View abstract

This abstract is assigned to sessions

Presentation type	Oral presentation
Title	Refractive Predictability Following Cataract Surgery in Eyes with Clinically Significant Corneal Pathology

Purpose	IOL power calculation is challenging in eyes with corneal pathology due to altered or irregular corneal measurements. We evaluated refractive outcomes following cataract surgery and identified factors associated with reduced refractive predictability.
Methods	Methods: This single-centre retrospective cohort study included 192 eyes of 139 patients with clinically significant corneal pathology undergoing cataract surgery. Prediction error was calculated as postoperative spherical equivalent minus surgeon-selected target refraction. Outcomes included absolute prediction error and proportions within ±0.50 D and ±1.00 D of target. Outcomes were compared across pathology groups and predictors of reduced refractive accuracy assessed.
Results	Postoperative refraction was available for 128 eyes. Median absolute prediction error was 0.48 D; 54.7% and 78.9% achieved ±0.50 D and ±1.00 D of target, respectively. Refractive accuracy differed significantly between pathology groups (p<0.001). Ectasia demonstrated reduced predictability (median absolute error 0.79 D; 15.8% within ±0.50 D and 52.6% within ±1.00 D) and was associated with error >1.00 D (OR 4.55, 95% CI 1.62–12.78; p=0.004). Abnormal biometry was also associated with error >1.00 D (OR 3.98, 95% CI 1.59–9.97; p=0.003).
Conclusion	Most eyes with clinically significant corneal pathology achieved acceptable refractive outcomes. Ectasia and abnormal biometry identified eyes at increased risk of refractive surprise, supporting enhanced counselling, biometric assessment and individualised IOL planning.
Conflict of interest	No

Authors 1

Last name	BHARGAV
Initials	J
Department	Musgrove Park Ophthalmology
City	Taunton