Patients scheduled for bilateral cataract surgery at the Eye Department of the University of Salerno between January 2017 and September 2017 were included in the present study. Patients that underwent previously refractive surgery were excluded from the study. The study was consistent with the tenets of the Declaration of Helsinki, and institutional ethics committee approval and written informed patient consent were obtained from all individual participants included in the study. The time interval for the surgery of the fellow eye was at least 2 months after the previous surgery. Before the first cataract surgery, both eyes of the patients underwent a complete ophthalmic examination, including an evaluation with an IOLMaster (5.4.4.0006; Carl Zeiss Meditec AG). The AL evaluation was the mean of at least three measurements, with the highest signal-to-noise ratio at least above 2. Based on these criteria, 196 eyes of 98 patients (48 males) were identified.
The same evaluations were repeated in both eyes the day before the fellow eye surgery.
The first operated eyes were evaluated, and the fellow eyes were used as control. Only eyes without previous ocular surgery; with ocular media that allowed the IOLMaster evaluation; without glaucoma, corneal scars, or other ocular or systemic diseases that could alter the results of the study; and eyes that underwent uneventful surgery were included in the present study.
One surgeon (N.R.) performed all surgeries using the same surgical procedure. The clear corneal stab incision was made using a 3.0-mm stainless knife at 12.00. A continuous curvilinear capsulorhexis of approximately 5.0 mm in diameter was performed using a 25-gauge bent needle and a capsulorhexis forceps. After hydrodissection, endocapsular phacoemulsification of the nucleus and aspiration, an IOL (PCB00; Abbot Medical Optics, Santa Ana, CA, USA) was implanted. Hydration of the wounds, without corneal suture, was performed, and the eye was patched. None of the eyes received astigmatism keratotomy, limbar relaxing incision, or any other corneal incision beside the superior corneal stab incision and the paracenteses.
The Km and AL measurements obtained in the operated eyes before and 2 months after surgery were compared to the measurements obtained in the fellow eyes at the same time interval. A statistical evaluation was performed utilizing a paired t-test, a Bland-Altman evaluation, and R2 analysis.
For the measurements of the AL after cataract surgery in the operated eye, the IOLMaster pseudophakic and aphakic options were utilized.