LONG-TERM REFRACTIVE AND OCULAR PARAMETER CHANGES FOLLOWING CATARACT SURGERY: A 2-YEAR FOLLOW-UP STUDY

Purpose: Cataract surgery aims to improve visual acuity and refraction, but refractive changes over the long term remain underexplored. This study aims to assess the timeline of changes in spherical equivalent refraction (SER) and ocular parameters over a 2-year follow-up period after cataract phacoemulsification surgery. Methods: This retrospective observational study included 256 eyes of 160 patients who underwent cataract phacoemulsification surgery between January 1, 2022, and December 31, 2022, at one private/charitable hospital. The patients were followed up for 2 years post-operatively, with measurements of keratometry, anterior chamber depth (ACD), central corneal thickness (CCT), and axial length (AL) taken at 1 month, 1 year, and 2 years post-surgery. Spherical equivalent refraction (SER) was assessed at each visit, and changes in ocular parameters and SER were analyzed. Results: At 1 month, 83.5% of eyes achieved the target SER, with 92.3% at 1 year and 82.7% at 2 years. A myopic shift (0.32 ± 0.21 D, p < 0.001) occurred in 33.6% of eyes, while a hypermetropic shift (0.35 ± 0.22 D, p < 0.001) occurred in 45.2% of eyes over the 2-year follow-up period. Significant changes in ACD were observed between 1 month and 2 years (p = 0.007), and there was a significant decrease in CCTbetween 1 month and 1 year (p < 0.001). No significant changes were observed in AL. The greatest changes in SER occurred in the first 12 months, with smaller shifts occurring in the second year. Conclusion: The study reveals significant refractive changes within 2 years postcataract surgery, primarily a hypermetropic shift. These changes are associated with changes in ACD and corneal curvature, emphasizing the need to consider long-term refractive adjustments when planning cataract surgery and setting expectations.