Predictive Accuracy of Refraction after Transscleral Fixation of Intraocular Lenses in Trabeculectomized Eyes with Glaucoma

Purpose: To investigate the predictive accuracy of refraction and any change in intraocular pressure (IOP) after transscleral fixation of intraocular lenses (IOLs) in trabeculectomized eyes with glaucoma.Methods: We retrospectively reviewed the medical records of glaucoma patients who underwent trabeculectomy, followed by transscleral fixation of dislocated IOLs combined with vitrectomy. The refraction predicted by the SRK/T formula and the postoperative refraction were converted into spherical equivalents. Predictive refraction accuracies were analyzed when the differences between the two values were within ± 0.5 diopters (D) and ± 1.0 D. The IOP was measured before and after surgery.Results: Eleven eyes of 11 men (mean age, 67.27 ± 10.55 years) were included. The mean axial length was 23.64 ± 1.26 mm; the mean predicted and postoperative refractions were -0.02 ± 0.46 D and -0.80 ± 0.98 D, respectively (p = 0.029). The refractive outcome was more myopic (by -0.78 ± 1.11 D) than predicted. The predictive accuracies were 36.4% and 72.7% when the differences were ± 0.5 and ± 1.0 D, respectively. The IOP did not change during follow-up (13.18 ± 4.56, 12.82 ± 5.88, and 12.73 ± 4.58 mmHg at baseline, 1 week, and 3 months, respectively).Conclusions: In trabeculectomized eyes, transscleral IOL fixation did not affect the IOP, but the refractive outcome was more myopic than predicted. This difference should be considered when choosing IOL target power.