34 EyeWorld Asia-Pacific | December 2024 REFRACTIVE SURGERY the methodology of a thorough EMR review focusing on preoperative angle kappa measurements and standard refractive and subjective postoperative outcomes. “We assessed postoperative refractive accuracy (sphere, cylinder, spherical equivalent, defocus equivalent), visual acuity, and postoperative patient satisfaction—near, intermediate, and distance vision, and likelihood of recommending the procedure,” they said. There was no relationship between preoperative angle kappa and the postoperative likelihood of recommending the MIOL procedure to friends and relatives (N=4,543 eyes; R2=0.0000; P=0.8485). Source: Mathieu Gauvin, PhD “To ensure the accuracy and reliability of our findings, we implemented rigorous data validation processes,” they continued. Outlier angle kappa values—those beyond three standard deviations from the mean—were excluded from the analysis. Extreme values exceeding 2.5 standard deviations were reviewed by two expert eyecare professionals to verify accuracy, with any erroneous data points being manually discarded. “This meticulous approach allowed us to maintain a robust dataset, providing a highly reliable and comprehensive analysis of angle kappa’s impact on MIOL outcomes.” The study sought to characterize angle kappa and explore its relationship with postoperative refractive accuracy, visual outcomes, and patient satisfaction in a large population of eyes with MIOLs. “It’s crucial to thoroughly understand and characterize angle kappa in studies because not all measurements of angle kappa are equivalent,” they explained. “In our study, we used the kappa displacement distance (DD), which measures the distance between the pupillary axis intercept on the cornea and the vertex normal, a point that closely corresponds to the visual axis. This measurement is known to be more accurate than the chord mu that is used in other studies, though the chord mu is a reasonable approximation.” Chord mu measures the distance between the center of the entrance pupil and the subject-fixated coaxially sighted corneal light reflex. While these measures are often used interchangeably, they are not identical. “Kappa DD values are generally larger than chord mu. Both measures are valuable for estimating angle kappa, but the distinction ensures consistency and accuracy in research.” The study findings revealed that nearly all eyes undergoing refractive lens exchange or cataract surgery have some level of angle kappa preoperatively, with 72% having an RMS angle kappa 0.5 mm or greater and 12% greater than 1.00 mm. The analysis showed that angle kappa does not correlate to postoperative refractive accuracy, vision, subjective satisfaction, or the likelihood of recommending the procedure to friends and relatives. The contribution of angle kappa to clinical outcomes in most eyes undergoing refractive lens exchange and cataract surgery was negligible in this large-scale study.
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