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Liu Q, Yang W, Li D, Wang Z, Chen W, Zhai C, Wei W. Total and simulated keratometry measurements using IOLMaster 700 and Pentacam AXL after small incision lenticule extraction. Int Ophthalmol 2024; 44:237. [PMID: 38902457 DOI: 10.1007/s10792-024-03191-w] [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] [Received: 11/19/2023] [Accepted: 06/15/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE Calculating the intraocular lens (IOL) in patients after corneal refractive surgery presents a challenge. Because an overestimation of corneal power in cases undergone this surgery leading to a subsequent under-correction of IOL power. However, recent advancements in technology have eliable measurement of total corneal power. The aim of this research was to assess the agreement in simulated keratometry (SimK) and total keratometry (TK) values between IOLMaster 700 and Pentacam AXL. METHODS The study involved 99 patients (99 eyes) undergone small incision lenticule extraction (SMILE) surgery. Each patient underwent scans using IOL Master 700 and Pentacam AXL. The following parameters were recorded: SimK1, SimK2, Total K1 (TK1), and Total K2 (TK2) for IOLMaster 700; and SimK1, SimK2, True Net Power (TNP) K1, TNPK2, Total Corneal Refractive Power (TCRP) K1, and TCRP K2 for Pentacam AXL. Agreement between the two devices was evaluated using Bland-Altman plot, while paired t-test was utilized to compare any differences in the same parameter by both instruments. RESULTS The results revealed a strong correlation between the two devices.Noticeable comparability was identified for all SimK variables. However, there were noticeable differences in TK measurements as well as TK1-TNPK1, TK2-TNP K2, TK1-TCRP K1, and TK2-TCRP K2 parameters when comparing the two devices. The IOLMaster 700 consistently measured steeper values than the Pentacam AXL, with significant and clinically relevant differences of 1.34, 1.37, 0.87, and 0.95 diopters, respectively. CONCLUSION While there was a noticeable correlation between the IOLMaster 700 and Pentacam AXL in SimK measurements, a marked difference was noted in TK values. The two devices cannot be used interchangeably when quantifying TK values.
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Affiliation(s)
- Qian Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
| | - Wenli Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China.
| | - Dongjun Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
| | - Ziyang Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
| | - Wei Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
| | - Changbin Zhai
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
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Pan X, Wang Y, Li Z, Ye Z. Intraocular Lens Power Calculation in Eyes After Myopic Laser Refractive Surgery and Radial Keratotomy: Bayesian Network Meta-analysis. Am J Ophthalmol 2024; 262:48-61. [PMID: 37865389 DOI: 10.1016/j.ajo.2023.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/17/2023] [Accepted: 09/27/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE To compare the accuracy of formulas for calculating intraocular lens power in eyes after myopic laser refractive surgery or radial keratotomy. DESIGN Bayesian network meta-analysis. METHODS PubMed, Embase, the Cochrane Data Base of Systematic Reviews, and the Cochrane Central Register of Controlled Trials databases were searched for retrospective and prospective clinical studies published from January 1, 2012, to August 24, 2022. The outcome measurement was the percentage of eyes with a predicted error within the target refractive range (±0.50 diopter [D] or ±1.00 D). RESULTS Our meta-analysis includes 24 studies of 1172 eyes after myopic refractive surgery that use 12 formulas for intraocular lens power calculation. (1) A network meta-analysis showed that Barrett true-K no history, the optical coherence tomography (OCT) formula, and the Masket formula had a significantly higher percent of eyes within ±0.50 D of the goal than the Haigis-L formula, whereas the Wang-Koch-Maloney formula showed the poor predictability. Using an error criterion of within ±1.00 D, the same 3 formulas performed slightly better than the Haigis-L formula. Based on performance using both prediction error criteria, the Barrett true-K no history formula, OCT formula, and Masket formula showed the highest probability of ranking as the top 3 among the 12 methods. (2) A direct meta-analysis with a subset of 4 studies and 5 formulas indicated that formulas did not differ in percent success for either the ±0.5 D or ±1.0 D error range in eyes that had undergone radial keratotomy. CONCLUSIONS The OCT, Masket, and Barrett true-K no history formulas are more accurate for eyes with previous myopic laser refractive surgery, whereas no significant difference was found among the formulas for eyes that had undergone radial keratotomy.
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Affiliation(s)
- Xiaoying Pan
- From the School of Medicine, Nankai University, Tianjin (X.P.); Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China
| | - Yuyao Wang
- Department of Ophthalmology, Medical School of Chinese People's Liberation Army, Beijing (Y.W.); Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China
| | - Zhaohui Li
- Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China
| | - Zi Ye
- Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China.
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Lischke R, Wiltfang R, Bechmann M, Kreutzer TC, Priglinger SG, Dirisamer M, Luft N. Intraocular lens power calculation using total keratometry and ray tracing in eyes with previous small incision lenticule extraction - A case series. Am J Ophthalmol Case Rep 2024; 34:102037. [PMID: 38487335 PMCID: PMC10937105 DOI: 10.1016/j.ajoc.2024.102037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/24/2024] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
Purpose To assess the IOL power calculation accuracy in post-SMILE eyes using ray tracing and a range of total keratometry based IOL calculation formulae. Observations Ray tracing showed excellent predictability in IOL power calculation after SMILE and its accuracy was clinically comparable with the Barrett TK Universal II and Haigis TK formula. Conclusions and importance Incorporating posterior corneal curvature measurements into IOL power calculation after SMILE seems prudent. The ray tracing method as well as selected TK-based formulae yielded excellent accuracy and should be favored in post-SMILE eyes.
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Affiliation(s)
- Roman Lischke
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany
- Department of Ophthalmology and Optometry, Medical University of Innsbruck, Austria
| | - Rainer Wiltfang
- SMILE Eyes Clinic, Munich, Germany
- SMILE Eyes Clinic, Trier, Germany
| | - Martin Bechmann
- SMILE Eyes Clinic, Munich, Germany
- SMILE Eyes Clinic, Trier, Germany
| | | | - Siegfried G. Priglinger
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany
- SMILE Eyes Clinic, Austria
| | - M. Dirisamer
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany
- SMILE Eyes Clinic, Austria
| | - Nikolaus Luft
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany
- SMILE Eyes Clinic, Austria
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Moshirfar M, Ayesha A, Jaafar M, Han K, Omidvarnia S, Altaf A, Stoakes IM, Hoopes PC. Precision in IOL Calculation for Cataract Patients with Prior History of Combined RK and LASIK Histories. Clin Ophthalmol 2024; 18:1277-1286. [PMID: 38741583 PMCID: PMC11090196 DOI: 10.2147/opth.s461988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/28/2024] [Indexed: 05/16/2024] Open
Abstract
Purpose This study aimed to evaluate the accuracy of 12 intraocular lens (IOL) power calculation formulae for eyes that have undergone both radial keratotomy (RK) and laser assisted in situ keratomileusis (LASIK) surgery to determine the efficacy of various IOL calculations for this unique patient group. Currently, research on this surgical topic is limited. Methods In this retrospective study, 11 eyes from 7 individuals with a history of RK and LASIK who underwent cataract surgery at Hoopes Vision were analyzed. Preoperative biometric and corneal topographic measurements were performed. Subjective refraction was obtained postoperatively. Twelve different intraocular lens (IOL) power calculations were used: Barrett True K No History, Barrett True K (prior LASIK, Prior RK history), Barrett Universal 2, Camellin-Calossi-Camellin (3C), Double K-Modified Holladay, Haigis-L, Galilei, OCT, PEARL-DGS, Potvin-Hill, Panacea, and Shammas. Results The rankings of mean arithmetic error (MAE), from least to greatest, were as follows: 3C (0.088), Haigis-L-L (-0.508), Shammas (-0.516), OCT Average (-0.538), Barrett True K (-0.557), OCT RK (-0.563), Galilei (-0.570), IOL Master (-0.571), OCT LASIK (-0.583), Barrett True K No History (-0.597), Pearl-DGS (-0.606), Potvin-Hill SF (-0.770), Potvin-Hill TNP (-0.778), Panacea (-0.876), and Barrett Universal 2 (-1.522). The 3C formula achieved the greatest percentage of eyes within ±0.25 D of target range (91%), while Haigis-L, Shammas, Galilei, Potvin Hill, Barrett True K, IOL Master, PEARL-DGS, and OCT formulae performed similarly, achieving 45% of eyes within ±0.75D of target refraction. Conclusion This study demonstrates the accuracy of the lesser known 3C formula in IOL calculation, particularly for patients who have undergone both RK and LASIK. Well-known formulae, such as Haigis-L, Shammas, and Galilei, which are used by the American Society of Cataract and Refractive Surgery (ASCRS), are viable options, although 3C formulae should be considered in this patient population. Furthermore, larger studies can confirm the best IOL power formulas for post-RK and LASIK cataract patients.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA
- Utah Lions Eye Bank, John A. Moran Eye Center, Murray, UT, USA
| | - Azraa Ayesha
- Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Muhammad Jaafar
- University of Arizona- Phoenix College of Medicine, Phoenix, AZ, USA
