lens calculations are affected in combined procedures. This study addresses this problem and ,in addition, explores the relationship between preoperative central foveal thickness and final refractive outcomes.

*Department of Ophthalmology, Harkness Eye Institute, Columbia University Medical Center, New York, New York;

College of Physicians and Surgeons, Columbia University, New York, New York; and

Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Reprint requests: Jonathan S. Chang, MD, Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, 2870 University Avenue, Suite 206, Madison, WI 53705; e-mail:

Supported in part by the Gerstner Family Foundation, and unrestricted grant to Columbia University from Research to Prevent Blindness. It was also supported in part by a National Eye Institute Vision Research Core grant (P30 EY016665) to the University of Wisconsin an unrestricted grant to the University of Wisconsin from Research to Prevent Blindness. The funding organizations had no role in the design or conduct of this research.

Portions of this research were presented at the Association for Research in Vision and Ophthalmology, Seattle, WA, 2016, and at the American Academy of Ophthalmology annual meeting, Chicago, Illinois, October 2016.

None of the authors has any financial/conflicting interests to disclose.

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© 2019 by Ophthalmic Communications Society, Inc.