Retrospective comparative study evaluates axial length asymmetry's effect on refractive error after cataract surgery, indicating significant implications for patient outcomes.
Purpose: To evaluate whether interocular axial length (AL) asymmetry is associated with postoperative refractive error, independent of absolute AL. Patients and Methods: This retrospective comparative study included 42 patients (84 eyes) who underwent bilateral cataract surgery. Within-patient comparisons were performed between longer-AL and shorter-AL eyes, and longer-AL eyes were also compared with an AL-matched control group. Postoperative spherical equivalent (SE) at 1 month was compared with predicted SE using the Barrett Universal II and SRK/T formulas. Multivariable regression analysis was performed. Results: Mean postoperative refractive error (mean ± SD) was − 0.20 ± 0.63 D in the longer-AL group vs 0.02 ± 0.50 D in the shorter-AL group (BU, p = 0.01), and − 0.41 ± 0.84 D vs − 0.05 ± 0.53 D (SRK/T, p = 0.02). Longer-AL eyes showed a significantly greater myopic shift than shorter-AL and control eyes. Interocular AL difference remained independently associated with postoperative refractive error. Conclusion: Interocular AL asymmetry was associated with postoperative myopic shift, even after adjustment for axial length and other covariates.
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Ouchi et al. (2026) studied this question.
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