| | - Kenneth Han
- University of Arizona- Phoenix College of Medicine, Phoenix, AZ, USA
| | - Soroush Omidvarnia
- Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, USA
| | - Amal Altaf
- University of Arizona- Phoenix College of Medicine, Phoenix, AZ, USA
| | - Isabella M Stoakes
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA
- Pacific Northwest University of Health Science School of Medicine, Yakima, WA, USA
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Wei Y, Liu Y, Li H, Song H. Theoretical Accuracy of the Raytracing Method for Intraocular Calculation of Lens Power in Myopic Eyes after Small Incision Extraction of the Lenticule. Klin Monbl Augenheilkd 2024; 241:221-229. [PMID: 37722612 PMCID: PMC10898958 DOI: 10.1055/a-2177-4998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
AIM To evaluate the accuracy of the raytracing method for the calculation of intraocular lens (IOL) power in myopic eyes after small incision extraction of the lenticule (SMILE). METHODS Retrospective study. All patients undergoing surgery for myopic SMILE between May 1, 2020, and December 31, 2020, with Scheimpflug tomography optical biometry were eligible for inclusion. Manifest refraction was performed before and 6 months after refractive surgery. One eye from each patient was included in the final analysis. A theoretical model was invited to predict the accuracy of multiple methods of lens power calculation by comparing the IOL-induced refractive error at the corneal plane (IOL-Dif) and the SMILE-induced change of spherical equivalent (SMILE-Dif) before and after SMILE surgery. The prediction error (PE) was calculated as the difference between SMILE-Dif-IOL-Dif. IOL power calculations were performed using raytracing (Olsen Raytracing, Pentacam AXL, software version 1.22r05, Wetzlar, Germany) and other formulae with historical data (Barrett True-K, Double-K SRK/T, Masket, Modified Masket) and without historical data (Barrett True-K no history, Haigis-L, Hill Potvin Shammas PM, Shammas-PL) for the same IOL power and model. In addition, subgroup analysis was performed in different anterior chamber depths, axial lengths, back-to-front corneal radius ratio, keratometry, lens thickness, and preoperative spherical equivalents. RESULTS A total of 70 eyes of 70 patients were analyzed. The raytracing method had the smallest mean absolute PE (0.26 ± 0.24 D) and median absolute PE (0.16 D), and also had the largest percentage of eyes within a PE of ± 0.25 D (64.3%), ± 0.50 D (81.4%), ± 0.75 D (95.7%), and ± 1.00 D (100.0%). The raytracing method was significantly better than Double-K SRK/T, Haigis, Haigis-L, and Shammas-PL formulae in postoperative refraction prediction (all p < 0.001), but not better than the following formulae: Barrett True-K (p = 0.314), Barrett True-K no history (p = 0.163), Masket (p = 1.0), Modified Masket (p = 0.806), and Hill Potvin Shammas PM (p = 0.286). Subgroup analysis showed that refractive outcomes exhibited no statistically significant differences in the raytracing method (all p < 0.05). CONCLUSION Raytracing was the most accurate method in predicting target refraction and had a good consistency in calculating IOL power for myopic eyes after SMILE.
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Affiliation(s)
- Yinjuan Wei
- Department of Cataract, Tianjin Eye Hospital, Tianjin, China
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin, China
| | - Yianzhu Liu
- Department of Cataract, Tianjin Eye Hospital, Tianjin, China
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin, China
| | - Hongyu Li
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China
| | - Hui Song
- Department of Cataract, Tianjin Medical University Eye Hospital, Tianjin, China
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Savage DE, Pantanelli SM. An update on intraocular lens power calculations in eyes with previous laser refractive surgery. Curr Opin Ophthalmol 2024; 35:34-43. [PMID: 37820078 DOI: 10.1097/icu.0000000000001004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
PURPOSE OF REVIEW There is an ever-growing body of research regarding intraocular lens (IOL) power calculations following photorefractive keratectomy (PRK), laser-assisted in-situ keratomileusis (LASIK), and small-incision lenticule extraction (SMILE). This review intends to summarize recent data and offer updated recommendations. RECENT FINDINGS Postmyopic LASIK/PRK eyes have the best refractive outcomes when multiple methods are averaged, or when Barrett True-K is used. Posthyperopic LASIK/PRK eyes also seem to do best when Barrett True-K is used, but with more variable results. With both aforementioned methods, using measured total corneal power incrementally improves results. For post-SMILE eyes, the first nontheoretical data favors raytracing. SUMMARY Refractive outcomes after cataract surgery in eyes with prior laser refractive surgery are less accurate and more variable compared to virgin eyes. Surgeons may simplify their approach to IOL power calculations in postmyopic and posthyperopic LASIK/PRK by using Barrett True-K, and employing measured total corneal power when available. For post-SMILE eyes, ray tracing seems to work well, but lack of accessibility may hamper its adoption.
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Affiliation(s)
- Daniel E Savage
- Department of Ophthalmology, David and Ilene Flaum Eye Institute
- Center for Visual Science, University of Rochester, Rochester, New York
| | - Seth M Pantanelli
- Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania, USA
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Yoon SH, Song JR, Lee SH, Eom Y, Hyon JY, Jeon HS. Actual anterior-posterior corneal radius ratio in eyes with prior myopic laser vision correction according to axial length. Sci Rep 2023; 13:14267. [PMID: 37652933 PMCID: PMC10471610 DOI: 10.1038/s41598-023-41062-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
We retrospectively evaluate the actual anterior-posterior (AP) corneal radius ratio in eyes with previous laser correction for myopia (M-LVC) according to axial length (AL) using biometry data exported from swept-source optical coherence tomography between January 2018 and October 2021 in a tertiary hospital (1018 eyes with a history of M-LVC and 19,841 control eyes). The AP ratio was significantly higher in the LVC group than in the control group. Further, it was significantly positively correlated with AL in the LVC group. We also investigated the impact of the AP ratio, AL and keratometry (K) on the absolute prediction error (APE) in 39 eyes that underwent cataract surgery after M-LVC. In linear regression analyses, there were significant correlations between APE and AL/TK, while APE and AP ratio had no correlation. The APE was significantly lower in the Barrett True-K with total keratometry (Barrett True-TK) than in the Haigis-L formula on eyes with AL above 26 mm and K between 38 and 40 D. In conclusion, in eyes with previous M-LVC, AP ratio increases with AL. The Barrett True-K or Barrett True-TK formulas are recommended rather than Haigis-L formula in M-LVC eyes with AL above 26 mm and K between 38 and 40D.
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Affiliation(s)
- Seung Hee Yoon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Ryong Song
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Republic of Korea
| | - Seung Hyen Lee
- Department of Ophthalmology, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Republic of Korea
| | - Youngsub Eom
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA
| | - Joon Young Hyon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Republic of Korea
| | - Hyun Sun Jeon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.
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Meziane Elotmani A, Messerschmidt-Roth A, Nehme A, Müller HH, Sekundo W. Comparison of intraocular lens power calculation formulas with and without total keratometry and ray tracing in patients with previous myopic SMILE. J Cataract Refract Surg 2023; 49:467-473. [PMID: 36700932 DOI: 10.1097/j.jcrs.0000000000001139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/03/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE To evaluate the prediction error (PE) variance and absolute median PE of different intraocular lens (IOL) calculation formulas including last-generation formulas such as Barrett True-K with K, Okulix and total keratometry (TK)-based calculations with Haigis, and Barrett True-K in a simulation model in post-small-incision lenticule extraction (SMILE) eyes. SETTINGS Department of Ophthalmology, University Hospital Marburg, Marburg, Germany. DESIGN Prospective study. METHODS Preoperative measurements included IOL power calculation before and after SMILE surgery. The target refraction was set to be the lowest myopic refractive error in pre-SMILE eyes. The IOL power targeting at the lowest myopic refractive error in pre-SMILE eyes was selected for the post-SMILE IOL calculation of the same eye. The difference between the predicted refraction of pre- and post-SMILE eyes with the same IOL power was defined as IOL difference. The refractive change induced by SMILE was defined as the difference between preoperative and postoperative manifest refraction. RESULTS 98 eyes from 49 patients underwent bilateral myopic SMILE. The PE variance of Okulix was not significantly different compared with Barrett True-K with TK ( P = .471). The SDs of the mean PEs were ±0.413 D (Haigis-TK), ±0.453 D (Okulix), ±0.471 D (Barrett True-K with TK), ±0.556 D (Haigis-L), and ±0.576 D (Barrett True-K with K). The mean absolute PE was 0.340 D, 0.353 D, 0.404 D, 0.511 D, and 0.715 D for Haigis-TK, Okulix, Barrett True-K with TK, Barrett True-K with K, and Haigis-L, respectively. The highest percentage of eyes within ±0.50 D was achieved by Okulix, followed by Haigis-TK, Barrett True-K with TK, Barrett True-K with K, and Haigis-L. CONCLUSIONS Results suggest that Haigis in combination with TK, Okulix, and Barrett True-K with and without TK offer good options for accurate IOL power calculation after SMILE. Haigis-L showed a tendency for myopic shift in eyes after previous SMILE.
