The Effect of Gas Tamponade on the Intraocular Lens Position and Refractive Error after Phacovitrectomy: A Swept-source Anterior Segment OCT Analysis

Abstract Objective To investigate the intraocular lens position and refractive outcomes following cataract surgery and phacovitrectomy using swept-source anterior segment optical coherence tomography (SS-ASOCT). Design Retrospective case series Subjects Patients underwent cataract surgery (Group A; 34 eyes), phacovitrectomy without gas tamponade (Group B; 20 eyes), and phacovitrectomy with gas tamponade (Group C; 22 eyes). Methods Various parameters associated with the anterior chamber and lens were measured by SS-ASOCT (CASIA2®) before and after surgery. Axial lengths were measured by optical biometry (IOLMaster). The refraction (spherical equivalent) was measured 1 week and 1 month after surgery. Main Outcome Measures Refractive outcomes and the parameters measured by SS-ASOCT were statistically evaluated. Results The overall mean median absolute error (MedAE) was 0.34 D at 1 month postoperatively. The MedAE was greater in the Group C (0.47 D) than in the Group A (0.31 D) and Group B (0.20 D). The overall mean refractive prediction error (ME) was 0.22 ± 0.62 D at 1 month postoperatively. The ME was significantly greater in the Group C (-0.82 ± 0.64 D) than in the Group A (0.08 ± 0.39 D) and Group B (-0.07 ± 0.45 D) (P Conclusions Forward fixation of the IOL caused myopic refractive errors even after the gas had disappeared in eyes that underwent phacovitrectomy with gas tamponade.