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He MY, Feng JR, Zhang L. Treatment of Nanophthalmos Cataracts: Surgery and Complications. Semin Ophthalmol 2022; 37:849-855. [PMID: 35856463 DOI: 10.1080/08820538.2022.2102929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE Cataract surgery in patients with nanophthalmos is complicated for ophthalmologists to perform. Due to the unique ocular anatomy, there is a high incidence of complex complications such as angle-closure glaucoma, fluid misdirection syndrome, and uveal effusion syndrome (UES) in the perioperative period of cataract surgery. This article will discuss the management options for cataract surgery in nanophthalmic eyes and complications. METHODS This review is searched through PubMed, focusing on articles published in the past 20 years. Articles were reviewed on the anatomical structure of nanophthalmic cataracts, the pathogenesis of complications, the selection of intraocular lenses, and surgical methods. CONCLUSION There is a strong correlation between abnormal ocular anatomy and complications in patients with nanophthalmos. Clinicians must not only select the appropriate intraocular lens formula based on the depth of the anterior chamber but also formulate personalized surgical methods based on its unique anatomical structure to avoid complications.
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Affiliation(s)
- Mei-Ying He
- Eye Hospital, the First Affiliated Hospital of Harbin Medical University, Harbin, HL, China
| | - Jing-Ru Feng
- Eye Hospital, the First Affiliated Hospital of Harbin Medical University, Harbin, HL, China
| | - Lu Zhang
- Eye Hospital, the First Affiliated Hospital of Harbin Medical University, Harbin, HL, China
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Belov DF, Nikolaenko VP. [Alternative method of intraocular lens power calculation in eyes with short axial length]. Vestn Oftalmol 2022; 138:24-28. [PMID: 35801876 DOI: 10.17116/oftalma202213803124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE To develop an alternative method of intraocular lens (IOL) power calculation in eyes with mature cataract and axial length (AL) of less than 22.0 mm using modern formulas Barrett Universal II and Hill RBF. MATERIAL AND METHODS The study enrolled 41 patients (41 eyes) who underwent phacoemulsification (PE). Ultrasound biometry (Tomey Biometer Al-100) and keratometry (Topcon-8800) were used for IOL power calculation by SRK/T and Haigis formulas. To calculate IOL power by Barrett Universal II and Hill RBF formulas, 0.2 mm were added to AL measured with ultrasonography (retinal thickness). One month after PE, spherical equivalent of refraction was compared with target refraction (calculated by the formulas listed above), and based on that a conclusion was made on the accuracy of calculations. RESULTS Haigis formula was found to be the least accurate (IOL calculation error -0.39±0.79 D). The calculation error in SRK/T (0.04±0.79 D), Barrett Universal II (0.02±0.79 D) and Hill RBF (-0.05±0.73 D) formulas was much lower. However, among them Hill RBF had the lowest spread of the mean absolute IOL calculation error. Pairwise comparison revealed significant difference of mean IOL calculation error by Haigis formula versus the others. There was no significant difference in the following pairs: SRK/T - Barrett Universal II (p=0.855), and SRK/T - Hill RBF (p=0.167), but there was a significant difference (p=0.043) in the Barrett Universal II - Hill RBF pairdue to the tendency for slight hypermetropic calculation error in the former and the inherent slight myopic shift in the latter.. CONCLUSION The proposed alternative method of IOL power calculation in eyes with mature cataract and short AL using modern formulas (Barrett Universal II and Hill RBF) shows higher accuracy compared to the formulas embedded in ultrasound biometer (SRK/T and Haigis), and can be recommended for use in everyday practice.
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Affiliation(s)
- D F Belov
- Saint Petersburg Multifield Hospital No. 2, St. Petersburg, Russia
| | - V P Nikolaenko
- Saint Petersburg Multifield Hospital No. 2, St. Petersburg, Russia
- Saint Petersburg State University, St. Petersburg, Russia
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Yan C, Yao K. Effect of Lens Vault on the Accuracy of Intraocular Lens Calculation Formulas in Shallow Anterior Chamber Eyes. Am J Ophthalmol 2022; 233:57-67. [PMID: 34293335 DOI: 10.1016/j.ajo.2021.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE To explore the impact of preoperative lens vault (LV) on the accuracy of the Barrett Universal Ⅱ, Haigis, Hoffer Q, Hoffer QST, Holladay 1, Kane, and SRK/T formulas in eyes with a shallow anterior chamber. DESIGN Retrospective case series. METHODS Included were 409 eyes with anterior chamber depth (ACD) shallower than 3.0 mm that underwent phacoemulsification. Eyes were divided into a short axial length (AL) group (<22.00 mm) and a normal AL group (22.00 ≤ AL < 24.50 mm). Each group was further divided into a small LV subgroup (LV <0.95 mm) and a large LV subgroup (LV ≥0.95 mm) according to the median of the preoperative LV. Postoperative refraction was measured 3 months after surgery. Mean absolute error (MAE) was calculated and compared for each formula. The correlation between LV and the mean numeric error predicted by each formula was analyzed. RESULTS Overall, the Barrett and Kane formulas generated the smallest MAE in both short AL and normal AL groups (P < .05 for both). In short AL eyes with small LV, the Haigis formula performed better than other traditional formulas (P < .05 for all). In normal AL eyes with a small LV, the Barrett and Kane formulas showed higher accuracy (P < .05 for all), and other formulas were comparable. In either subgroup with a large LV, the Haigis formula created a significant higher MAE (P < .001 for all), followed by Hoffer QST. Positive correlations were found between LV and mean numeric errors predicted by all formulas, except for Barrett and Kane formulas (P < .001 for all), indicating a postoperative hyperopic shift with an increased LV. CONCLUSIONS In shallow anterior chamber eyes with a large LV, the Haigis and Hoffer QST formulas taking preoperative ACD into calculation surprisingly showed a larger prediction error. However, the Barrett and the Kane formulas, which include both ACD and lens thickness as predictive parameters, showed good accuracy in both small and large LV subgroups. Therefore, although formulas referring to preoperative ACD are generally believed to achieve better refractive results in patients with a shallow anterior chamber, LV may be valuable to consider when choosing an IOL power calculation formula.
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Affiliation(s)
- Chenxi Yan
- From the Eye Center (C.Y., K.Y.) of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ke Yao
- From the Eye Center (C.Y., K.Y.) of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
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Sakai D, Hirami Y, Nakamura M, Kurimoto Y. Accuracy of Intraocular Lens Power Calculation Formulas in Myopic Eyes with Target Refractions of Emmetropia and Intentional Myopia. Clin Ophthalmol 2021; 15:4535-4541. [PMID: 34866898 PMCID: PMC8636696 DOI: 10.2147/opth.s342392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/19/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose To compare the accuracy of the intraocular lens (IOL) power calculation formulas for predicting the postoperative refraction in eyes with a target of emmetropia or intentional myopia. Patients and Methods This is a retrospective study conducted at Kobe City Eye Hospital, Kobe, Japan. Fifty eyes of 50 patients with axial myopia who underwent uncomplicated phacoemulsification and single-type IOL implantation for a target of emmetropia (plano to −0.5 D) or intentional myopia (−2.0 D to −3.0 D) were selected. Preoperative ocular biometry was performed using IOLMaster700 in all eyes. Refractive prediction errors of 6 IOL formulas integrated into IOLMaster700 were compared between eyes with a target of emmetropia and intentional myopia. Results The mean numerical errors of SRK/T (Sanders, Retzlaff, and Kraft/theoretical), Holladay 1, Hoffer Q, and Holladay 2 significantly differed between the two groups (p < 0.001, p = 0.008, 0.02, and 0.007, respectively). The values for mean numerical errors in eyes with a target of intentional myopia were smaller, showing relatively myopic outcome, as compared with those in eyes with a target of emmetropia. In eyes with a target of emmetropia, the mean numerical errors of Holladay 1 (p < 0.001, 95% confidence interval [CI]: 0.32 to 0.63), Hoffer Q (p = 0.001, 95% CI: 0.12 to 0.42), and Barrett Universal II (p = 0.007, 95% CI: 0.06 to 0.35) were significantly different from zero (hyperopic trend). Furthermore, in eyes with a target of intentional myopia, the mean numerical error of SRK/T (p = 0.001, 95% CI: −0.61 to −0.17) and Holladay 2 (p = 0.023, 95% CI: −0.43 to −0.04) were significantly different from zero (myopic trend). Conclusion In patients with axial myopia, some IOL formulas may show a myopic trend in the refractive outcome when targeting intentional myopia as compared to emmetropia.
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Affiliation(s)
- Daiki Sakai
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Japan.,Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuhiko Hirami
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Makoto Nakamura
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuo Kurimoto
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Japan
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Accuracy of IOL power calculation formulas in Marfan lens subluxation patients with in-the-bag IOLs and implantation of scleral-sutured single-eyelet modified capsular tension rings. J Cataract Refract Surg 2021; 47:1423-1429. [PMID: 34675149 DOI: 10.1097/j.jcrs.0000000000000649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/11/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the accuracy of intraocular lens (IOL) formulas for the prediction of postoperative refraction in lens subluxation in Marfan syndrome. SETTING Eye and ENT Hospital of Fudan University, Shanghai, China. DESIGN Consecutive retrospective clinical observational case series. METHODS 60 eligible eyes with lens subluxation from 39 young patients with Marfan syndrome (8.53 ± 4.38 years) underwent phacoemulsification combined with single-eyelet modified capsular tension ring (MCTR) and IOL implantation. The prediction error values with mean zero out (relative prediction error) and their absolute values (AE) were calculated. RESULTS Generally, the SRK/T formula with Wang-Koch (WK) adjustment had the lowest median AE at 0.418 diopters (D), and the Holladay 1 with WK adjustment had the lowest mean AE at 0.499 D. The median AE of the other 10 formulas, in order from lowest to highest, were Haigis with WK (0.494 D), Holladay 1 with WK (0.495 D), Hoffer Q with WK (0.508 D), Haigis (0.525 D), T2 (0.542 D), Hoffer Q (0.624 D), SRK/T and Holladay 1 (0.660 D), Super (0.680 D), and Barrett Universal II (0.714 D) formulas. Haigis formula was found to be statistically significantly different from SRK/T, Holladay 1, and Barrett Universal II (all 3 P < .001) but not Hoffer Q (P = .236) formula. CONCLUSIONS The Haigis formula was recommended for young Marfan lens subluxation patients with in-the-bag IOLs and scleral-sutured single-eyelet MCTR implantation. WK adjustments were successful in those cases where the axial length was longer than 25.0 mm.