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Affiliation(s)
- Anouar Meziane Elotmani
- From the Department of Ophthalmology, University Hospital Marburg (UKGM), Philipps University of Marburg, Marburg, Germany (Elotmani, Messerschmidt-Roth, Nehme, Sekundo); Institute of Medical Bioinformatics and Biostatistics, Philipps University of Marburg, Marburg, Germany (Müller)
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IOL Power Calculations and Cataract Surgery in Eyes with Previous Small Incision Lenticule Extraction. J Clin Med 2022; 11:jcm11154418. [PMID: 35956035 PMCID: PMC9369542 DOI: 10.3390/jcm11154418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/30/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023] Open
Abstract
Small incision lenticule extraction (SMILE), with over 5 million procedures globally performed, will challenge ophthalmologists in the foreseeable future with accurate intraocular lens power calculations in an ageing population. After more than one decade since the introduction of SMILE, only one case report of cataract surgery with IOL implantation after SMILE is present in the peer-reviewed literature. Hence, the scope of the present multicenter study was to compare the IOL power calculation accuracy in post-SMILE eyes between ray tracing and a range of empirically optimized formulae available in the ASCRS post-keratorefractive surgery IOL power online calculator. In our study of 11 post-SMILE eyes undergoing cataract surgery, ray tracing showed the smallest mean absolute error (0.40 D) and yielded the largest percentage of eyes within ±0.50/±1.00 D (82/91%). The next best conventional formula was the Potvin–Hill formula with a mean absolute error of 0.66 D and an ±0.50/±1.00 D accuracy of 45 and 73%, respectively. Analyzing this first cohort of post-SMILE eyes undergoing cataract surgery and IOL implantation, ray tracing showed superior predictability in IOL power calculation over empirically optimized IOL power calculation formulae that were originally intended for use after Excimer-based keratorefractive procedures.
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Lanza M, Ruggiero A, Ha J, Simonelli F, Kane JX. Accuracy of Formulas for Intraocular Lens Power Calculation After Myopic Refractive Surgery. J Refract Surg 2022; 38:443-449. [PMID: 35858195 DOI: 10.3928/1081597x-20220602-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the accuracy of the following intraocular lens (IOL) power formulas: Barrett True-K No History (BTKNH), Emmetropia Verifying Optical 2.0 Post Myopic LASIK/PRK (EVO 2.0), Haigis-L, American Society of Cataract and Refractive Surgery (ASCRS) average, and Shammas, designed for patients who have undergone previous myopic refractive surgery, independent of preexisting clinical history and corneal tomographic measurements. METHODS Data from 302 eyes of 302 patients who previously underwent myopic refractive surgery and had cataract surgery done by a single surgeon with only one IOL type inserted were included. The predicted refraction was calculated for each of the formulas and compared with the actual refractive outcome to give the prediction error. Subgroup analysis based on the axial length and mean keratometry was performed. RESULTS On the basis of mean absolute prediction error (MAE), the formulas were ranked as follows: Haigis-L (0.61 diopters [D]), ASCRS average (0.63 D), BTKNH (0.67 D), EVO 2.0 (0.68 D), and Shammas (0.69 D). The Haigis-L had a statistically significant lower MAE compared with all formulas (P < .05) except the ASCRS average. Hyperopic mean prediction errors were seen in all formulas for axial lengths of greater than 30 mm or mean keratometry values of 35.00 diopters or less. CONCLUSIONS The Haigis-L and the ASCRS average formulas provided the most accurate results in the overall population evaluated in this study. Moreover, according to data observed, it is important to be careful handling very long eyes and very flat corneas because hyperopic refractions could be more common. [J Refract Surg. 2022;38(7):443-449.].
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Fang X, Ben S, Dong Y, Chen X, Xue W, Wang Y. Outcomes of the Haigis-L formula for calculating intraocular lens power in extreme long axis eyes after myopic laser in situ keratomileusis. Eye (Lond) 2022; 36:1178-1184. [PMID: 34117389 PMCID: PMC9151766 DOI: 10.1038/s41433-021-01551-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 03/07/2021] [Accepted: 04/13/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate the accuracy of refractive prediction by the Haigis-L formula compared to four other IOL power calculation formulas in eyes with extremely long axial lengths (AL > 29.0 mm) after LASIK. SETTING Shanghai Eye Disease and Prevention Treatment Center, Shanghai, China. DESIGN Retrospective case series. METHODS Twenty-nine eyes from 19 patients were available for analysis. The primary outcome measure was the arithmetic refractive prediction error (RPE), defined as the difference between the actual postoperative refractive error and the intended formula-derived refractive target. The main outcome measure was the median absolute refraction prediction error (MedAE). The accuracy of the Haigis-L was compared with Barrett True K No History, Shammas-PL, SRK/Tcorrected K, and Holladay 2corrected K methods to calculate IOL power. RESULTS The Haigis-L formula had a significantly larger MedAE than Shammas-PL and SRK/Tcorrected K formulas (P = 0.005 and P = 0.015, respectively), a smaller percentage of eyes within ±1.50 diopter (D) of predicted error in refraction compared with Shammas-PL and SRK/Tcorrected K formulas (P = 0.014 and P = 0.005, respectively). The refractive prediction errors of 6 eyes with corneal keratometry of less than 35 D by Haigis-L all had more than 1.95 D of myopic overestimation, while none of the other four methods resulted in an absolute error over 1.95 D. CONCLUSIONS The Haigis-L formula was relatively accurate in predicting extreme long axis (>29.0 mm) eyes after myopic LASIK surgery but less accurate for eyes with extremely flat corneas (<35 D). SRK/Tcorrected K and Shammas-PL performed better than the other methods for refractive prediction in this type of eyes. SYNOPSIS Haigis-L performed worse than SRK/Tcorrected K and Shammas-PL in predicting IOL power in extremely long axis (>29.0 mm) eyes after myopic LASIK, especially with extremely flat corneas (K < 35 D).
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Affiliation(s)
- Xiaoling Fang
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Shenyu Ben
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Yiping Dong
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Xia Chen
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Wenwen Xue
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Yulan Wang
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
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IOL power calculation with ray tracing based on anterior segment OCT and adjusted axial length after myopic excimer laser surgery. J Cataract Refract Surg 2022; 48:947-953. [PMID: 35121684 DOI: 10.1097/j.jcrs.0000000000000902] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/27/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To report the results of intraocular lens (IOL) power calculation by ray-tracing in eyes with previous myopic excimer laser surgery. SETTING G.B. Bietti Foundation I.R.C.C.S., Rome, Italy. DESIGN Retrospective interventional case series. METHODS A series of consecutive patients undergoing phacoemulsification and IOL implantation after myopic excimer laser was investigated. IOL power was calculated using ray-tracing software available on the anterior segment optical coherence tomographer MS-39 (CSO, Italy). Axial length (AL) was measured by optical biometry and 4 values were investigated: 1) that from the printout, 2) the modified Wang/Koch formula, 3) the polynomial equation for the Holladay 1 and 4) for the Holladay 2 formula. The mean prediction error (PE), median absolute error (MedAE), percentage of eyes with a PE within ±0.50 diopters (D) were reported. RESULTS We enrolled 39 eyes. Entering the original AL into ray-tracing led to a mean hyperopic PE (+0.56 ±0.54 D), whereas with the Wang/Koch formula a mean myopic PE (-0.41 ±0.53D) was obtained. The Holladay 1 and 2 polynomial equations lead to the lowest PEs (-0.10 ±0.49 and +0.08 ±0.49 D respectively), lowest MedAE (0.37 and 0.25 D) and highest percentages of eyes with a PE within ±0.50 D (71.79 and 76.92%). Calculations based on the Holladay 2 polynomial equation showed a statistically significant difference compared to other methods used (including Barrett-True K formula), with the only exception of the Holladay 1 polynomial equation. CONCLUSIONS IOL power can be accurately calculated by ray-tracing with adjusted AL according to the Holladay 2 polynomial equation.
