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Impact of axial length and prior radiotherapy on postoperative effective lens position and refractive outcomes in cataract surgery: A longitudinal study
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Z. Zhang   |
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Abstract: (46 Views) |
Background: Cataract surgery requires accurate prediction of the effective lens position (ELP) to optimize refractive outcomes. Both axial length (AL) and prior ocular tissue changes, including radiotherapy exposure, can influence postoperative results. Materials and Methods: This longitudinal study included 285 patients (312 eyes) undergoing phacoemulsification with intraocular lens implantation. Among them, 27 patients (29 eyes) had a documented history of orbital or periocular radiotherapy, delivered with external beam therapy (median cumulative dose 45 Gy, range 30-60 Gy) for ocular adnexal or head and neck malignancies. Preoperative AL was measured using partial coherence interferometry, and postoperative ELP was determined via anterior segment optical coherence tomography (AS-OCT). Refractive error and best-corrected visual acuity were evaluated at 1, 3, 6, and 12 months. Statistical analyses were performed using SPSS with bivariate correlation and subgroup comparisons. Results: Short AL eyes (<22.0 mm) demonstrated a mean ELP of 4.50 mm (SD ± 0.35), while long AL eyes (>24.5 mm) had a shallower mean ELP of 4.00 mm (SD ± 0.40) (p < 0.001). Eyes with prior radiotherapy exhibited a significant posterior displacement of the ELP (mean reduction 0.18 mm, p = 0.042) and a higher incidence of hyperopic shift. Despite overall visual improvement across all groups, radiotherapy-treated and long AL eyes showed greater refractive variability, with slower stabilization within ±0.4 D. Conclusion: Both axial length and prior radiotherapy independently affect postoperative ELP and refractive predictability. Careful surgical planning is essential in these high-risk groups to optimize visual outcomes. |
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| Keywords: Axial length, cataract extraction, lens implantation, intraocular, radiotherapy. |
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Full-Text [PDF 841 kb]
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Type of Study: Original Research |
Subject:
Radiation Biology
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