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Why Use Ultrashort Pulses in Ophthalmology and Which Factors Affect Cut Quality. ACTA ACUST UNITED AC 2021; 57:medicina57070700. [PMID: 34356980 PMCID: PMC8304458 DOI: 10.3390/medicina57070700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 11/17/2022]
Abstract
The power density of femtosecond lasers and exposure time to the tissue are crucial for a successful procedure in terms of safety and precision. The reduction of the pulse duration allows reducing the quantity of the energy to be delivered to the tissue for disruption with strongly diminished mechanical and thermal collateral damage. The cutting effect of ultra-short pulses is very precise, minimally traumatic, safe, and predictable. Future developments will lead to further energy reductions to achieve optical breakdowns. However, the pulse length cannot be shortened arbitrarily because below 100 fs nonlinear effects can change the process in an unfavorable way. Compared to manual-conventional cataract surgery, femtosecond laser-assisted cataract surgery (FLACS) shows many advantages in clinical application, especially with regard to precision and tissue protection. The femtosecond laser has become particularly important and has made the overall procedure safer when we deal with complex cataract cases such as subluxated lenses. We provide an overview of the evolution of femtosecond laser technology for use in refractive and cataract surgeries. This article describes the advantages of available laser platforms with ultrashort pulses and mainly focuses on the technical and physical backgrounds of ophthalmic surgery technologies.
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Recurring themes during cataract assessment and surgery. Eye (Lond) 2021; 35:2482-2498. [PMID: 33927353 DOI: 10.1038/s41433-021-01548-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 03/01/2021] [Accepted: 04/09/2021] [Indexed: 02/06/2023] Open
Abstract
The aim of this review was to discuss frequently encountered themes such as cataract surgery in presence of age-related macular degeneration (AMD), dementia, Immediate Sequential Bilateral Cataract Surgery (ISBCS), discussing non-standard intraocular lens (IOL) options during consultation in the National Health Services (NHS) and the choice of the biometric formulae based on axial length. Individual groups of authors worked independently on each topic. We found that cataract surgery does improve visual acuity in AMD patients but the need for cataract surgery should be individualised. In patients with dementia, cataract surgery should be considered 'sooner rather than later' as progression may prevent individuals presenting for surgery. This should be planned after discussion of patients' best interests with any carers; multifocal IOLs are not proven to be the best option in these patients. ISBCS gives comparable outcomes to delayed sequential surgeries with a low risk of bilateral endophthalmitis and it can be cost-saving and efficient. Patients are entitled to know all suitable IOL options that can improve their quality of life. Deliberately withholding this information or pressuring patients to choose a non-standard IOL is inappropriate. However, one should be mindful of the not spending inappropriate amounts of time discussing these in the NHS setting which may affect care of other NHS patients. Evidence suggests Hoffer Q, Haigis, Hill-RBF and Kane formulae for shorter eyes; Barrett Universal II (BU II), Holladay II, Haigis and Kane formulae for longer eyes and BU II, Hill-RBF and Kane formulae for medium axial length eyes.
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Affiliation(s)
- Pammal T Ashwin
- Birmingham and Midland Eye Centre, Birmingham, United Kingdom
| | - Sunil Shah
- Birmingham and Midland Eye Centre, Birmingham, United Kingdom
- Aston University, School of Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom E‐mail:
| | - James S Wolffsohn
- Aston University, School of Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom E‐mail:
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Choi JJ, Kim HK, Yi K. Comparison of the Accuracies of Intraocular Lens Power Formulae by the Type of Implanted Lens. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.3.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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10
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Koga Y, Kojima K, Yoshii K, Kusada N, Kagitani Y, Aoki T, Horiuchi N, Kitazawa K, Sotozono C. Prediction Error of Intraocular Lens Power Calculation in Very Elderly Patients over 90 Years Old. Curr Eye Res 2020; 46:1148-1153. [PMID: 33356625 DOI: 10.1080/02713683.2020.1858486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND To investigate the influence of age on prediction error (PE) after cataract surgery in very elderly (VE) patients aged more than 90 years. METHODS We retrospectively analyzed 66 eyes of patients aged ≥90 years (VE group) who underwent phacoemulsification and intraocular lens (IOL) implantation. As the control group (CG), we investigated 121 eyes of patients aged 70-89 years who underwent the same surgery. PE was calculated 1 month post-surgery as the actual postoperative spherical equivalent minus the target diopter, which was calculated using the Sanders-Retzlaff-Kraff/T formula. The absolute and arithmetic PE were compared between the two groups. The factors affecting absolute PE outside ±0.5 diopter (D) and ±1.0 D were determined through logistic regression analysis with the variables age, sex, axial length (AL), average corneal power, preoperative best-corrected visual acuity, target diopter, and coexisting pseudoexfoliation syndrome. RESULTS The absolute PE was significantly larger in the VE group than that in the CG (0.60 ± 0.52 D and 0.34 ± 0.25 D, respectively; P < .001). There was no significant difference in terms of arithmetic PE between the two groups (-0.06 ± 0.79 D and -0.07 ± 0.42 D, respectively; P = .653). In the logistic regression analysis, age was significantly associated with absolute PE outside ±0.50 D (Odds ratio [OR]: 1.05). Age and AL were significantly associated with absolute PE outside ±1.0 D (OR: 1.24 and 0.20, respectively). CONCLUSIONS Absolute PE tended to increase in the cataract surgery of VE patients.
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Affiliation(s)
- Yusuke Koga
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kentaro Kojima
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kengo Yoshii
- Department of Mathematics and Statistics in Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Natsuki Kusada
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yu Kagitani
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takanori Aoki
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Noriko Horiuchi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koji Kitazawa
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Fernández-Vega Cueto A, Rodríguez-Una I, Rodríguez-Calvo PP, Alfonso JF. Femtosecond laser-assisted cataract surgery in shallow anterior chamber cases. Int Ophthalmol 2020; 41:707-717. [PMID: 33099746 DOI: 10.1007/s10792-020-01628-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 10/17/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the effectiveness, safety and predictability of femtosecond laser-assisted cataract surgery (FLACS) in eyes with shallow anterior chamber (AC). METHODS This is a prospective consecutive clinical study. All eyes presented an anterior chamber depth (ACD) ≤ 2.1 mm and were submitted to FLACS with monofocal intraocular lens (mIOL) or trifocal intraocular lens (tIOL) implantation. Uncorrected distance visual acuity (VA) and corrected distance VA values were used to assess efficacy and safety of the surgery. Refraction, intraocular pressure (IOP), endothelial cell density (ECD) and ACD were evaluated before and 6 months post-surgery. RESULTS Phacoemulsification was carried out successfully in all eyes, without intra- or postoperative complications. Efficacy and safety indexes were 0.96 and 1.26 for the mIOL group, and 0.87 and 1.01 for the tIOL group, respectively. The mean postoperative spherical equivalent was - 0.06 ± 0.28D and - 0.14 ± 0.38D for the mIOL and tIOL groups, respectively. The ECD varied from 2470 ± 483 to 2009 ± 538 cells/mm2 (p < 0.05) and from 2443 ± 319 to 2245 ± 628 cells/mm2 (p = 0.06) for the mIOL and tIOL groups, respectively. IOP significantly decreased (p < 0.05) after the surgery from 14.34 to 12.85 mmHg for the mIOL group and from 14.37 to 11.91 mmHg for the tIOL group, with a general reduction of medical hypotensive treatment in both groups (85% of cases required ≤ number of medications). ACD changed significantly (p < 0.05) from 1.96 ± 0.15 mm to 3.75 ± 0.30 mm after the surgery in the mIOL group and from 1.94 ± 0.15 mm to 3.23 ± 0.21 mm for the tIOL group. CONCLUSION FLACS with implantation of either mIOL or tIOL may provide good efficacy, safety and predictability in eyes with shallow AC.