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Lupardi E, Taroni L, Hoffer KJ, Schiano-Lomoriello D, Savini G. Comparison of Corneal Power Calculation by Standard Keratometry and Total Keratometry in Eyes With Previous Myopic FS-LASIK. J Refract Surg 2021; 37:848-852. [PMID: 34914555 DOI: 10.3928/1081597x-20211213-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To compare the accuracy of Total Keratometry (TK) and standard keratometry (K) with the IOLMaster 700 (Carl Zeiss Meditec) in evaluating the corneal refractive change in eyes with previous myopic femtosecond laser-assisted LASIK (FS-LASIK). METHODS A series of consecutive patients who had undergone myopic FS-LASIK was prospectively enrolled. The refractive change in spherical equivalent (ΔSE) was defined as the difference between the preoperative target correction entered into the laser software and the postoperative cycloplegic refraction. The difference between the postoperative and the preoperative K (ΔK) and the difference between the postoperative and the preoperative TK (ΔTK) were compared to the ΔSE. Only the right eye of each patient was selected for the statistical analysis. RESULTS Twenty-five eyes of 25 patients were enrolled. The mean ΔSE was -4.41 ± 1.68 diopters (D). The mean ΔK (-3.82 ± 1.60 D) revealed a statistically significant underestimation of the laser-induced refractive change (P < .0001), whereas the mean ΔTK (-4.36 ± 1.78 D) did not show any significant difference (P = .45). The difference between ΔK and ΔTK was statistically significant (P < .0001). Linear regression between the laser-induced refractive change and the individual difference between the postoperative K and TK disclosed a statistically significant relationship (r = -0.6930, r2 = 0.4803, P < .0001), thus revealing that higher refractive corrections increase the difference between the postoperative values of K and TK. CONCLUSIONS TK does not underestimate the laser-induced corneal changes and can be considered a reliable option for intraocular lens power calculation after myopic excimer laser surgery. [J Refract Surg. 2021;37(12):848-852.].
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Prediction accuracy of No History IOL formulas for a diffractive extended depth-of-focus IOL after myopic corneal refractive surgery. J Cataract Refract Surg 2021; 48:462-468. [PMID: 34978784 DOI: 10.1097/j.jcrs.0000000000000873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
Purpose To compare the accuracy of intraocular lens (IOL) calculation methods for extended depth-of-focus (EDOF) IOLs in eyes with a history of myopic LASIK/PRK surgery lacking historical data. Setting Changsha Aier Eye Hospital, Changsha, and Wuhan Aier Eye Hospital, Wuhan, China. Design Retrospective case series. Methods Patients with ALs >= 25.0 mm and a history of myopic LASIK/PRK surgery who underwent cataract surgery with implantation of EDOF IOLs were enrolled. A comparison was performed of the accuracy of 10 IOL methods lacking historical data, including Barrett True-K No History (Barrett TKNH), Haigis-L, Shammas, Potvin-Hill, "Average", 'minimum" and "maximum" IOL power on the ASCRS online post-refractive IOL calculator; Triple-S formula; and SToP formulas based on Holladay1 and SRK/T. IOL power was calculated with the abovementioned methods in 2 groups according to AL (Group1: 25.0 mm <= AL < 28.0 mm and Group2: AL >= 28.0 mm). Results Sixty-four eyes were included. Excellent outcomes were achieved with the "Minimum", Barrett TKNH, SToP (SRK/T) and Triple-S in the whole sample and subgroups, which led to similar median absolute error, mean absolute error, and the percentage of eyes with a prediction error within +/- 0.5 D. In the whole sample, the Haigis-L and "Maximum" had a significantly higher absolute error than "Minimum", SToP (SRK/T) and Barrett TKNH. The "Maximum" also had a significantly lower percentage of eyes within +/- 0.5 D than the Barrett TKNH, and SToP (SRK/T) (15.6% vs 50% and 51.5%, all P<0.05 with Bonferroni correction). Conclusions No-history IOL formulas in predicting the EDOF IOL power in post-myopic refractive eyes remain challenging. The Barrett TKNH, Triple-S, "Minimum" and SToP (SRK/T) achieved the best accuracy when AL >= 25.0 mm, while the Barrett TKNH and SToP (SRK/T) were recommended when AL >= 28.0mm.
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de Rojas Silva MV, Tobío Ruibal A, Suanzes Hernández J. Corneal power measurements by ray tracing in eyes after small incision lenticule extraction for myopia with a combined Scheimpflug Camera-Placido disk topographer. Int Ophthalmol 2021; 42:921-931. [PMID: 34799784 DOI: 10.1007/s10792-021-02073-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the accuracy of the measurements of corneal power obtained by ray tracing with a combined Scheimpflug camera-Placido disk corneal topographer (Sirius) in eyes after small incision lenticule extraction for myopia (SMILE). METHODS Retrospective cases study includes 50 eyes of 50 patients who underwent myopic SMILE. Mean value of simulated keratometry (Kpost), mean pupil power (MPP) (ray tracing, diameter of the entrance pupil range 3-6 mm), anterior and posterior corneal radius, and corneal thickness were obtained with Sirius topographer preoperatively and three months postoperatively, as well as cycloplegic refraction. True net power, equivalent keratometry readings, and Haigis equivalent power formula were calculated, and these measurements, MPP and Kpost, were compared with the corneal power calculated with the clinical history method (CHM). RESULTS Corneal power measurements obtained with all methods were significantly different from CHM (P < 0.001), except the value of MPP obtained at 5.5 mm (P = 0.927). A good direct correlation was found between CHM and all measurements. The distribution of differences as compared with the CHM showed that the lowest difference corresponded to the value of MMP at 5.5 mm (- 0.002 ± 0.6). The Bland-Altman plots for the MPP at 5.5 mm showed 95% limits of agreement between - 1.1787 D and 1.1741 D. CONCLUSIONS MPP obtained by ray tracing within a diameter of entrance pupil of 5.5 mm could predict corrected corneal power derived from the CHM in eyes following SMILE surgery.
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Affiliation(s)
- Mª Victoria de Rojas Silva
- Victoria de Rojas Instituto Oftalmológico, Policlínica Assistens, A Coruña, Spain. .,Department of Ophthalmology, Complexo Hospitalario Universitario, A Coruña, Spain.
| | - Adrián Tobío Ruibal
- Victoria de Rojas Instituto Oftalmológico, Policlínica Assistens, A Coruña, Spain
| | - Jorge Suanzes Hernández
- Research Support Unit, Complexo Hospitalario Universitario, A Coruña, Spain.,Institute of Biomedical Research (INIBIC), A Coruña, Spain
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Soifer M, Passi SF, Wisely CE, Raufi NN, Thompson AC, Kim T, Gupta PK. Refractive Outcomes Using Intraoperative Aberrometry for Highly Myopic, Highly Hyperopic, and Post-refractive Eyes. J Refract Surg 2021; 37:609-615. [PMID: 34506237 DOI: 10.3928/1081597x-20210609-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate whether intraoperative aberrometry improves the accuracy of refractive outcomes after cataract surgery in highly myopic, highly hyperopic, and post-refractive eyes. METHODS This single-center, retrospective review compared the spherical equivalent of postoperative refraction to that predicted by the Barrett Universal II formula versus Optiwave Refractive Analysis (ORA) (Alcon Laboratories, Inc) for highly myopic and hyperopic eyes and to the Barrett True K formula versus ORA for post-refractive eyes. The number and magnitude of lens changes were analyzed and used to determine in how many cases refractive surprises were affected by ORA, with additional subanalysis of outcomes based on average keratometry values. RESULTS ORA led to a change in the lens power implanted in 48% (96 of 198) of eyes, and prevented hyperopic surprise in 27% (15 of 55) and excess myopia in 46% (19 of 41). Steeper keratometry values correlated with more frequent changes on ORA-recommended implanted intraocular lens (P = .0031). ORA led to a similar percentage of eyes falling within ±0.50, ±0.75, and ±1.00 diopters compared to the Barrett Universal II and Barrett True K formulas. In post-refractive eyes, ORA led to a similar mean absolute error when compared to the Barrett True K formula (P = .62). For highly myopic eyes with an axial length of greater than 27 mm, ORA demonstrated a trend toward lower mean absolute error when compared to the Barrett Universal II formula (P = .076). CONCLUSIONS ORA demonstrated similar refractive results to the Barrett True K formula in post-refractive eyes and to the Barrett Universal II formula in highly myopic and hyper-opic eyes and may provide additional benefit for eyes with steeper corneas or an axial length of greater than 27 mm. [J Refract Surg. 2021;37(9):609-615.].
