Purpose: to report the difficulties in biometry in patients with cataract and synchysis scintillans and the way to avoid the biometrical errors in such patients.
Materials And Methods: Observational study on 4 patients (from 3 different surgeons) with cataract and synchysis scintillans.
Results: In two patients, the biometry obtained an increased IOL dioptrical value (+29D, and +28D, respectively) which proved to be wrong by not obtaining the planed emmetropia postoperatively. Instead, the postoperative refraction showed increased myopia (-9D and -6.5D spherical equivalent, respectively), and explantation with re-implantation was needed. The secondary implant was chosen based on the postoperative refraction and primary implant value (+20D, and +24D respectively). In other two cases, the biometrical error was avoided by manually selecting the real antero-posterior axis value, not the mean value calculated by the computer. This method proved to be correct by obtaining near-emmetropia postoperatively.
Conclusions: The association between cataract and synchysis scintillans is frequent, and the presence of synchysis scintillans could be a cause of errors in biometry. The biometrical errors could be avoided by amending the method of measurement. These observations stress the necessity of ocular echography in the case of opaque ocular media.
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