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Affiliation(s)
- Andrés Fernández-Vega Cueto
- Fernández-Vega Ophthalmological Institute, University of Oviedo, Avda. Dres. Fernández-Vega, 34, 33012, Oviedo, Spain
| | - Ignacio Rodríguez-Una
- Fernández-Vega Ophthalmological Institute, University of Oviedo, Avda. Dres. Fernández-Vega, 34, 33012, Oviedo, Spain.
| | - Pedro P Rodríguez-Calvo
- Fernández-Vega Ophthalmological Institute, University of Oviedo, Avda. Dres. Fernández-Vega, 34, 33012, Oviedo, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, University of Oviedo, Avda. Dres. Fernández-Vega, 34, 33012, Oviedo, Spain
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Mălăescu M, Stanca HT, Tăbăcaru B, Stănilă A, Stanca S, Danielescu C. Accuracy of five intraocular lens formulas in eyes with trifocal lens implant. Exp Ther Med 2020; 20:2536-2543. [PMID: 32765746 PMCID: PMC7401767 DOI: 10.3892/etm.2020.8891] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/22/2020] [Indexed: 11/14/2022] Open
Abstract
Accuracy of intraocular lens (IOL) calculation formulas SRK/T, Hoffer Q, Holladay 1, Haigis and Barrett Universal II were compared in prediction of postoperative refraction for multifocal and implants using a single optical biometry device. The authors included 88 refractive lens exchange and cataract surgeries, with AcrySof IQ PanOptix implant (Alcon Laboratories, Inc.). All eyes were divided into three groups based on axial length (AL), group 1: <22 mm (14 eyes), group 2: 22-24.5 mm (68 eyes) and group 3: >24.5 mm (6 eyes). The refractive prediction error (RPE) and mean absolute error (MAE) were calculated for 5 different formulas: SRK/T, Hoffer Q, Holladay 1, Haigis and Barrett Universal II. For eyes with the AL between 22 mm and 24.5 mm the greatest percentage of eyes with RPEs within ±0.25 D was 32.4% for Haigis formula, followed by Barrett Universal II, Hoffer Q and Holladay 1 with 29.4%. The percentage of eyes with RPEs within ±0.50 D was 100% only for Barrett Universal II and Holladay 1, 94.1% for SRK/T and 91.2% for Haigis and Hoffer Q. The first and third group with AL <22 and >24.5 mm were too small to have statistical significance due to the reluctancy to use multifocal IOLs on extreme ALs. ANOVA test showed no statistical difference (P=0.166) between the RPEs measured for each formula in this cohort. This study showed no statistical difference between formulas for this trifocal lens implant. There was a tendency for the RPE to be within ±0.25 D for most of the eyes with the Haigis formula, and within ±0.50 D for all the eyes with the Barrett Universal II formula in the group with the AL between 22 and 24.5 mm.
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Affiliation(s)
- Monica Mălăescu
- Department of Ophthalmology, Faculty of Medicine, 'Lucian Blaga' University, 550159 Sibiu, Romania
| | - Horia T Stanca
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Bogdana Tăbăcaru
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Adriana Stănilă
- Department of Ophthalmology, Faculty of Medicine, 'Lucian Blaga' University, 550159 Sibiu, Romania
| | - Simona Stanca
- Department of Pediatrics, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Ciprian Danielescu
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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Level of agreement of intraocular lens power measurements between an image-guided system and partial coherence interferometry. J Cataract Refract Surg 2020; 46:573-580. [DOI: 10.1097/j.jcrs.0000000000000085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Shrivastava AK, Behera P. Accuracy of the refractive prediction determined by intraocular lens power calculation formulas in high myopia. Indian J Ophthalmol 2019; 67:1905-1906. [PMID: 31638072 PMCID: PMC6836619 DOI: 10.4103/ijo.ijo_780_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ankur K Shrivastava
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Pranayee Behera
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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Shrivastava AK, Behera P, Kacher R, Kumar B. Effect of anterior chamber depth on predictive accuracy of seven intraocular lens formulas in eyes with axial length less than 22 mm. Clin Ophthalmol 2019; 13:1579-1586. [PMID: 31692493 PMCID: PMC6708392 DOI: 10.2147/opth.s217932] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 07/16/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose This study aimed to evaluate whether different anterior chamber depth (ACD) affects the predictive accuracy of intraocular lens formulas in eyes with axial length (AL) less than 22 mm. Methods Eighty-five eyes of 85 patients with AL less than 22 mm were included in this retrospective study, which were divided into three groups: Group 1, ACD less than 2.4 mm; Group 2, ACD between 2.4 and 2.9 mm; and Group 3, ACD greater than 2.9 mm. Optical biometry with partial coherence interferometry was performed in all cases. The median absolute error (MedAE) was compared by Friedman’s test, using the optimized lens constant, among seven formulas (Barrett Universal II, Haigis, Hill-RBF, Hoffer Q, Holladay 1, Holladay 2, and SRK/T) in each group. Results Friedman’s test showed no significant difference in MedAE among all formulas in Groups 1 and 3. However, as the Haigis formula had the highest MedAE and lowest percentage of eyes within ±0.25 Diopter, it is least preferred in Group 1. On the contrary, in Group 3 it fared the best, having the least MedAE and highest percentage of eyes within ±0.25 Diopter. In Group 2, Friedman’s test gave significant difference, and post-hoc analysis showed statistical superiority of Haigis over the Holladay 1 (p=0.02), Holladay 2 (p=0.01), Hill-RBF (p=0.04), and SRK/T (p=0.02) formulas. However, there was no statistical difference between the Barrett Universal II, Haigis, and Hoffer Q formulas. Conclusion Considering the ACD in eyes with AL less than 22 mm, Haigis is the preferred formula while SRK/T proved to be the worst formula in Groups 2 and 3.
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Affiliation(s)
- Ankur K Shrivastava
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, India
| | - Pranayee Behera
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, India
| | - Rajaram Kacher
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, India
| | - Binod Kumar
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, India
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Sudhakar S, Hill DC, King TS, Scott IU, Mishra G, Ernst BB, Pantanelli SM. Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in short eyes. J Cataract Refract Surg 2019; 45:719-724. [DOI: 10.1016/j.jcrs.2018.12.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 02/08/2023]
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Batkov EN, Pashtayev NP, Mikhaylova VI. [Calculation of intraocular lens power in surgical treatment of extreme hyperopia]. Vestn Oftalmol 2019; 135:21-27. [PMID: 30830070 DOI: 10.17116/oftalma201913501121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Accuracy of calculation of the intraocular lens (IOL) power in eyes with short axial length is inferior to one in emmetropic eyes. Most studies focus on relatively standard eyes. PURPOSE To assess the accuracy of power calculation for IOL used to correct extreme hyperopia and to compare available formulas based on their predictive capacity. MATERIAL AND METHODS Results of 13 implantations involving IOLs of at least 40 Diopters (D) in power were retrospectively evaluated. IOL power was calculated using five formulas: Haigis, Hoffer Q, HolladayI, SRKII, SRK/T. Mean numerical refractive prediction error (RPE) and mean absolute refractive prediction error (ARPE) were calculated. Mean and median ARPE were computed after optimizing the A0 constant. Proportions of eyes within certain RPE limits were compared between the formulas. RESULTS Mean RPE ranged from 1.43 to 11.71 D before adjustment and from 1.08 to 5.34 D after adjustment (p<0.0001). Haigis formula produced the least RPE, and SRKII - the most. Pairwise comparison by mean ARPE after adjustment revealed no statistically significant difference between Haigis and Hoffer Q formulas. Comparison of formulas by percentage of eyes with minimal RPE identified Haigis and Hoffer Q as the most accurate, while the difference between the two was not statistically significant. The difference between the most accurate formulas (Haigis and Hoffer Q) and the least accurate (SRKII) was statistically significant. CONCLUSION In eyes with extremely short anterior-posterior axis, prediction errors in IOL power calculations are relatively frequent (only 31-46% of eyes are within ±0.5 D) and warrant reduction. Among the evaluated formulas, Haigis and Hoffer Q are the most accurate. In order to improve the accuracy of IOL power calculations, it is necessary to employ personalized constants.
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Affiliation(s)
- E N Batkov
- Cheboksary branch of S. Fyodorov Eye Microsurgery Federal State Institution, 10 Traktorostroiteley Pr., Cheboksary, Russian Federeation, 428027
| | - N P Pashtayev
- Cheboksary branch of S. Fyodorov Eye Microsurgery Federal State Institution, 10 Traktorostroiteley Pr., Cheboksary, Russian Federeation, 428027
| | - V I Mikhaylova
- Cheboksary branch of S. Fyodorov Eye Microsurgery Federal State Institution, 10 Traktorostroiteley Pr., Cheboksary, Russian Federeation, 428027
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Kim H, An Y, Joo CK. Gender-differences in age-related changes of corneal astigmatism in Korean cataract patients. BMC Ophthalmol 2019; 19:31. [PMID: 30678644 PMCID: PMC6346567 DOI: 10.1186/s12886-018-1001-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 12/06/2018] [Indexed: 11/23/2022] Open
Abstract
Background This cross-sectional study investigated age-related changes in anterior, posterior, and total corneal astigmatism and evaluated sex differences in corneal astigmatism with increasing age in cataract patients. Methods This study evaluated eyes with cataracts from May 2009 and July 2013. All eyes underwent a complete ophthalmological examination and corneal Scheimpflug imaging by a Pentacam camera (Oculus, Wetzlar, Germany). Anterior, posterior, and total corneal astigmatism were determined. Power vector J0 and linear regression analyses were determined and compared with respect to age and sex. Results Four hundred and fifteen patients (217 men, 198 women) aged 20–89 years were evaluated. For anterior corneal astigmatism, 100% of patients who were 20–39 years old had with-the-rule (WTR) in both sexes. WTR was significantly lower in patients 80–89 years old (25.6% of men and 37.8% of women). For total corneal astigmatism, WTR also tended to decrease with increasing age: 93.3% of men and 100% of women 20–39 years old versus 20.9% of men and 31.1% of women 80–89 years old. The regression coefficient of both the anterior corneal and total corneal J0 vector values analyzed by age were − 0.018 in men and − 0.016 in women (both p < .001). Conclusions The against-the-rule shift was faster for total corneal astigmatism than for anterior corneal astigmatism and it occurred earlier in men than in women. Trial registration Retrospectively registered. Registration number: KC15RISI0241. Registered April 20, 2016.
