Purpose To identify the ocular biometric parameters associated with refractive outcomes in Chinese Primary angle closure glaucoma (PACG) patients receiving phacoemulsification and intraocular lens (IOL) implantation (PEI) surgery.

Methods 165 Chinese PACG patients receiving PEI and goniosynechialysis (GSL) and 53 cataract patients as controls only receiving PEI surgery were recruited. The prediction accuracy of IOL power calculation was assessed by the prediction error (PE), mean absolute error (MAE), median absolute error (MedAE), and proportions of eyes with a PE within ± 0.25 diopters (D), ± 0.50 D, ± 0.75 D, and ± 1.00 D. The association of different ocular biometric parameters with the PE of IOL calculation were evaluated.

Results The PACG patients had significantly higher absolute of PE as compared to the control subjects, especially the acute PACG patients. The axial length (AL), changes in aqueous depth pre- and post-surgery (△AD), and the ratio of △AD/AL were significantly associated with the PE in acute PACG patients. The association of △AD with the PE of IOL power calculation was found in PACG patients with AL ≥ 22 mm.

Conclusions This study revealed the association of AL and △AD with the PE of IOL calculation in Chinese PACG patients. Precisely predict the △AD is necessary for acute PACG patients, especially for those with AL ≥ 22 mm, to improve the refractive outcomes.

The authors have declared no competing interest.

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This study adhered to the Helsinki Declaration and was approved by the Medical Ethics Council of the Eye and ENT Hospital, Fudan University (2025268).

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