Refractive precision in uncomplicated eyes with pseudoexfoliation: three-piece versus one-piece intraocular lens implantation.

ABSTRACT

PURPOSE: To evaluate the refractive precision of three-piece versus one-piece intraocular lenses (IOLs) in eyes with pseudoexfoliation (PXF) and changes in anterior chamber depth (ACD) following cataract surgery. METHODS: This prospective, nonrandomized, interventional, comparative case series included PXF eyes, which were implanted with one-piece acrylic IOL or three-piece acrylic IOLs (Group A; n = 31, Group B; n = 30). Non-PXF control eyes were implanted with one-piece acrylic IOL (Group C; n = 30). Postoperative refractive error (RE) and absolute RE, as well as pre- to postoperative ACD changes, were statistically analysed. A p value < 0.05 was considered statistically significant. RESULTS: Changes in ACD (mean ± standard deviation) in Groups A, B and C were 0.9 ± 0.4, 1.0 ± 0.3 and 0.7 ± 0.4 mm, respectively. Significant differences were found between Groups A and C (p = 0.043) and between Groups B and C (p = 0.008). In Groups A, B and C, the median and interquartile (Q1 to Q3) values were 0.3 (-0.8 to 1.0), -0.5 (-0.8 to -0.3) and 0.1 (-0.4 to 0.3) for RE and 1.0 (0.4 to 1.3), 0.5 (0.3 to 0.8) and 0.3 (0.3 to 0.5) for absolute RE, respectively. The RE differences between Group A and B (p = 0.009) and Group B and C (p < 0.001) were statistically significant. For absolute RE, the differences were significant for all comparisons (p < 0.05). CONCLUSION: Refractive precision in PXF eyes may be better with three-piece than with one-piece IOL implantation, but worse than with one-piece IOL implantation in non-PXF eyes. Significant changes in ACD in PXF eyes may be related to RE.