The «optic disc — macula» distance as an independent predictor of refractive outcomes after phacoemulsification with IOL implantation

Abstract

Modern intraocular lens calculation methods do not always achieve ideal refraction due to the influence of additional anatomical factors. This retrospective cohort study evaluated the effect of the optic disc–macula distance, measured by optical coherence tomography, on refractive outcomes after phacoemulsification with IOL implantation in cataract patients. The distance was measured on OCT images, followed by correlation, regression, and ROC analyses with subsequent validation on a control sample. It was established that the studied anatomical parameter is an independent predictor of refractive error. A threshold value was determined that allows for high-sensitivity prediction of the risk of a clinically significant deviation from the target refraction. The nature of the distance’s influence varies depending on the baseline refraction: in hyperopic eyes with a short axis, a pronounced inverse correlation with residual hyperopia was revealed, whereas in myopia, the effect is mediated by the axial length of the eye. These findings substantiate the feasibility of preoperative measurement of the optic disc–macula distance for personalized IOL calculation, especially in patients with hyperopia, which will minimize the risk of unexpected refractive errors and increase patient’s satisfaction.