Predictability of refraction following immediate sequential bilateral XXXX surgery (ISBCS) performed under general anaesthesia.

@entity1 @entity2790 @entity231
BACKGROUND: To evaluate the predictability of refraction following immediate sequential bilateral @entity231 surgery (ISBCS) performed under general anaesthesia. METHODS: This is a retrospective review of all ISBCS performed at Kantonsspital Winterthur, Switzerland, between April 2000 and September 2013. The case notes of 250 @entity1 were reviewed. @entity1 having full refraction reported (110 @entity1 /220 eyes) were included. 210 (95  %) eyes had a straight forward phacoemulsification with posterior chamber @entity2790 implantation, seven eyes had a planned extracapsular @entity231 extraction (ECCE); three eyes had an intracapsular @entity231 extraction. RESULTS: Both eyes of 110 @entity1 (64 @entity1 , 46 @entity1 ) with a mean age of 79.0  years, standard deviation (SD)   11.4 (range 26 to 97  years) were included. Median preoperative best corrected visual acuity (BCVA) was 0.5 LogMAR in the first eye, the interquartile range (IQR) was [0.4, 1.2]; 0.7 LogMAR in the second eye with IQR [0.4, 1.8]. At one month, the median BCVA was 0.2 LogMAR, IQR [0.1, 0.3] in the first eye, median BCVA was 0.1 LogMAR and IQR [0.0, 0.5] in the second eye. There were 3 eyes (3  %) that lost 3 lines or more in BCVA at one month (control vs. pre-operatively). In all three cases, poor visual acuity had been recorded pre-operatively (>1 LogMAR). Achieved refraction was within   1.0 D of the target in 83  % of eyes. There were only 5  % (n   =   6) of cases where if delayed sequential bilateral extraction had been performed could potentially @entity2790 ( @entity2790 ) choice have been adjusted, in four of these cases, target refraction was within   1.0 D in the second eye. CONCLUSIONS: ISBCS performed under general anaesthesia achieves target refraction in 83  % of eyes after consideration of complications, ocular co-morbidities and systemic restrictions. In the majority of cases where @entity2790 power calculation could be considered, the achieved refraction of the second surgical eye was within   1.0 D of intended refraction. This undermines the utility of @entity2790 power adjustments in the second surgical eye.