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Affiliation(s)
- Hyojin Kim
- Department of Visual Optics, Division of Health Science and Graduate School of Health and Welfare, Baekseok University, Cheonan, South Korea
| | - Youngju An
- Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Choun-Ki Joo
- Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, South Korea. .,Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-040, South Korea.
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Shrivastava AK, Behera P, Kumar B, Nanda S. Precision of intraocular lens power prediction in eyes shorter than 22 mm: An analysis of 6 formulas. J Cataract Refract Surg 2018; 44:1317-1320. [DOI: 10.1016/j.jcrs.2018.07.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/23/2018] [Accepted: 07/04/2018] [Indexed: 12/12/2022]
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20
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Mustafa MZ, Khan AA, Bennett H, Tatham AJ, Wright M. Accuracy of biometric formulae in hypermetropic patients undergoing cataract surgery. Eur J Ophthalmol 2018; 29:510-515. [PMID: 30270649 DOI: 10.1177/1120672118803509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To audit and analyse the accuracy of current biometric formulae on refractive outcomes following cataract surgery in patients with axial length less than 22 mm. METHODS A total of 84 eyes from 84 patients with axial length <22 mm were identified from consecutive patients undergoing cataract surgery retrospectively at a single university hospital. All subjects had biometry using the IOLMaster (Carl Zeiss Meditec, Inc, Dublin, CA, USA) and a Sensar AR40 intraocular lens implant (Abbott Medical Optics, CA, USA). One eye from each patient was randomly selected for inclusion. Prediction errors were calculated by comparing expected refraction from optimized formulas (SRK/T, Hoffer Q, Haigis and Holladay 1) to postoperative refraction. A national survey of ophthalmologists was conducted to ascertain biometric formula preference for small eyes. RESULTS The mean axial length was 21.00 ± 0.55 mm. Mean error was greatest for Hoffer Q at -0.57 dioptres. There was no significant difference in mean absolute error between formulae. SRK/T achieved the highest percentage of outcomes within 0.5 dioptres (45.2%) and 1 dioptre (76.2%) of target. Shallower anterior chamber depth was associated with higher mean absolute error for SRK/T (p = 0.028), Hoffer Q (p = 0.003) and Haigis (p = 0.016) but not Holladay (p = 0.111). CONCLUSION SRK/T had the highest proportion of patients achieving refractive results close to predicted outcomes. However, there was a significant association between a shallower anterior chamber depth and higher mean absolute error for all formulae except Holladay 1. This suggests that anterior chamber depth with axial length should be considered when counselling patients about refractive outcome.
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Affiliation(s)
| | | | | | | | - Mark Wright
- Princess Alexandra Eye Pavilion, Edinburgh, UK
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21
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Kane JX, Van Heerden A, Atik A, Petsoglou C. Intraocular lens power formula accuracy: Comparison of 7 formulas. J Cataract Refract Surg 2018; 42:1490-1500. [PMID: 27839605 DOI: 10.1016/j.jcrs.2016.07.021] [Citation(s) in RCA: 200] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 06/21/2016] [Accepted: 07/04/2016] [Indexed: 12/23/2022]
Abstract
PURPOSE To assess the accuracy of 7 intraocular lens (IOL) power formulas (Barrett Universal II, Haigis, Hoffer Q, Holladay 1, Holladay 2, SRK/T, and T2) using IOLMaster biometry and optimized lens constants. SETTING Public hospital ophthalmology department. DESIGN Retrospective case series. METHODS Data from patients having uneventful cataract surgery with Acrysof IQ SN60WF IOL implantation over 5 years were obtained from the biometry and patient charts. Optimized lens constants were calculated for each formula and used to determine the predicted refractive outcome for each patient. This was compared with the actual refractive outcome to give the prediction error. Eyes were separated into subgroups based on axial length (AL) as follows: short (≤22.0 mm), medium (>22.0 to <24.5 mm), medium long (≥24.5 to <26.0 mm), and long (≥26.0 mm). RESULTS The study included 3241 patients. The Barrett Universal II formula had the lowest mean absolute prediction error over the entire AL range (P < .001, all formulas) as well as in the medium (P < .001, all formulas), medium-long (P < .001, except Holladay 1 and T2), and long AL (P < .001, except T2) subgroups. No statistically significant difference was seen between formulas in the short AL subgroup. Overall, the Barrett Universal II formula resulted in the highest percentage of eyes with prediction errors between ±0.25 diopter D, ±0.50 D, and ±1.00 D. CONCLUSION In eyes with an AL longer than 22.0 mm, the Barrett Universal II formula was a more accurate predictor of actual postoperative refraction than the other formulas. FINANCIAL DISCLOSURE None of the authors has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Jack X Kane
- From the Department of Ophthalmology (Kane, Van Heerden, Atik), Alfred Health, Melbourne, and the Discipline of Clinical Ophthalmology (Kane, Petsoglou), University of Sydney, Sydney, Australia.
| | - Anton Van Heerden
- From the Department of Ophthalmology (Kane, Van Heerden, Atik), Alfred Health, Melbourne, and the Discipline of Clinical Ophthalmology (Kane, Petsoglou), University of Sydney, Sydney, Australia
| | - Alp Atik
- From the Department of Ophthalmology (Kane, Van Heerden, Atik), Alfred Health, Melbourne, and the Discipline of Clinical Ophthalmology (Kane, Petsoglou), University of Sydney, Sydney, Australia
| | - Constantinos Petsoglou
- From the Department of Ophthalmology (Kane, Van Heerden, Atik), Alfred Health, Melbourne, and the Discipline of Clinical Ophthalmology (Kane, Petsoglou), University of Sydney, Sydney, Australia
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22
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Hirnschall N, Farrokhi S, Amir-Asgari S, Hienert J, Findl O. Intraoperative optical coherence tomography measurements of aphakic eyes to predict postoperative position of 2 intraocular lens designs. J Cataract Refract Surg 2018; 44:1310-1316. [PMID: 30219261 DOI: 10.1016/j.jcrs.2018.07.044] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/11/2018] [Accepted: 07/18/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE To evaluate intraoperative anterior chamber depth (ACD) measurements of the aphakic eye to predict the postoperative ACD and compare 2 intraocular lens (IOL) designs. SETTING Hanusch Hospital, Vienna, Austria. DESIGN Prospective study. METHODS In this prospective study, patients scheduled for cataract surgery received a plate-haptic IOL (Asphina, Carl Zeiss Meditec AG) or an open-loop haptic IOL (ZCB00, Johnson & Johnson). Preoperatively, optical biometry (IOLMaster 700, CZM, or Lenstar, Haag-Streit) was performed. Intraoperatively, a prototype setup was used to perform time-domain OCT scans of the anterior eye segment (Visante connected to OPMI Lumera 200, both CZM). The intraoperative ACD was measured and used to predict the postoperative IOL position. Optical biometry and subjective refraction and autorefraction (RM 8800, Topcon) were performed 2 months postoperatively. RESULTS The study comprised 203 eyes of 203 patients. A partial least-square regression model for ACD generated 2 months postoperatively showed that the predictive power of the intraoperative ACD (0.48) was highest followed by the axial eye length (0.45) and then the preoperatively measured ACD (0.30). These findings were confirmed in a bootstrapping model. Regression models combining the preoperative ACD and intraoperative ACD resulted in further significant improvement. CONCLUSIONS Intraoperative ACD measurements predicted the postoperative position of open-loop IOLs and plate-haptic IOLs better than preoperative ACD measurements. Combining preoperative and intraoperative ACD measurements further improved the prediction.
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Affiliation(s)
- Nino Hirnschall
- From the Vienna Institute for Research in Ocular Surgery (Hirnschall, Farrokhi, Amir-Asgari, Hienert, Findl), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria; Moorfields Eye Hospital NHS Foundation Trust (Findl), London, United Kingdom
| | - Sanaz Farrokhi
- From the Vienna Institute for Research in Ocular Surgery (Hirnschall, Farrokhi, Amir-Asgari, Hienert, Findl), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria; Moorfields Eye Hospital NHS Foundation Trust (Findl), London, United Kingdom
| | - Sahand Amir-Asgari
- From the Vienna Institute for Research in Ocular Surgery (Hirnschall, Farrokhi, Amir-Asgari, Hienert, Findl), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria; Moorfields Eye Hospital NHS Foundation Trust (Findl), London, United Kingdom
| | - Julius Hienert
- From the Vienna Institute for Research in Ocular Surgery (Hirnschall, Farrokhi, Amir-Asgari, Hienert, Findl), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria; Moorfields Eye Hospital NHS Foundation Trust (Findl), London, United Kingdom
| | - Oliver Findl
- From the Vienna Institute for Research in Ocular Surgery (Hirnschall, Farrokhi, Amir-Asgari, Hienert, Findl), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria; Moorfields Eye Hospital NHS Foundation Trust (Findl), London, United Kingdom.