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Christopher KL, Patnaik JL, Miller DC, Lynch AM, Taravella MJ, Davidson RS. Accuracy of Intraoperative Aberrometry, Barrett True-K With and Without Posterior Cornea Measurements, Shammas-PL, and Haigis-L Formulas After Myopic Refractive Surgery. J Refract Surg 2021; 37:60-68. [PMID: 33432996 DOI: 10.3928/1081597x-20201030-02] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/30/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the accuracy of intraoperative aberrometry, the Barrett True-K No History (Barrett TKNH), Barrett TKNH with posterior corneal measurements (Barrett TKNH with PC), Shammas-PL, and Haigis-L formulas in patients with cataract who had prior myopic refractive surgery. METHODS This was a retrospective consecutive case series of patients with prior myopic refractive surgery undergoing cataract extraction. Mean absolute error (MAE) and median absolute error (MedAE) of refraction prediction were compared for each formula. Interactions of each biometry measurement were modeled for each formula to evaluate those with the most significant impact on refraction prediction. RESULTS One hundred sixteen eyes of 79 patients were analyzed. MAE was 0.40 ± 0.33 diopters (D) for intraoperative aberrometry and 0.42 ± 0.31 D for the Barrett TKNH, 0.38 ± 0.30 D for the Barrett TKNH with PC, 0.47 ± 0.38 D for the Shammas-PL, and 0.56 ± 0.39 D for the Haigis-L formulas. Comparisons between formulas were significant for Barrett TKNH versus Barrett TKNH with PC formulas (P = .046), Barrett TKNH with PC versus Shammas-PL formulas (P = .023), and for all comparisons with the Haigis-L formula (P < .001), and not significant for all other comparisons (P > .05). Eyes were within ±0.50 D of prediction 73%, 72%, 69%, 62%, and 52% of the time for intraoperative aberrometry, the Barrett TKNH with PC, Barrett TKNH, Shammas-PL, and Haigis-L formulas, respectively. Corneal asphericity (Q value) was significantly associated with prediction error for all five methods. Changes in anterior chamber depth had a significant impact on Shammas-PL prediction errors. CONCLUSIONS Newer technology using information from the posterior cornea modestly improved outcomes when compared to established methods for intraocular lens selection in eyes that had previous laser refractive surgery for myopia. [J Refract Surg. 2021;37(1):60-68.].
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Wei L, Meng J, Qi J, Lu Y, Zhu X. Comparisons of intraocular lens power calculation methods for eyes with previous myopic laser refractive surgery: Bayesian network meta-analysis. J Cataract Refract Surg 2021; 47:1011-1018. [PMID: 34290197 DOI: 10.1097/j.jcrs.0000000000000562] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 12/14/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the accuracy of the methods for calculation of intraocular lens (IOL) power in eyes with previous myopic laser refractive surgery. SETTING EENT Hospital of Fudan University, Shanghai, China. DESIGN Network meta-analysis. METHODS A literature search of MEDLINE and Cochrane Library from January 2000 to July 2019 was conducted for studies that evaluated methods of calculating IOL power in eyes with previous myopic laser refractive surgery. Outcomes measurements were the percentages of prediction error within ±0.50 diopters (D) and ±1.00 D of the target refraction (% ±0.50 D and % ±1.00 D). Traditional and network meta-analysis were conducted. RESULTS Nineteen prospective or retrospective clinical studies, including 1217 eyes and 13 calculation methods, were identified. A traditional meta-analysis showed that compared with the widely used Haigis-L method, the Barrett True-K formula, optical coherence tomography (OCT), and Masket methods showed significantly higher % ±0.50 D, whereas no difference was found in the % ±1.00 D. A network meta-analysis revealed that compared with the Haigis-L method, the OCT, Barrett True-K formula, and optiwave refractive analysis (ORA) methods performed better on the % ±0.50 D, whereas the Barrett True-K formula and ORA methods performed better on the % ±1.00 D. Based on the performances of both outcomes, the Barrett True-K formula, OCT, and ORA methods showed highest probability to rank the top 3 among the 13 methods. CONCLUSIONS The Barrett True-K formula, OCT, and ORA methods seemed to offer greater accuracy than others in calculating the IOL power for postrefractive surgery eyes.
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Affiliation(s)
- Ling Wei
- From the Department of Ophthalmology and Eye Institute, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Science; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Comparison of intraocular lens power formulas according to axial length after myopic corneal laser refractive surgery. J Cataract Refract Surg 2021; 47:297-303. [PMID: 32991505 DOI: 10.1097/j.jcrs.0000000000000445] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/01/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the predictive accuracy of 4 no-history intraocular lens (IOL) power formulas in eyes with prior myopic excimer laser surgery, classified in 4 groups according to their axial length (AL), and investigate the relationship between AL and predictive accuracy. SETTING Seoul St. Mary's Hospital, Republic of Korea. DESIGN Retrospective case series. METHODS IOL power was calculated with the Barrett True-K, Haigis-L, Shammas-PL, and Triple-S formulas in 4 groups classified according to AL. Primary outcomes were the median absolute error (MedAE) and percentage of eyes with a prediction error (PE) within ±0.50 diopter (D). RESULTS This study included 107 eyes of 107 patients. The Barrett True-K had the lowest MedAE when AL was <26.0 mm (0.30 D) and between 26.0 and 28.0 mm (0.54 D); in these subgroups, it had the highest percentages with a PE within ±0.50 D (71.4% and 46.2%). For AL between 28.0 and 30.0 mm, the Triple-S method showed the lowest MedAE (0.43 D) and highest percentage with a PE within ±0.50 D (58.3%). For AL ≥30.0 mm, the Shammas-PL formula produced the lowest MedAE (0.41 D) and highest percentage with a PE within ±0.50 D (58.3%). The Barrett True-K was the only formula with a correlation between AL and PE (r = -0.219/P = .023). CONCLUSIONS The predictive accuracy of no-history IOL formulas depends on the AL. The Barrett True-K had the highest accuracy when AL was < 28.0 mm and the Triple-S when it ranged from 28.0 mm to 30.0 mm, whereas the Shammas-PL was more accurate when AL was ≥30.0 mm.
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Predictability of intraocular lens power calculation after small-incision lenticule extraction for myopia. J Cataract Refract Surg 2021; 47:304-310. [PMID: 32932366 DOI: 10.1097/j.jcrs.0000000000000405] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 08/03/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate and compare the predictability of intraocular lens (IOL) power calculation after small-incision lenticule extraction (SMILE) for myopia and myopic astigmatism. SETTING Department of Ophthalmology, Philipps University of Marburg, Marburg, Germany. DESIGN Retrospective comparative case series. METHODS Preoperative evaluation included optical biometry using IOLMaster 500 and corneal tomography using Pentacam HR. The corneal tomography measurements were repeated at 3 months postoperatively. The change of spherical equivalent due to SMILE was calculated by the manifest refraction at corneal plane (SMILE-Dif). A theoretical model, involving the virtual implantation of the same IOL before and after SMILE, was used, and the IOL power calculations were performed using ray tracing (OKULIX, version 9.06) and third- (Hoffer Q, Holladay 1, and SRK/T) and fourth-generation (Haigis-L and Haigis) formulas. The difference between the IOL-induced refractive error at corneal plane before and after SMILE (IOL-Dif) was compared with SMILE-Dif. The prediction error (PE) was calculated as the difference between SMILE-Dif-IOL-Dif. RESULTS The study included 204 eyes that underwent SMILE. The PE with ray tracing was -0.06 ± 0.40 diopter (D); Haigis-L, -0.39 ± 0.62 D; Haigis, 0.70 ± 0.48 D; Hoffer Q, 0.84 ± 0.47 D; Holladay 1, 1.21 ± 0.51 D; and SRK/T, 1.46 ± 0.54 D. The PE with ray tracing was significantly smaller compared with that of all formulas (P ≤ .001). The PE variance with ray tracing was σ2 = 0.159, being significantly more homogenous compared with that of all formulas (P ≤ .011, F ≥ 6.549). Ray tracing resulted in an absolute PE of 0.5 D or lesser in 81.9% of the cases, followed by Haigis-L (53.4%), Haigis (35.3%), Hoffer Q (25.5%), Holladay 1 (6.4%), and SRK/T (2.9%) formulas. CONCLUSIONS Ray tracing was the most accurate approach for IOL power calculation after myopic SMILE.
