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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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Chang JSM, Ng JCM, Chan VKC, Law AKP. Cataract Surgery with a New Fluidics Control Phacoemulsification System in Nanophthalmic Eyes. Case Rep Ophthalmol 2016; 7:218-226. [PMID: 27920717 PMCID: PMC5121556 DOI: 10.1159/000452158] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 09/29/2016] [Indexed: 11/24/2022] Open
Abstract
Purpose To report visual outcomes and complications after cataract surgery in nanophthalmic eyes with a phacoemulsification system using the active fluidics control strategy. Methods This is a retrospective case series. All eyes with an axial length of less than 20 mm that underwent cataract surgery or refractive lens exchange using the Centurion Vision System (Alcon Laboratories Inc.) in Hong Kong Sanatorium and Hospital were evaluated. The visual acuity and intraoperative and postoperative complications were reported. Prior approval from the Hospital Research Committee has been granted. Results Five eyes of 3 patients were included. The mean follow-up period was 10.2 ± 5.3 months (range, 4–18). Two eyes (40%) had a one-line loss of corrected distance visual acuity. No uveal effusion and posterior capsular tear developed. An optic crack and haptic breakage in the intraocular lens developed in 1 eye (20%) and 2 eyes (40%), respectively. Additional surgeries to treat high postoperative intraocular pressure were required in 1 eye (20%). Conclusion The use of a new phacoemulsification system, which actively monitors and maintains the intraoperative pressure, facilitated anterior chamber stability during cataract surgery in nanophthalmic eyes. This minimized the risk of major complications related to unstable anterior chambers such as uveal effusion and posterior capsular tear. Development of intraoperative crack/breakage in a high-power intraocular lens was common.
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Affiliation(s)
- John S M Chang
- Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong
| | - Jack C M Ng
- Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong
| | - Vincent K C Chan
- Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong
| | - Antony K P Law
- Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong
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Singh H, Wang JCC, Desjardins DC, Baig K, Gagné S, Ahmed IIK. Refractive outcomes in nanophthalmic eyes after phacoemulsification and implantation of a high-refractive-power foldable intraocular lens. J Cataract Refract Surg 2016; 41:2394-402. [PMID: 26703488 DOI: 10.1016/j.jcrs.2015.05.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 05/25/2015] [Accepted: 05/26/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the refractive and postoperative outcomes of a high-power foldable intraocular lens (IOL) in nanophthalmic eyes. SETTING Six ophthalmic surgical centers in Canada. DESIGN Retrospective case series. METHODS Consecutive charts of nanophthalmic patients having cataract extraction and insertion of the CT Xtreme D IOL were reviewed. Demographic and clinical data were collected, including age, sex, axial length (AL), minimum keratometry (K) value and maximum K value, corneal white-to-white (WTW), anterior chamber depth, lens thickness (LT), and complications. The following preoperative and operative data were collected: uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA), sphere, cylinder, and spherical equivalence (SE). The primary outcome measure was change in SE. The secondary outcome measures were changes in UDVA and CDVA. RESULTS A total of 21 eyes from 13 patients with a mean follow-up time of 9.6 ± 8.5 months were studied. Mean preoperative data were: age (51.4 ± 15.2 years), AL (16.63 ± 0.68 mm), minimum K value (46.20 ± 2.26 D), maximum K value (47.55 ± 2.34 D), anterior chamber depth (2.60 ± 0.49 mm), WTW (11.08 ± 1.38 mm), LT (4.70 ± 0.97 mm), and IOL power implanted (+49.9 ± 3.3 diopters [D]). SE improved from +16.11 ± 3.26 D preoperatively to +2.00 ± 2.37 D postoperatively (P < .0001). UDVA improved from 1.47 ± 0.30 logMAR preoperatively to 0.74 ± 0.43 logMAR postoperatively (P = .016). CDVA did not change significantly. Five eyes (23.8%) had serious postoperative complications. Of these eyes, 2 had malignant glaucoma, 2 had vitreous hemorrhages, and 1 eye had a vitreous hemorrhage with retinal detachment resulting in visual acuity of no light perception. CONCLUSION Implanting foldable high-power IOLs in a series of nanophthalmic eyes yielded significant improvement in UDVA and SE. Cataract surgery in these eyes carries increased risk. FINANCIAL DISCLOSURE Iqbal Ike K. Ahmed is a consultant to Carl Zeiss Meditec AG. No other author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Harmanjit Singh
- From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada
| | - Jay Ching-Chieh Wang
- From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada
| | - Daniel Christian Desjardins
- From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada
| | - Kashif Baig
- From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada
| | - Sébastien Gagné
- From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada
| | - Iqbal Ike K Ahmed
- From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada.
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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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Hua X, Yuan XY, Song H, Tang X. Long-term results of clear lens extraction combined with piggyback intraocular lens implantation to correct high hyperopia. Int J Ophthalmol 2013; 6:650-5. [PMID: 24195042 DOI: 10.3980/j.issn.2222-3959.2013.05.18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 09/13/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To assess the refractive outcome of clear lensectomy combined with piggyback intraocular lens implantation in highly hyperopic patients. METHODS This case review included 19 eyes of 10 patients with high hyperopia and axial length less than 21mm. Intraocular lens power was calculated for emmetropia using the Holladay II formula in 17 eyes, and SRK/T formula in 2 eyes following clear lens extraction and piggyback intraocular lens implantation. Patients were examined periodically over 24 months for visual acuity and spherical equivalent (SE). RESULTS The mean postoperative SE at 24 months was 0.20±1.39D (range, -3.00 to 2.50D), better than preoperative 9.81±2.62D (range, +6.00 to +14.50D) (P<0.001). Five eyes had SE within ±0.5D of emmetropia and 11 eyes within ±1.00D at postoperative 24 months. The mean postoperative uncorrected visual acuity (UCVA) at 24 months was 0.60±0.36, significantly improved compared to preoperative 1.39±0.33 (P<0.001). The mean best-corrected visual acuity (BCVA) at 24 months was 0.49±0.35, not statistically different compared to preoperative 0.38±0.30 (P=0.34). Twelve eyes maintained and 1 gained 1 or more Snellen line of BCVA, 4 eyes lost 1 line, and 2 eyes lost 2 lines at 24 postoperative months. Twelve eyes best-corrected near visual acuity (BCNVA) achieved J1 at postoperative 24 months compared to preoperative 7 eyes and the other 7 eyes better than J3. CONCLUSION Clear lens extraction combined piggyback intraocular lens implantation appears to be an effective procedure to correct high hyperopia but mild overcorrection and intralenticular opacification may require secondary procedure.
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Affiliation(s)
- Xia Hua
- Tianjin Medical University, No.22 Qixiangtai Rd, Tianjin 300070, China ; Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, No.4 Gansu Rd, Tianjin 300020, China ; Clinic Barraquer of Ophthalmology, C/Laforja 88, Barcelona 08021, Spain
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