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To evaluate relationship between intraoperative lens thickness, estimated postoperative refractive outcomes and changes in target refraction in patients undergoing femtosecond laser-assisted cataract surgery (FLACS)
Retrospective chart review of patients that underwent FLACS. Surgery was performed by residents and fellows at the Illinois Eye and Ear Infirmary. Estimated target refraction was based on biometry calculation. Lens measurements including anteroposterior distance and lens tilting are taken in consideration. Eyes with preoperative ocular pathology, keratoconus, history of refractive surgery and toric IOL were excluded.
86 eyes were included. Average axial length was 24.3mm (21.4 - 28.7mm). Mean lens thickness 5201 microns (3709 - 6363 microns). Mean target refraction was -0.2D (-2.66 to +0.23D) and mean difference from target refraction at POM#1 was 0.44D (0 to 1.64D). Twenty percent of the eyes had more than 0.50D of difference from target refraction and of these eyes, 75% had a lens thickness higher than 5000 microns. There was a correlation of 0.26 (p 0.02) between lens thickness and greater difference from target refraction.
Eyes with thicker lenses are less likely to achieve the target refraction after cataract surgery. Lens thickness may impact the accuracy of the measure of the intraocular lens and could potentially impact the final position of the IOL. All these variables should be considered to predict the refractive outcome of these patients.