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Color light-emitting diode reflection topography: Validation of Equivalent K Reading for IOL power calculation in eyes with previous corneal myopic refractive surgery. J Cataract Refract Surg 2021; 48:32-36. [PMID: 34074995 DOI: 10.1097/j.jcrs.0000000000000709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/26/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the accuracy of the Equivalent K reading (EKR) from Color Light-Emitting Diode Corneal Topographer (Cassini, iOptics) to that of other no-history formulas for intraocular lens (IOL) power calculation in eyes with previous myopic excimer laser surgery. SETTING Centro de Oftalmología Barraquer, Barcelona, Spain. DESIGN Retrospective case series. PATIENTS AND METHODS In 37 eyes, the refractive outcomes of the Cassini EKR entered into the Haigis formula were compared to those of the Barrett-True K, Haigis-L, Shammas-PL formulas and the Triple-S method combined with the Haigis formula. Optimized lens constants for virgin eyes were used. The mean prediction error (PE), median absolute error (MedAE) and the percentage of eyes with a PE within ±0.25 D, ±0.50 D, ±0.75 D and ±1.00 D were calculated. RESULTS The Haigis-L, Shammas-PL and Barrett True-K no-history methods produced a myopic mean PE that was significantly different from zero (p<0.01, p<0.01 and p=0.01, respectively), whereas the mean PEs of Cassini EKR and the Triple-S combined with the Haigis formula were not different from zero. Repeated measures ANOVA disclosed a significant difference among all methods (p<0.0001). The MedAE of the Cassini EKR, Barrett True-K, Haigis-L, Shammas-PL and Triple-S were, respectively, 0.34D, 0.34D, 0.49 D, 0.48 D and 0.31D (p=0.0026). CONCLUSIONS The performance of the combination of standard Haigis formula with Cassini EKR was comparable to other no-history formulas in eyes with previous myopic excimer laser surgery.
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Zhang J, Shao J, Zheng L, Shen Y, Zhao X. Comparative clinical accuracy analysis of the newly developed ZZ IOL and four existing IOL formulas for post-corneal refractive surgery eyes. BMC Ophthalmol 2021; 21:231. [PMID: 34034681 PMCID: PMC8146991 DOI: 10.1186/s12886-021-01991-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intraocular lens (IOL) calculation using traditional formulas for post-corneal refractive surgery eyes can yield inaccurate results. This study aimed to compare the clinical accuracy of the newly developed Zhang & Zheng (ZZ) formula with previously reported IOL formulas. STUDY DESIGN Retrospective study. METHODS Post-corneal refractive surgery eyes were assessed for IOL power using the ZZ, Haigis-L, Shammas, Barrett True-K (no history), and ray tracing (C.S.O Sirius) IOL formulas, and their accuracy was compared. No pre-refractive surgery information was used in the calculations. RESULTS This study included 38 eyes in 26 patients. ZZ IOL yielded a lower arithmetic IOL prediction error (PE) compared with ray tracing (P = 0.04), whereas the other formulas had values like that of ZZ IOL (P > 0.05). The arithmetic IOL PE for the ZZ IOL formula was not significantly different from zero (P = 0.96). ZZ IOL yielded a lower absolute IOL PE compared with Shammas (P < 0.01), Haigis-L (P = 0.02), Barrett true K (P = 0.03), and ray tracing (P < 0.01). The variance of the mean arithmetic IOL PE for ZZ IOL was significantly smaller than those of Shammas (P < 0.01), Haigis-L (P = 0.03), Barrett True K (P = 0.02), and ray tracing (P < 0.01). The percentages of eyes within ± 0.5 D of the target refraction with the ZZ IOL, Shammas, Haigis-L, Barrett True-K, and ray-tracing formulas were 86.8 %, 45.5 %, 66.7 %, 73.7 %, and 50.0 %, respectively (P < 0.05 for Shammas and ray tracing vs. ZZ IOL). CONCLUSIONS The ZZ IOL formula might offer superior outcomes for IOL power calculation for post-corneal refractive surgery eyes without prior refractive data.
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Affiliation(s)
- Jun Zhang
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Jie Shao
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Li Zheng
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Ye Shen
- Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
| | - Xia Zhao
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
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Panda BB, Thakur S, Mohapatra S, Parida S. Artificial intelligence in ophthalmology: A new era is beginning. Artif Intell Med Imaging 2021; 2:5-12. [DOI: 10.35711/aimi.v2.i1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/31/2020] [Accepted: 02/12/2021] [Indexed: 02/06/2023] Open
Abstract
The use of artificial intelligence (AI) in ophthalmology is not very new and its use is expanding into various subspecialties of the eye like retina and glaucoma, thereby helping ophthalmologists to diagnose and treat diseases better than before. Incorporating “deep learning” (a subfield of AI) into image-based systems such as optical coherence tomography has dramatically improved the machine's ability to screen and identify stages of diabetic retinopathy accurately. Similar applications have been tried in the field of retinopathy of prematurity and age-related macular degeneration, a silent retinal condition that needs to be diagnosed early to prevent progression. The advent of AI into glaucoma diagnostics in analyzing visual fields and assessing disease progression also holds a promising role. The ability of the software to detect even a subtle defect that the human eye can miss has led to a revolution in the management of certain ocular conditions. However, there are few significant challenges in the AI systems, such as the incorporation of quality images, training sets and the black box dilemma. Nevertheless, despite the existing differences, there is always a chance of improving the machines/software to potentiate their efficacy and standards. This review article shall discuss the current applications of AI in ophthalmology, significant challenges and the prospects as to how both science and medicine can work together.
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Affiliation(s)
- Bijnya Birajita Panda
- Department ofOphthalmology, S.C.B Medical College and Hospital, Cuttack 753007, Odisha, India
| | - Subhodeep Thakur
- Department ofOphthalmology, S.C.B Medical College and Hospital, Cuttack 753007, Odisha, India
| | - Sumita Mohapatra
- Department ofOphthalmology, S.C.B Medical College and Hospital, Cuttack 753007, Odisha, India
| | - Subhabrata Parida
- Department ofOphthalmology, S.C.B Medical College and Hospital, Cuttack 753007, Odisha, India
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Gjerdrum B, Gundersen KG, Lundmark PO, Aakre BM. Refractive Precision of Ray Tracing IOL Calculations Based on OCT Data versus Traditional IOL Calculation Formulas Based on Reflectometry in Patients with a History of Laser Vision Correction for Myopia. Clin Ophthalmol 2021; 15:845-857. [PMID: 33664562 PMCID: PMC7924114 DOI: 10.2147/opth.s298007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 01/28/2021] [Indexed: 02/06/2023] Open
Abstract
Purpose To compare the refractive predictability of ray tracing IOL calculations based on OCT data versus traditional IOL calculation formulas based on reflectometry in patients with a history of previous myopic laser vision correction (LVC). Patients and Methods This was a prospective interventional single-arm study of IOL calculations for cataract and refractive lens exchange (RLE) patients with a history of myopic LVC. Preoperative biometric data were collected using an optical low coherence reflectometry (OLCR) device (Haag-Streit Lenstar 900) and two optical coherence tomography (OCT) devices (Tomey Casia SS-1000 and Heidelberg Engineering Anterion). Traditional post LVC formulas (Barret True-K no-history and Haigis-L) with reflectometry data, and ray tracing IOL calculation software (OKULIX, Panopsis GmbH, Mainz, Germany) with OCT data were used to calculate IOL power. Follow-up examination was 2 to 3 months after surgery. The main outcome measure, refractive prediction error (RPE), was calculated as the achieved postoperative refraction minus the predicted refraction. Results We found that the best ray tracing combination (Anterion-OKULIX) resulted in an arithmetic prediction error statistically significantly lower than that achieved with the best formula calculation (Barret True-K no-history) (−0.13 D and −0.32 D, respectively, adjusted p = 0.01), while the Barret TK NH had the lowest SD. The absolute prediction error was 0.26 D and 0.35 D for Anterion-OKULIX and Barret TK NH, respectively, but this was not statistically significantly different. The Anterion-OKULIX calculation also had the highest percentage of eyes within ± 0.25, compared to both formulas and within ±0.50 and ±0.75 compared to the Haigis-L (p = 0.03). Conclusion Ray tracing calculation based on OCT data from the Anterion device can yield similar or better results than traditional post LVC formulas. Ray tracing calculations are based on individual measurements and do not rely on the ocular history of the patient and are therefore applicable for any patient, also without previous refractive surgery.
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Affiliation(s)
- Bjørn Gjerdrum
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway.,Ifocus Eye Clinic, Haugesund, Norway
| | | | - Per Olof Lundmark
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | - Bente Monica Aakre
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
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Total keratometry for determination of true corneal power after myopic small incision lenticule extraction. J Cataract Refract Surg 2021; 47:1285-1289. [PMID: 33769762 DOI: 10.1097/j.jcrs.0000000000000630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/21/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To gauge the value of total keratometry (TK) to estimate corneal power change in eyes that underwent SMILE for treatment of myopia or myopic astigmatism. SETTING Department of Ophthalmology, Ludwig-Maximilians-University and SMILE Eyes Clinic Munich Airport, Munich, Germany. DESIGN Prospective cross-sectional trial. METHODS A total of 40 eyes of 40 patients who had undergone myopic SMILE were enrolled in this prospective study. Total corneal refractive power (TCRP; Pentacam HR; Wetzlar, Germany) and TK (IOL Master 700; Carl Zeiss Meditec AG, Jena, Germany) values were compared to the clinical history method (CHM). The surgically induced changes in TCRP (ΔTCRP) and TK (ΔTK) were also compared to the changes in spherical equivalent on the corneal plane (ΔSEco). RESULTS The correlation between TK and CHM (R2=0.91, p<.001) was stronger than between TCRP and CHM (R2=0.87, p<.001). As compared with the CHM, TCRP underestimated corneal power by a mean relative error of 0.59 D and TK by 0.17 D. Linear regression analysis of ΔTCRP/ΔTK and the difference between preoperative and postoperative manifest refraction spherical equivalent at the corneal plane (Δ SEco) showed stronger correlation in ΔTK (R2=0.88), than in ΔTCRP (R2=0.82). CONCLUSIONS The findings endorse TK as an accurate measure for corneal power after myopic SMILE.