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23
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Zhang Z, Miao Y, Fang X, Luo Q, Wang Y. Accuracy of the Haigis and SRK/T Formulas in Eyes Longer than 29.0 mm and the Influence of Central Corneal Keratometry Reading. Curr Eye Res 2018; 43:1316-1321. [PMID: 29958004 DOI: 10.1080/02713683.2018.1488265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Zhihua Zhang
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuyu Miao
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoling Fang
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai, China
| | - Qin Luo
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai, China
| | - Yulan Wang
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai, China
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24
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Day AC, Cooper D, Burr J, Foster PJ, Friedman DS, Gazzard G, Che-Hamzah J, Aung T, Ramsay CR, Azuara-Blanco A. Clear lens extraction for the management of primary angle closure glaucoma: surgical technique and refractive outcomes in the EAGLE cohort. Br J Ophthalmol 2018; 102:1658-1662. [PMID: 29453222 DOI: 10.1136/bjophthalmol-2017-311447] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/04/2018] [Accepted: 01/31/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND To describe the surgical technique and refractive outcomes following clear lens extraction (CLE) in the Effectiveness, in Angle-closure Glaucoma, of Lens Extraction trial. METHODS Review of prospectively collected data from a multicentre, randomised controlled trial comparing CLE and laser peripheral iridotomy. Eligible participants were ≥50 years old and newly diagnosed with (1) primary angle closure (PAC) with intraocular pressure above 30 mm Hg or (2) PAC glaucoma. We report the postoperative corrected distance visual acuity (CDVA) and refractive outcomes at 12 and 36 months postoperatively for those who underwent CLE. RESULTS Of the 419 participants, 208 were randomised to CLE. Mean baseline CDVA was 77.9 (SD 12.4) letters and did not change significantly at 36 months when mean CDVA was 79.9 (SD 10.9) letters. Mean preoperative spherical equivalents were +1.7 (SD 2.3) and +0.08 (SD 0.95) diopters (D) at 36 months. Fifty-nine per cent and 85% eyes were within ±0.5D and ±1.0D of predicted refraction, respectively, at 36 months. CONCLUSIONS Mean CDVA in patients undergoing CLE for angle-closure glaucoma appeared stable over the 3-year study period. Refractive error was significantly reduced with surgery but refractive predictability was suboptimal. TRIAL REGISTRATION NUMBER
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Affiliation(s)
- Alexander C Day
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London, London, UK
| | - David Cooper
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Jennifer Burr
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London, London, UK
| | | | - Gus Gazzard
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London, London, UK
| | | | - Tin Aung
- Singapore Eye Research Institute, Singapore
| | - Craig R Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Wang Q, Jiang W, Lin T, Wu X, Lin H, Chen W. Meta-analysis of accuracy of intraocular lens power calculation formulas in short eyes. Clin Exp Ophthalmol 2017; 46:356-363. [DOI: 10.1111/ceo.13058] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/24/2017] [Accepted: 08/31/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Qiwei Wang
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou; People's Republic of China
| | - Wu Jiang
- Department of Colorectal Surgery; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangzhou People's Republic of China
| | - Tiao Lin
- The First Affiliated Hospital; Sun Yat-sen University; Guangzhou People's Republic of China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou; People's Republic of China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou; People's Republic of China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou; People's Republic of China
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Razmjoo H, Atarzadeh H, Kargar N, Behfarnia M, Nasrollahi K, Kamali A. The Comparative Study of Refractive Index Variations between Haigis, Srk/T and Hoffer-Q Formulas Used for Preoperative Biometry Calculation in Patients with the Axial Length >25 mm. Adv Biomed Res 2017; 6:78. [PMID: 28808644 PMCID: PMC5539664 DOI: 10.4103/2277-9175.210657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: To compare refractive index variation between Hoffer-Q, Haigis and SRK/T formulas used for preoperative biometry calculation in patients with axial length >25 mm, undergoing cataract surgery. Materials and Methods: This is a randomized clinical trial study was performed on 54 eyes of 54 patients with ages of 40–70 years old and axial length >25 mm classified into three groups that their IOL POWER were calculated by Haigis, SRK/T and Hoffer-Q formulas before undergoing cataract surgery. Their refractive index variations were calculated from the difference between predicted refractive error formula and actual post-operative refractive error formula. The collected data was entered in SPSS software and was analyzed by ANOVA and Chi-square statistical test. Results: With comparison sphere, astigmatism and spherical equivalent indexes before and after of cataract surgery between Haigis, SRK/T, and Hoffer-Q formulas, statistically significant differences were found between the mean of sphere and SE indexes in patients with use of Haigis and SRK/T formulas that have been more favorable post-operative refraction. Conclusions: Haigis formula and then, with slight difference, SRK/T formula have better and more acceptable post-operative refraction results than Hoffer-Q formula in patients with high axial myopia. Therefore, it is recommended using Haigis and SRK/T formulas for IOL power calculation in patients with high axial myopia undergoing cataract surgery.
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Affiliation(s)
- Hasan Razmjoo
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
| | - Hosein Atarzadeh
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
| | - Neda Kargar
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
| | - Mohammad Behfarnia
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
| | - Kobra Nasrollahi
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
| | - Ali Kamali
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
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27
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Gökce SE, Zeiter JH, Weikert MP, Koch DD, Hill W, Wang L. Intraocular lens power calculations in short eyes using 7 formulas. J Cataract Refract Surg 2017; 43:892-897. [DOI: 10.1016/j.jcrs.2017.07.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/22/2017] [Accepted: 03/29/2017] [Indexed: 12/31/2022]
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28
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Jeong J, Song H, Lee JK, Chuck RS, Kwon JW. The effect of ocular biometric factors on the accuracy of various IOL power calculation formulas. BMC Ophthalmol 2017; 17:62. [PMID: 28464806 PMCID: PMC5414130 DOI: 10.1186/s12886-017-0454-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 04/22/2017] [Indexed: 11/16/2022] Open
Abstract
Background To evaluate how differences in ocular biometry affects the Hoffer Q, Holladay 1, SRK/T, and Haigis intraocular lens power calculation formulae predictions. Methods This study was performed on 91 eyes of 91 patients who underwent uneventful cataract surgery. Ocular biometry values were measured using the IOL Master 500, and intraocular lens (IOL) power was calculated using the Haigis, Hoffer Q, Holladay 1, and SRK/T formulas. We calculated the expected difference (ED) of each 3rd generation formula from the Haigis formula by subtracting the predicted refraction of the Haigis formula from the predicted refraction of each 3rd generation formula. Post-operative anterior chamber depth (ACD) was measured at 1 month after surgery using the IOL master. We calculated errors of each formula by subtracting predicted from manifest refraction at post-operative 1 month. Correlation analysis was performed between ocular biometry values, formula expectation values, formula errors and absolute formula errors. Results Multiple regression analysis revealed that preoperative ACD was the only significant factor for ED prediction in all of the 3rd generation formulas. For mean errors, axial length and post-operative 1-month change of ACD (delta ACD) correlated significantly with the errors in all 3rd generation formulas, but not with errors of the Haigis formula. Median absolute error (MedAE) of the formulas were 0.40 D for the Hoffer Q formula, 0.37 D for the Holladay formula, 0.34 D for the SRK/T formula, and 0.41 D for the Haigis formula. The MAE of the formulas were 0.50 ± 0.47 D for the Hoffer Q formula, 0.50 ± 0.50 D for the Holladay formula, 0.47 ± 0.51 D for the SRK/T formula, and 0.50 ± 0.47 D for the Haigis formula. Conclusion Regarding ED between the third generation and Haigis formulas, preoperative ACD demonstrated the greatest influence. Calculating mean absolute errors of the formulas, all IOL formulas showed excellent and comparable accuracy. Post-operative change (delta) of ACD correlated significantly with errors of third generation formulas according to simulated ACD.
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Affiliation(s)
- Jinho Jeong
- Department of Ophthalmology, Jeju National University College of Medicine, Jeju, Korea
| | - Han Song
- Department of Ophthalmology, Myongji Hospital Seonam University College of Medicine, 697-24, Hwajung-Dong, Deokyang-Gu, Goyang-Si, Gyeonggi-Do, 412-270, Korea
| | - Jimmy K Lee
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA
| | - Roy S Chuck
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA
| | - Ji-Won Kwon
- Department of Ophthalmology, Myongji Hospital Seonam University College of Medicine, 697-24, Hwajung-Dong, Deokyang-Gu, Goyang-Si, Gyeonggi-Do, 412-270, Korea. .,Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA.
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Meta-analysis of optical low-coherence reflectometry versus partial coherence interferometry biometry. Sci Rep 2017; 7:43414. [PMID: 28233846 PMCID: PMC5324074 DOI: 10.1038/srep43414] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 01/24/2017] [Indexed: 12/18/2022] Open
Abstract
A meta-analysis to compare ocular biometry measured by optical low-coherence reflectometry (Lenstar LS900; Haag Streit) and partial coherence interferometry (the IOLMaster optical biometer; Carl Zeiss Meditec). A systematic literature search was conducted for articles published up to August 6th 2015 in the Cochrane Library, PubMed, Medline, Embase, China Knowledge Resource Integrated Database and Wanfang Data. A total of 18 studies involving 1921 eyes were included. There were no statistically significant differences in axial length (mean difference [MD] 0 mm; 95% confidence interval (CI) −0.08 to 0.08 mm; p = 0.92), anterior chamber depth (MD 0.02 mm; 95% CI −0.07 to 0.10 mm; p = 0.67), flat keratometry (MD −0.05 D; 95% CI −0.16 to 0.06 D; p = 0.39), steep keratometry (MD −0.09 D; 95% CI −0.20 to 0.03 D; p = 0.13), and mean keratometry (MD −0.15 D; 95% CI −0.30 to 0.00 D; p = 0.05). The white to white distance showed a statistically significant difference (MD −0.14 mm; 95% CI −0.25 to −0.02 mm; p = 0.02). In conclusion, there was no difference in the comparison of AL, ACD and keratometry readings between the Lenstar and IOLMaster. However the WTW distance indicated a statistically significant difference between the two devices. Apart from the WTW distance, measurements for AL, ACD and keratometry readings may be used interchangeability with both devices.
