Refractive Prediction Error Following Phacoemulsification Cataract Surgery in Patients With Uveitis.

Abstract

Purpose: To compare the refractive prediction error (PE) following phacoemulsification cataract surgery in patients with and without uveitis, and identify the factors associated with PE in patients with uveitis.

Methods: This retrospective cohort study was conducted on the data obtained from patients who underwent uncomplicated phacoemulsification cataract surgery, which was performed by a single surgeon at Xi'an People's Hospital between January 2021 and February 2024. The patients were divided into two cohorts based on the operated eyes' history of uveitis. PE was analyzed before and after propensity score matching based on confounding variables, which included patient gender and age, procedure laterality, anterior chamber depth (ACD), axial length (AL), and keratometry. Then the factors associated with PE in the uveitis cohort were identified.

Results: The PE significantly differed between the matched uveitis and non-uveitis cohorts (0.16 ± 0.65 vs -0.19 ± 0.50 diopters [D], P < .001), with a shift toward hyperopia in the uveitis cohort. However, the absolute PE did not significantly differ between the matched cohorts (0.49 ± 0.45 and 0.42 ± 0.33, P = .081). For patients with uveitis, PE was positively associated with the course of uveitis (β = 0.027, 95% CI = 0.003 to 0.052, P = .027), preoperative posterior synechiae (β = 0.226, 95% CI = 0.027 to 0.425, P = .026), and preoperative ACD (β = 0.417, 95% CI = 0.089 to 0.746, P = .013) and AL (β = 0.068, 95% CI = 0.009 to 0.128, P = .025).

Conclusions: For patients with uveitis who underwent phacoemulsification cataract surgery, postoperative PE presented with a hyperopic shift relative to that in patients without uveitis. This was associated with the course of uveitis, preoperative posterior synechiae, and preoperative ACD and AL. [J Refract Surg. 2025;41(5):e427-e434.].