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Park SY, Kwag JY, Choi JS, Pak KH, Chung SK. Intraocular Lens Power Calculation Using Shammas-PL Formula after Laser In-situ Keratomileusis. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.2.201] [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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Pantanelli SM, Lin CC, Al-Mohtaseb Z, Rose-Nussbaumer JR, Santhiago MR, Steigleman WA, Schallhorn JM. Intraocular Lens Power Calculation in Eyes with Previous Excimer Laser Surgery for Myopia: A Report by the American Academy of Ophthalmology. Ophthalmology 2021; 128:781-792. [PMID: 33500124 DOI: 10.1016/j.ophtha.2020.10.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To review the literature to evaluate the outcomes of intraocular lens (IOL) power calculation in eyes with a history of myopic LASIK or photorefractive keratectomy (PRK). METHODS Literature searches were conducted in the PubMed database in January 2020. Separate searches relevant to cataract surgery outcomes and corneal refractive surgery returned 1169 and 162 relevant citations, respectively, and the full text of 24 was reviewed. Eleven studies met the inclusion criteria for this assessment; all were assigned a level III rating of evidence by the panel methodologist. RESULTS When automated keratometry was used with a theoretical formula designed for eyes without previous laser vision correction, the mean prediction error (MPE) was universally positive (hyperopic), the mean absolute errors (MAEs) and median absolute errors (MedAEs) were relatively high (0.72-1.9 diopters [D] and 0.65-1.73 D, respectively), and a low (8%-40%) proportion of eyes were within 0.5 D of target spherical equivalent (SE). Formulas developed specifically for this population requiring both prerefractive surgery keratometry and manifest refraction (i.e., clinical history, corneal bypass, and Feiz-Mannis) produced a proportion of eyes within 0.5 D of target SE between 26% and 44%. Formulas requiring only preoperative keratometry or no history at all had lower MAEs (0.42-0.94 D) and MedAEs (0.30-0.81 D) and higher (30%-68%) proportions within 0.5 D of target SE. Strategies that averaged several methods yielded the lowest reported MedAEs (0.31-0.35 D) and highest (66%-68%) proportions within 0.5 D of target SE. Even after using the best-known methods, refractive outcomes were less accurate in eyes that had previous excimer laser surgery for myopia compared with those that did not have it. CONCLUSIONS Calculation methods requiring both prerefractive surgery keratometry and manifest refraction are no longer considered the gold standard. Refractive outcomes of cataract surgery in eyes that had previous excimer laser surgery are less accurate than in eyes that did not. Patients should be advised of this refractive limitation when considering cataract surgery in the setting of previous corneal refractive surgery. Conclusions are limited by the small sample sizes and retrospective nature of nearly all existing literature in this domain.
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Affiliation(s)
| | - Charles C Lin
- Byers Eye Institute, Stanford University, Palo Alto, California
| | | | - Jennifer R Rose-Nussbaumer
- Division of Research Kaiser Permanente Northern California and Francis I Proctor Foundation University of California, San Francisco, California
| | | | | | - Julie M Schallhorn
- Francis I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco, California
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Savini G, Taroni L, Schiano-Lomoriello D, Hoffer KJ. Repeatability of total Keratometry and standard Keratometry by the IOLMaster 700 and comparison to total corneal astigmatism by Scheimpflug imaging. Eye (Lond) 2021; 35:307-315. [PMID: 33139878 PMCID: PMC7852681 DOI: 10.1038/s41433-020-01245-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/04/2020] [Accepted: 10/19/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES We aimed (1) to assess the repeatability of Total Keratometry (TK) and standard keratometry (K) measurements, as provided by the IOLMaster 700 (Carl Zeiss Meditec), and (2) to compare the corneal astigmatism measured by TK to the total corneal astigmatism (TCA) measured by a Scheimpflug camera (Pentacam AXL, Oculus). METHODS Two groups of patients were prospectively enrolled: Group A included previously unoperated eyes undergoing cataract surgery, and Group B eyes with previous myopic corneal excimer laser surgery. TK and K were measured three times by the same examiner. Repeatability was assessed based on the within-subject standard deviation (Sw), test-retest variability, coefficient of variation and intraclass correlation coefficient (ICC). In Group A, TCA was measured once and compared to TK astigmatism. Vector analysis was performed according to Næser. RESULTS In Group A (69 eyes) the mean K and TK were, respectively, 43.14 ± 1.37 D and 43.18 ± 1.37 D. In Group B (51 eyes) the mean K and TK were, respectively, 40.14 ± 2.20 D and 39.71 ± 2.35 D. The repeatability of the average K and TK was high (Sw < 0.10D). All measurements revealed an ICC > 0.9. For most measurements the variance of K and TK did not show any statistically significant difference either within groups or between groups. Vectors KP(45) were significantly different between TK astigmatism and TCA. CONCLUSIONS TK measurements offer high repeatability in unoperated and post-excimer laser surgery eyes. TK astigmatism and TCA measurements could not be considered interchangeable.
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Affiliation(s)
| | - Leonardo Taroni
- S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | | | - Kenneth J Hoffer
- Stein Eye Institute, University of California, Los Angeles, CA, USA
- St. Mary's Eye Center, Santa Monica, CA, USA
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Gjerdrum B, Gundersen KG, Lundmark PO, Aakre BM. Repeatability of OCT-Based versus Scheimpflug- and Reflection-Based Keratometry in Patients with Hyperosmolar and Normal Tear Film. Clin Ophthalmol 2020; 14:3991-4003. [PMID: 33239862 PMCID: PMC7680682 DOI: 10.2147/opth.s280868] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/13/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose To compare the repeatability of keratometry between different instruments in patients with hyperosmolar tear film and a control group. Patients and Methods Subjects with tear-film osmolarity of 316 mOsm/L or more in either eye or 308 m/Osm/L or lower in both eyes were assigned to the hyperosmolar and the control group, respectively. The test eye was the eye with higher osmolarity in the hyperosmolar group and randomly chosen in the control group. The repeatability of keratometry was compared between a reflectometry device (Haag-Streit Lenstar 900), a Scheimpflug device (Oculus Pentacam HR) and two optical coherence tomography (OCT) devices (Tomey Casia SS-1000 and Heidelberg Anterion), based on two measurements from each device. Results The study included 94 subjects (31 hyperosmolar and 63 controls). Both OCT devices had higher mean differences of average simulated keratometry (SimK) vs the Lenstar in both groups, though all differences in means were <0.07 D. The Casia had the highest mean vector difference of SimK astigmatism in the control group (differences in means <0.11 D). These differences of the instruments were statistically significant (p < 0.02), except for the Anterion in the control group. With all subjects, the coefficient of repeatability varied from 0.1 to 0.3 for average SimK (highest for both OCT devices) and from 0.4 to 0.7 for SimK astigmatism (highest for the Casia). Similar results were found for total corneal power (OCT devices compared to the Pentacam). Conclusion Both OCT devices show more variability in average SimK and the Casia more variability in SimK astigmatism compared to the Lenstar and the Pentacam. However, the results suggested that repeatability was not influenced by osmolarity.