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Doshi D, Limdi P, Parekh N, Gohil N. A Comparative Study to Assess the Predictability of Different IOL Power Calculation Formulas in Eyes of Short and Long Axial Length. J Clin Diagn Res 2017; 11:NC01-NC04. [PMID: 28273986 DOI: 10.7860/jcdr/2017/22095.9136] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 11/01/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Accurate Intraocular Lens (IOL) power calculation in cataract surgery is very important for providing postoperative precise vision. Selection of most appropriate formula is difficult in high myopic and hypermetropic patients. AIM To investigate the predictability of different IOL (Intra Ocular Lens) power calculation formulae in eyes with short and long Axial Length (AL) and to find out most accurate IOL power calculation formula in both groups. MATERIALS AND METHODS A prospective study was conducted on 80 consecutive patients who underwent phacoemulsification with monofocal IOL implantation after obtaining an informed and written consent. Preoperative keratometry was done by IOL Master. Axial length and anterior chamber depth was measured using A-scan machine ECHORULE 2 (BIOMEDIX). Patients were divided into two groups based on AL. (40 in each group). Group A with AL<22 mm and Group B with AL>24.5 mm. The IOL power calculation in each group was done by Haigis, Hoffer Q, Holladay-I, SRK/T formulae using the software of ECHORULE 2. The actual postoperative Spherical Equivalent (SE), Estimation error (E) and Absolute Error (AE) were calculated at one and half months and were used in data analysis. The predictive accuracy of each formula in each group was analyzed by comparing the Absolute Error (AE). The Kruskal Wallis test was used to compare differences in the (AE) of the formulae. A statistically significant difference was defined as p-value<0.05. RESULTS In Group A, Hoffer Q, Holladay 1 and SRK/T formulae were equally accurate in predicting the postoperative refraction after cataract surgery (IOL power calculation) in eyes with AL less than 22.0 mm and accuracy of these three formulae was significantly higher than Haigis formula. Whereas in Group B, Hoffer Q, Holladay 1, SRK/T and Haigis formulae were equally accurate in predicting the postoperative refraction after cataract surgery (IOL power calculation) in eyes with AL more than 24.5 mm. CONCLUSION Hoffer Q, Holladay 1 and SRK/T formulae were showing significantly higher accuracy than Haigis formula in predicting the postoperative refraction after cataract surgery (IOL power calculation) in eyes with AL less than 22.0 mm. In eyes with AL more than 24.5 mm Hoffer Q, Holladay 1, SRK/T and Haigis formulae were equally accurate.
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Affiliation(s)
- Dharmil Doshi
- Resident, Department of Ophthalmology, Goverment Medical College and Sir T. Hospital , Bhavnagar, Gujarat, India
| | - Purvi Limdi
- Resident, Department of Ophthalmology, Goverment Medical College and Sir T. Hospital , Bhavnagar, Gujarat, India
| | - Nilesh Parekh
- Professor, Department of Ophthalmology, Goverment Medical College and Sir T. Hospital , Bhavnagar, Gujarat, India
| | - Neepa Gohil
- Assistant Professor, Department of Ophthalmology, Goverment Medical College and Sir T. Hospital , Bhavnagar, Gujarat, India
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Fouad M, El Din Farahat H, Said Ahmed K, Gad Marey H. Intraocular lens master optical biometry versus conventional ultrasound biometry in intraocular lens power calculations in highly myopic eyes. ACTA ACUST UNITED AC 2017. [DOI: 10.4103/1110-2098.215434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Faramarzi A, Aghajani A, Ghiasian L. Accuracy of Various Intraocular Lens Power Calculation Formulas in Steep Corneas. J Ophthalmic Vis Res 2017; 12:385-389. [PMID: 29090047 PMCID: PMC5644404 DOI: 10.4103/jovr.jovr_20_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose: To compare the accuracy of four different intraocular lens (IOL) power calculation formulas for eyes with mean keratometry values greater than 46 diopters (D). Methods: Forty five eyes from 45 patients who were candidates for senile cataract surgery with mean keratometry values greater than 46 D were included. Calculation of the IOL power was performed by the Lenstar. The implanted IOL in all cases was Acrysof SA60AT. The average absolute value of the differences between the actual and predicted spherical equivalent (SE) of the postoperative refractive error (mean absolute error: MAE) was calculated using 4 formulas (Haigis, Holladay 1, Hoffer Q, and SRK/T) with optical IOL constants from the User Group for Laser Interference Biometry constants. Results: The MAE was smallest in the SRK/T formula (0.39 D ± 0.35) followed by those of the Holladay 1 (0.44 D ± 0.32), Haigis (0.45 D ± 0.35) and Hoffer Q (0.5 D ± 0.38) formulas. However, there was no statistically significant difference between the MAE among different formulas. The SRK/T formula predicted more eyes within ± 0.5 D of the SE (77.8%) compared to other formulas. Conclusion: In eyes with steep corneas, there were no statistically significant differences among the accuracies of the four common IOL power calculation formulas.
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Affiliation(s)
- Amir Faramarzi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Aghajani
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Ghiasian
- Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Qu Y, Li F, Li J. Bilateral cataract surgery in a 56-year-old man following presbyopia laser in situ keratomileusis: A case report. Saudi J Ophthalmol 2016; 30:268-271. [PMID: 28003790 PMCID: PMC5161808 DOI: 10.1016/j.sjopt.2016.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 10/19/2016] [Accepted: 10/31/2016] [Indexed: 11/17/2022] Open
Abstract
We describe a case of bilateral cataract surgery in a 56-year-old man following presbyopia laser in situ keratomileusis. The preoperative refraction was −2.00 in the right eye and −0.75 × 105 in the left eye. On the last examination, the uncorrected distance visual acuity was 20/80 that can be corrected to 20/20 in the right eye with a refraction of −2.25 and 20/20 in the left eye, whereas the visual acuity for reading was 20/40 in the right eye and 20/80 in the left eye with a refraction of +2.25. His monovision surgery design of previous cornea surgery was also taken into consideration for the phacoemulsification and posterior chamber intraocular lens (IOL) implantation. Two-step surgery is helpful for predicting an accurate IOL degree.
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Affiliation(s)
- Ya Qu
- Southwest Eye Hospital, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Fuliang Li
- Southwest Eye Hospital, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Jiawen Li
- Southwest Eye Hospital, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
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Gür Güngör S, Akman A, Asena L, Aksoy M, Sarıgül Sezenöz A. Changes in Anterior Chamber Depth after Phacoemulsification in Pseudoexfoliative Eyes and their Effect on Accuracy of Intraocular Lens Power Calculation. Turk J Ophthalmol 2016; 46:255-258. [PMID: 28050320 PMCID: PMC5177780 DOI: 10.4274/tjo.56659] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 03/02/2016] [Indexed: 12/01/2022] Open
Abstract
Objectives: To compare anterior chamber depth (ACD) changes after phacoemulsification surgery in patients with pseudoexfoliation syndrome (PEX) and normal patients using an anterior segment imaging method. Another aim of this study was to evaluate the effect of these changes on the accuracy of intraocular lens (IOL) power calculation and postoperative refraction. Materials and Methods: Twenty-two eyes of 22 patients with PEX and 30 eyes of 30 normal patients who underwent uneventful phacoemulsification surgery and IOL implantation were included in the study. The ACD of all patients was evaluated preoperatively and at 3 months postoperatively with the ALLEGRO Oculyzer (WaveLight® Oculyzer™ II, Alcon, Novartis)-Scheimpflug imaging system. Results: The postoperative mean ACD values were significantly larger than the preoperative ACD values in both groups (p<0.001 for both groups). The pre- to postoperative change in ACD was 0.46±0.3 mm in the PEX group, which was a larger change than seen in the normal patients (0.12±0.1 mm) (p=0.04). The mean absolute errors (MAE) calculated with different IOL formulas (SRK/T, Haigis, Hoffer and Holladay 1 formulas) were comparable and no statistically significant difference was observed between the two groups (p=0.21). Conclusion: Phacoemulsification induces more significant ACD changes in patients with PEX compared to normal patients. However, the MAE did not differ significantly between the groups.
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Affiliation(s)
- Sirel Gür Güngör
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - Ahmet Akman
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - Leyla Asena
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - Mustafa Aksoy
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
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Hui S, Yi L. Comparison of two optical biometers in intraocular lens power calculation. Indian J Ophthalmol 2016; 62:931-4. [PMID: 25370395 PMCID: PMC4244739 DOI: 10.4103/0301-4738.143930] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims: To compare the consistency and accuracy in ocular biometric measurements and intraocular lens (IOL) power calculations using the new optical low-coherence reflectometry and partial coherence interferometry. Subjects and Methods: The clinical data of 122 eyes of 72 cataract patients were analyzed retrospectively. All patients were measured with a new optical low-coherence reflectometry system, using the LENSTAR LS 900 (Haag Streit AG)/ALLEGRO BioGraph biometer (Wavelight., AG), and partial coherence interferometry (IOLMaster V.5.4 [Carl Zeiss., Meditec, AG]) before phacoemulsification and IOL implantation. Repeated measurements, as recommended by the manufacturers, were performed by the same examiner with both devices. Using the parameters of axial length (AL), corneal refractive power (K1 and K2), and anterior chamber depth (ACD), power calculations for AcrySof SA60AT IOL were compared between the two devices using five formulas. The target was emmetropia. Statistical analysis was performed using Statistical Package for the Social Sciences software (SPSS 13.0) with t-test as well as linear regression. A P value < 0.05 was considered to be statistically significant. Results: The mean age of 72 cataract patients was 64.6 years ± 13.4 [standard deviation]. Of the biometry parameters, K1, K2 and [K1 + K2]/2 values were significantly different between the two devices (mean difference, K1: −0.05 ± 0.21 D; K2: −0.12 ± 0.20 D; [K1 + K2]/2: −0.08 ± 0.14 D. P <0.05). There was no statistically significant difference in AL and ACD between the two devices. The correlations of AL, K1, K2, and ACD between the two devices were high. The mean differences in IOL power calculations using the five formulas were not statistically significant between the two devices. Conclusions: New optical low-coherence reflectometry provides measurements that correlate well to those of partial coherence interferometry, thus it is a precise device that can be used for the pre-operative examination of cataract patients.
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Affiliation(s)
| | - Lu Yi
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
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Influence of Patient Age on Intraocular Lens Power Prediction Error. Am J Ophthalmol 2016; 170:232-237. [PMID: 27562431 DOI: 10.1016/j.ajo.2016.08.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 08/09/2016] [Accepted: 08/10/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE To examine whether intraocular lens (IOL) power prediction error (PE) after cataract surgery differs according to patient age. DESIGN Prospective cohort study. METHODS We consecutively enrolled 75 eyes of 75 patients 59 years of age or younger, and 150 eyes of 150 patients in each of 3 age groups (60-69, 70-79, and 80-89 years), for whom phacoemulsification and implantation of a single-piece acrylic IOL was planned. The IOL power was calculated using the optimized SRK/T formula. Objective refraction was measured using an autorefractometer at approximately 3 months postoperatively, and the mean arithmetic PE and median absolute PE were compared among age groups. RESULTS The mean preoperative refractive error predicted by the SRK/T formula was similar among age groups (P = .4179). The mean postoperative spherical equivalent was significantly more myopic in younger patients (P < .0001). Mean PE was -0.24 diopters (D) in those ≤59 years of age, -0.17 D in those 60-69 years of age, -0.11 D in those 70-79 years of age, and -0.05 D in those 80-89 years of age; the mean PE was less myopic in older patients (P = .0008). The median absolute PE did not differ significantly among groups (P = .6192). Mean PE was positively correlated with age (P < .0001). Multiple regression analysis revealed that age, preoperative axial length, average corneal curvature, and anterior chamber depth were independent predictors of the age-related difference in PE. CONCLUSION PE was less myopic by approximately 0.06 D per decade as age increased, suggesting that patient age should be considered when selecting IOL power.
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Kim KN, Lim HB, Lee JJ, Kim CS. Influence of Biometric Variables on Refractive Outcomes after Cataract Surgery in Angle-closure Glaucoma Patients. KOREAN JOURNAL OF OPHTHALMOLOGY 2016; 30:280-8. [PMID: 27478355 PMCID: PMC4965603 DOI: 10.3341/kjo.2016.30.4.280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 09/15/2015] [Indexed: 11/27/2022] Open
Abstract
Purpose To evaluate the influence of biometric variables on refractive outcomes after cataract surgery in angle-closure glaucoma (ACG) patients. Methods In this case-control study, 42 ACG patients, 40 open-angle glaucoma (OAG) patients, and 35 controls without glaucoma who had undergone conventional cataract surgery were enrolled consecutively. Electronic medical records, including preoperative biometric variables (keratometric diopter, axial length, anterior chamber depth, and lens thickness), the refractive change (RC), and the absolute value of refractive change (ARC) were reviewed. Results In the control and OAG patients, the anterior chamber depth was negatively correlated with the ARC (r = -0.344, p = 0.043 and r = -0.431, p = 0.006, respectively), whereas there was no correlation in the ACG patients. Lens thickness was positively correlated with the RC, but not with the ARC, in the control and OAG groups (r = 0.391, p = 0.020 and r = 0.501, p = 0.001, respectively). In contrast, lens thickness in the ACG group was not correlated with the RC but was positively correlated with the ARC (r = 0.331, p = 0.032). Conclusions In contrast with the anterior chamber depth, preoperatively measured lens thickness may be a useful predictor of the direction of the RC after cataract surgery in control and OAG patients. However, in ACG patients, a thicker lens was correlated with a larger RC, regardless of the direction of the shift (hyperopic or myopic).
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Affiliation(s)
- Kyoung Nam Kim
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
| | - Hyung Bin Lim
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
| | - Jong Joo Lee
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
| | - Chang-Sik Kim
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea.; Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
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Karabela Y, Eliacik M, Kaya F. Performance of the SRK/T formula using A-Scan ultrasound biometry after phacoemulsification in eyes with short and long axial lengths. BMC Ophthalmol 2016; 16:96. [PMID: 27391470 PMCID: PMC4938914 DOI: 10.1186/s12886-016-0271-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 06/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The SRK/T formula is one of the third generation IOL calculation formulas. The purpose of this study was to evaluate the performance of the SRK/T formula in predicting a target refraction ±1.0D in short and long eyes using ultrasound biometry after phacoemulsification. METHODS The present study was a retrospective analysis, which included 38 eyes with an AL < 22.0 mm (short AL), and 62 eyes ≥24.6 mm (long AL) that underwent uncomplicated phacoemulsification. Preoperative AL was measured by ultrasound biometry and SRK/T formula was used for IOL calculation. Three different IOLs were implanted in the capsular bag. The prediction error was defined as the difference between the achieved postoperative refraction, and attempted predicted target refraction. Statistical analysis was performed with SPSS V21. RESULTS In short ALs, the mean age was 65.13 ± 9.49 year, the mean AL was 21.55 ± 0.45 mm, the mean K1 and K2 were 45.76 ± 1.77D and 46.09 ± 1.61D, the mean IOL power was 23.96 ± 1.92D, the mean attempted (predicted) value was 0.07 ± 0.26D, the mean achieved value was 0.07 ± 0.63 D, the mean PE was 0.01 ± 0.60D, and the MAE was 0.51 ± 0.31D. A significant positive relationship with AL and K1, K2, IOL power and a strong negative relationship with PE and achieved postoperative was found. In long ALs, the mean age was 64.05 ± 7.31 year, the mean AL was 25.77 ± 1.64 mm, the mean K1 and K2 were 42.20 ± 1.57D and 42.17 ± 1.68D, the mean IOL power was 15.79 ± 5.17D, the mean attempted value was -0.434 ± 0.315D, the mean achieved value was -0.42 ± 0.96D, the mean PE was -0.004 ± 0.93D, the MAE was 0.68 ± 0.62D. A significant positive relationship with AL and K1, K2 and a significant positive relationship with PE and achieved value, otherwise a negative relationship with AL and IOL power was found. There was a little tendency towards hyperopic for short ALs and myopic for long ALs. The majority of eyes (94.74 %) for short ALs and (70.97 %) for long ALs were within ±1 D of the predicted refractive error. No significant relationship with PE and IOL types, AL, K1, K2, IOL power, and attempted value, besides with MAE and AL, K1, K2, age, attempted, achieved value were found in both groups. CONCLUSION The SRK/T formula performs well and shows good predictability in eyes with short and long axial lengths.
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Affiliation(s)
- Yunus Karabela
- Department of Ophthalmology, Istanbul Medipol University, Esenler Hospital, Birlik Mah., Bahceler Cad., Number 5, Esenler, Istanbul, 34230, Turkey.
| | - Mustafa Eliacik
- Department of Ophthalmology, School of Medicine, Istanbul Medipol University, Kadıkoy Medipol Hospital, Lambaci Sokak Number 1, Kosuyolu, Kadikoy, Istanbul, 34718, Turkey
| | - Faruk Kaya
- Department of Ophthalmology, Istanbul Medipol University, Esenler Hospital, Birlik Mah., Bahceler Cad., Number 5, Esenler, Istanbul, 34230, Turkey
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Moschos MM, Chatziralli IP, Koutsandrea C. Intraocular lens power calculation in eyes with short axial length. Indian J Ophthalmol 2016; 62:692-4. [PMID: 25005197 PMCID: PMC4131320 DOI: 10.4103/0301-4738.129791] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: To evaluate and compare the predictive capacity of four intraocular lens (IOL) power calculation formulas (SRK/T, Hoffer Q, Holladay 1, and Haigis) in eyes shorter than 22.0 mm. Setting and Design: Observational study. Materials and Methods: Participants in our study were 69 consecutive patients with a preoperative axial length (AL) of less than 22.0 mm in one or both eyes. All patients underwent phacoemulsification with IOL implantation and postoperative target of refraction was analyzed. Specifically, the differences in the mean absolute estimation error (AE) for the four formulas were analyzed. Furthermore, the percentage of eyes with AE within ±0.5 and ±1.0 D for each formula was estimated, as well as the correlation coefficient (r) between the AL and estimation error (E) for each formula. The Mann-Whitney U test was used to compare differences in the AEs of the formulas. A statistically significant difference was defined as P < 0.05. Results: The Haigis formula had statistically significant smaller mean AE in comparison to Holladay 1, Hoffer Q, and SRK/T. The Haigis formula predicted more eyes with E within ±0.5 and ±1.0 D of predicted spherical equivalent compared to other formulas. Correlation between AL and AE revealed a negative r value and P < 0.05 for all formulas. Conclusions: Haigis formula provides more accurate results concerning the postoperative target of refraction in eyes with AL less than 22.0 mm. Hoffer Q could be also used as an alternative.
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Affiliation(s)
| | - Irini P Chatziralli
- Department of Ophthalmology, Electrophysiology Laboratory, University of Athens, Athens, Greece
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Montes de Oca I, Gökce SE, Hallahan K, Wang L, Koch DD. IOL Calculations in Short, Long, and Postrefractive Eyes. Int Ophthalmol Clin 2016; 56:49-70. [PMID: 27257722 DOI: 10.1097/iio.0000000000000119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Wang JCC, Campos-Möller X, Shah M, Sheybani A, Ahmed IIK. Effect of endocyclophotocoagulation on refractive outcomes in angle-closure eyes after phacoemulsification and posterior chamber intraocular lens implantation. J Cataract Refract Surg 2016; 42:132-7. [DOI: 10.1016/j.jcrs.2015.07.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 07/01/2015] [Accepted: 07/02/2015] [Indexed: 10/22/2022]
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Hoffer KJ, Aramberri J, Haigis W, Olsen T, Savini G, Shammas HJ, Bentow S. Protocols for studies of intraocular lens formula accuracy. Am J Ophthalmol 2015; 160:403-405.e1. [PMID: 26117311 DOI: 10.1016/j.ajo.2015.05.029] [Citation(s) in RCA: 179] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 05/27/2015] [Accepted: 05/28/2015] [Indexed: 10/23/2022]
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Carifi G, Aiello F, Zygoura V, Kopsachilis N, Maurino V. Accuracy of the refractive prediction determined by multiple currently available intraocular lens power calculation formulas in small eyes. Am J Ophthalmol 2015; 159:577-83. [PMID: 25524494 DOI: 10.1016/j.ajo.2014.11.036] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/29/2014] [Accepted: 11/01/2014] [Indexed: 12/27/2022]
Abstract
PURPOSE To observe the refractive outcomes of cataract surgery in small adult eyes, and to investigate the accuracy of different intraocular lens (IOL) power prediction formulas. DESIGN Retrospective interventional case series. METHODS We included consecutive small eyes undergoing uneventful phacoemulsification cataract surgery with a single highly powerful IOL (Acrysof SA60AT) implanted in the capsular bag (range of powers +35.0 to +40.0 diopters [D]), at the Cataract Centre for Moorfields Eye Hospital. Exclusion criteria were combined or previous intraocular surgical procedures, and any type of intraoperative complications. Main outcome measures were mean prediction errors with Hoffer Q, Holladay 1, Holladay 2, Haigis, SRK-T, and SRK-II IOL power prediction formulas and proportions of eyes achieving absolute errors within the dioptric ranges of 0.5, 1.0, and 2.0 D of target and emmetropia, respectively. The ANOVA test was used to compare the refractive results among various formulas. RESULTS Twenty-eight eyes were studied; the mean numerical error was 0.22 ± 1.22 D and the mean absolute error was 0.95 ± 0.78 D with the adopted Hoffer Q formula; 39%, 61%, and 89% of the eyes had a final refraction within 0.5 D, 1.0 D, and 2.0 D of target, respectively. None of the latest-generation formulas significantly outperformed the others (P = .245). CONCLUSIONS The Hoffer Q formula led to good or fair refractive outcomes in less than two thirds of the cases. With Holladay 1 and 2 and Haigis formulas, outcomes would have not been significantly different. The SRK formulas yielded less accurate predictions. Possible reasons are discussed.
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Abstract
PURPOSE OF REVIEW Emerging data in the peer-reviewed literature indicate that femtosecond laser-assisted cataract surgery (LCS) is a well tolerated and effective alternative to conventional phacoemulsification. Initial reports have largely been based on findings from an optimal patient selection. As confidence with the technology has grown, clinical indications have expanded and the benefit of LCS in high-risk patients with complex cataracts is increasingly being considered. RECENT FINDINGS We discuss challenging cataract surgery cases, citing the currently available literature alongside experience from over 3000 completed LCS cases at our centre. SUMMARY Current experience is limited. However, LCS platforms are continuously evolving and improving. The results collected to date would suggest that the precision and safety offered by LCS may improve outcomes in these challenging cases.
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Kim BH, Wee WR, Kim MK. Analysis of Factors that Influence on Accuracy of Intraocular Lens Power Calculation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.2.173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Bo Hyuck Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Corneal Regenerative Medicine and Ocular Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Won Ryang Wee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Corneal Regenerative Medicine and Ocular Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Corneal Regenerative Medicine and Ocular Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
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Martin AI, Hughes P, Hodge C. First report of femtosecond laser cataract surgery in a nanophthalmic eye. Clin Exp Ophthalmol 2013; 42:501-2. [PMID: 24304700 DOI: 10.1111/ceo.12262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 09/29/2013] [Indexed: 12/01/2022]
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Sheard R. Optimising biometry for best outcomes in cataract surgery. Eye (Lond) 2013; 28:118-25. [PMID: 24310239 DOI: 10.1038/eye.2013.248] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 10/11/2013] [Indexed: 12/16/2022] Open
Abstract
Biometry has become one of the most important steps in modern cataract surgery and, according to the Royal College of Ophthalmologists Cataract Surgery Guidelines, what matters most is achieving excellent results. This paper is aimed at the NHS cataract surgeon and intends to be a critical review of the recent literature on biometry for cataract surgery, summarising the evidence for current best practice standards and available practical strategies for improving outcomes for patients. With modern optical biometry for the majority of patients, informed formula choice and intraocular lens (IOL) constant optimisation outcomes of more than 90% within ± 1 D and more than 60% within ± 0.5 D of target are achievable. There are a number of strategies available to surgeons wishing to exceed these outcomes, the most promising of which are the use of strict-tolerance IOLs and second eye prediction refinement.
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Affiliation(s)
- R Sheard
- Consultant Ophthalmologist, Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield, UK
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Predictability of intraocular lens power calculation formulae in infantile eyes with unilateral congenital cataract: results from the Infant Aphakia Treatment Study. Am J Ophthalmol 2013; 156:1252-1260.e2. [PMID: 24011524 DOI: 10.1016/j.ajo.2013.07.014] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 07/14/2013] [Accepted: 07/16/2013] [Indexed: 11/23/2022]
Abstract
PURPOSE To compare accuracy of intraocular lens (IOL) power calculation formulae in infantile eyes with primary IOL implantation. DESIGN Comparative case series. METHODS The Hoffer Q, Holladay 1, Holladay 2, Sanders-Retzlaff-Kraff (SRK) II, and Sanders-Retzlaff-Kraff theoretic (SRK/T) formulae were used to calculate predicted postoperative refraction for eyes that received primary IOL implantation in the Infant Aphakia Treatment Study. The protocol targeted postoperative hyperopia of +6.0 or +8.0 diopters (D). Eyes were excluded for invalid biometry, lack of refractive data at the specified postoperative visit, diagnosis of glaucoma or suspected glaucoma, or sulcus IOL placement. Actual refraction 1 month after surgery was converted to spherical equivalent and prediction error (predicted refraction - actual refraction) was calculated. Baseline characteristics were analyzed for effect on prediction error for each formula. The main outcome measure was absolute prediction error. RESULTS Forty-three eyes were studied; mean axial length was 18.1 ± 1.1 mm (in 23 eyes, it was <18.0 mm). Average age at surgery was 2.5 ± 1.5 months. Holladay 1 showed the lowest median absolute prediction error (1.2 D); a paired comparison of medians showed clinically similar results using the Holladay 1 and SRK/T formulae (median difference, 0.3 D). Comparison of the mean absolute prediction error showed the lowest values using the SRK/T formula (1.4 ± 1.1 D), followed by the Holladay 1 formula (1.7 ± 1.3 D). Calculations with an optimized constant showed the lowest values and no significant difference between the Holladay 1 and SRK/T formulae (median difference, 0.3 D). Eyes with globe AL of less than 18 mm had the largest mean and median prediction error and absolute prediction error, regardless of the formula used. CONCLUSIONS The Holladay 1 and SRK/T formulae gave equally good results and had the best predictive value for infant eyes.
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Day AC, MacLaren RE, Bunce C, Stevens JD, Foster PJ. Reply: Cataract surgery and microphthalmic eyes. J Cataract Refract Surg 2013; 39:818-9. [DOI: 10.1016/j.jcrs.2013.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Indexed: 11/29/2022]
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Wang JK, Chang SW. Optical biometry intraocular lens power calculation using different formulas in patients with different axial lengths. Int J Ophthalmol 2013; 6:150-4. [PMID: 23638414 DOI: 10.3980/j.issn.2222-3959.2013.02.08] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Accepted: 03/20/2013] [Indexed: 12/11/2022] Open
Abstract
AIM : To investigate the predictability of intraocular lens (IOL) power calculation using the IOLMaster and different IOL power calculation formulas in eyes with various axial length (AL). METHODS : Patients were included who underwent uneventful phacoemulsification with IOL implantation in the Department of Ophthalmology, Far Eastern Memorial Hospital, Taipei, Taiwan, China from February 2007 to January 2009. Preoperative AL and keratometric values (Ks) were measured by IOLMaster optical biometry. Patients were divided into 3 groups based on AL less than 22mm (Group 1), 22-26mm (Group 2), and more than 26mm (Group 3). The power of the implanted IOL was used to calculate the predicted postoperative spherical equivalence (SE) by various formulas: the Haigis, Hoffer Q, Holladay 1, and SRK/T. The predictive accuracy of each formula was analyzed by comparing the difference between the actual and predicted postoperative SE (MedAE, median absolute error). All the patients had follow-up periods exceeding 3 months. RESULTS : Totally, there were 200 eyes (33 eyes in Group 1, 92 eyes in Group 2, 75 eyes in Group 3). In all patients, the Haigis had the significantly lower MedAE generated by the other formulas (P<0.05). In Group 1 to 3, the MedAE calculated by the Haigis was either significantly lower or comparable to those calculated by the other formulas. CONCLUSION : Compared with other formulas using IOLMaster biometric data, the Haigis formula yields superior refractive results in eyes with various AL.
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Affiliation(s)
- Jia-Kang Wang
- Department of Ophthalmology, Far Eastern Memorial Hospital, Taipei, Taiwan, China ; Oriental Institute of Technology, Taipei, Taiwan, China ; Department of Medicine, National Yang Ming University, Taipei, Taiwan, China
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