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Affiliation(s)
- Bjørn Gjerdrum
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway.,Ifocus Eye Clinic, Haugesund, Norway
| | | | - Per Olof Lundmark
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | - Bente Monica Aakre
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
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Brenner LF, Gjerdrum B, Aakre BM, Lundmark PO, Nistad K. Presbyopic refractive lens exchange with trifocal intraocular lens implantation after corneal laser vision correction: Refractive results and biometry analysis. J Cataract Refract Surg 2020; 45:1404-1415. [PMID: 31564315 DOI: 10.1016/j.jcrs.2019.05.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 05/19/2019] [Accepted: 05/27/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the refractive and biometry results of presbyopic refractive lens exchange (RLE) with trifocal intraocular lens (IOL) implantation in eyes with previous myopic or hyperopic corneal laser vision correction (LVC). SETTINGS Memira AS, Norway, Sweden, and Denmark. DESIGN Retrospective case series. METHODS The refractive results included the manifest refraction spherical equivalent, uncorrected near (UNVA) and distance (UDVA) visual acuities, corrected distance visual acuity, safety, efficacy, and precision. The biometry analysis included the refractive prediction error (RPE), median absolute error (MedAE), and percentage of eyes within a certain RPE range for the formulas from the American Society of Cataract and Refractive Surgery (ASCRS) online calculator. RESULTS The study comprised 241 eyes. Six months postoperatively, 60.0% of eyes were within ±0.25 diopter (D), 80.9% within ±0.50 D, and 97.9% within ±1.00 D of emmetropia. There were no statistical differences in the mean monocular UDVA (0.87 ± 0.20 [SD]), safety index (0.98 ± 0.09), or efficacy index (0.81 ± 0.18) between the myopic ablation group and hyperopic ablation group. Binocularly, 85% of patients had simultaneous UDVA and UNVA of 0.9 or better and Jaeger 3, respectively. The ASCRS online calculator formulas gave different performances for previous myopic and hyperopic ablation profiles. Using optimized constants and nomogram for correcting the mean RPE improved the MedAE. CONCLUSIONS Presbyopic RLE was safe and effective in selected cases with a history of LVC. The use of optimized IOL constants and nomograms can improve the refractive precision of lens-based refractive surgery.
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Patel P, Ashena Z, Vasavada V, Vasavada SA, Vasavada V, Sudhalkar A, Nanavaty MA. Comparison of intraocular lens calculation methods after myopic laser-assisted in situ keratomileusis and radial keratotomy without prior refractive data. Br J Ophthalmol 2020; 106:47-53. [PMID: 33093154 DOI: 10.1136/bjophthalmol-2020-317681] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/22/2020] [Accepted: 10/03/2020] [Indexed: 11/03/2022]
Abstract
AIM To compare intraocular lens (IOL) calculation methods not requiring refraction data prior to myopic laser-assisted in situ keratomileusis (LASIK) and radial keratotomy (RK). METHODS In post-LASIK eyes, the methods not requiring prior refraction data were Hagis-L; Shammas; Barrett True-K no-history; Wang-Koch-Maloney; 'average', 'minimum' and 'maximum' IOL power on the American Society of Cataract and Refractive Surgeons (ASCRS) IOL calculator. Double-K method and Barrett True-K no-history, 'average', 'minimum' and 'maximum' IOL power on ASCRS IOL calculator were evaluated in post-RK eyes. The predicted IOL power was calculated with each method using the manifest postoperative refraction. Arithmetic and absolute IOL prediction errors (PE) (implanted-predicted IOL powers), variances in arithmetic IOL PE and percentage of eyes within ±0.50 and ±1.00 D of refractive PE were calculated. RESULTS Arithmetic or absolute IOL PE were not significantly different between the methods in post-LASIK and post-RK eyes. In post-LASIK eyes, 'average' showed the highest and 'minimum' showed the least variance, whereas 'average' and 'minimum' had highest percentage of eyes within ±0.5 D and 'minimum' had the highest percentage of eyes within ±1.0 D. In the post-RK eyes, 'minimum' had highest variance, and 'average' had the least variance and highest percentage of eyes within ±0.5 D and ±1.0 D. CONCLUSION In post-LASIK and post-RK eyes, there are no significant differences in IOL PE between the methods not requiring prior refraction data. 'Minimum' showed least variance in PEs and more chances of eyes to be within ±1.0 D postoperatively in post-LASIK eyes. 'Average' had least variance and more chance of eyes within ±1.0 D in post-RK eyes.
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Affiliation(s)
- Priyanka Patel
- Iladevi Cataract and IOL Research Center, Ahmedabad, India
| | - Zahra Ashena
- Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Viraj Vasavada
- Iladevi Cataract and IOL Research Center, Ahmedabad, India
| | | | | | | | - Mayank A Nanavaty
- Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK .,Brighton and Sussex Medical School, Brighton, BN1 9PX, United Kingdom
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Li QM, Wang F, Wu ZM, Liu Z, Zhan C, Chen BH, Sima J, Stieger K, Li SW. Trifocal diffractive intraocular lens implantation in patients after previous corneal refractive laser surgery for myopia. BMC Ophthalmol 2020; 20:293. [PMID: 32680481 PMCID: PMC7367255 DOI: 10.1186/s12886-020-01556-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/06/2020] [Indexed: 01/07/2023] Open
Abstract
Background With the difficulties in IOL power calculation and the potential side effects occurring postoperatively, multifocal IOL implantation after previous corneal refractive surgery are rarely reported especially for the trifocal IOL. Herein we report the clinical observation of trifocal IOL implantation in patients with previous myopia excimer laser correction. In this study, a multi-formula average method was performed for the IOLs power calculation to improve the accuracy. Visual and refractive outcomes were analyzed, and the subjective quality of patients’ life was evaluated by questionnaires survey. Methods This retrospective case series included patients with previous myopia excimer laser correction who underwent femtosecond laser assisted phacoemulsification and trifocal IOL (AT LISA tri 839 MP) implantation. Follow-up was done at 1-day, 1-month and 3-month to assess the visual outcomes. Outcome measures were uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA), manifest refraction, defocus curve, and subjective quality of vision. Results Twenty-one Eyes from sixteen patients (14 eyes with previous laser in situ keratomileusis and 7 eyes with previous photorefractive keratectomy) were included. Mean postoperative spherical equivalent (SE) at 3-month was − 0.56 D ± 0.49 SD, wherein, 10 eyes (47.6%) were within ±0.50 D of the desired emmetropia and 19 eyes (90.5%) were within ±1.0 D. Mean monocular UDVA, UIVA and UNVA (logMAR) at last visit were 0.02 ± 0.07, 0.10 ± 0.10, and 0.15 ± 0.11 respectively. Three patients (19%) reported halos and glare in postoperative 3 months, two of them needed to use spectacles to improve the intermediate visual acuity. Fifteen patients (94%) reported a satisfaction score of ≥3.5 out of 4.0, without any difficulty in daily activity. Thirteen patients (81%) did not need spectacles at all distances, while the other 3 patients (19%) used spectacles for near-distance related visual activity. Mean composite score of the VF-14 questionnaire was 95.00 ± 7.29 out of 100. Conclusions Trifocal IOL implantation after myopia excimer laser correction could restore good distance, intermediate visual acuity and acceptable near visual acuity, and provide accurate refractive outcomes as well as high spectacles independence rate.
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Affiliation(s)
- Qiu-Mei Li
- Beijing Aier-Intech Eye Hospital, Beijing, 100021, China
| | - Feng Wang
- Department of Ophthalmology, Aier School of Ophthalmology, Central South University, Changsha, 410083, China.,Department of Ophthalmology, Justus-Liebig-University, 35385, Giessen, Germany
| | - Zhe-Ming Wu
- Guangzhou Aier Eye Hospital, Guangzhou, 510260, China
| | - Zhen Liu
- Chongqing Aier Eye Hospital, Chongqing, 400020, China
| | - Chuan Zhan
- Wanzhou Aier Eye Hospital, Chongqing, 404000, China
| | | | - Jing Sima
- Shenzhen Aier Eye Hospital, Shenzhen, 518005, China
| | - Knut Stieger
- Department of Ophthalmology, Justus-Liebig-University, 35385, Giessen, Germany.
| | - Shao-Wei Li
- Beijing Aier-Intech Eye Hospital, Beijing, 100021, China. .,Department of Ophthalmology, Aier School of Ophthalmology, Central South University, Changsha, 410083, China.
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Wen D, Yu J, Zeng Z, McAlinden C, Hu L, Feng K, Wang Y, Song B, Chen S, Ning R, Jin Y, Wang Q, Yu AY, Huang J. Network Meta-analysis of No-History Methods to Calculate Intraocular Lens Power in Eyes With Previous Myopic Laser Refractive Surgery. J Refract Surg 2020; 36:481-490. [PMID: 32644171 DOI: 10.3928/1081597x-20200519-04] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/19/2020] [Indexed: 01/10/2024]
Abstract
PURPOSE To systematically compare and rank the predictability of no-history intraocular lens (IOL) power calculation methods after myopic laser refractive surgery. METHODS PubMed, Embase, the Cochrane Library, and the U.S. trial registry (www.ClinicalTrial.gov) were used to systematically search trials published up to August 2019. Included were case series studies reporting the following outcomes in patients with cataract undergoing phacoemulsification after laser refractive surgery: percentage of eyes with a refractive prediction error (PE) within ±0.50 and ±1.00 diopters (D), mean absolute error (MAE), and median absolute error (MedAE). A network meta-analysis was conducted using the STATA software version 13.1 (STATACorp LLC). RESULTS Nineteen studies involving 1,098 eyes and 19 formulas were identified. A network meta-analysis for the percentage of eyes with a PE within ±0.50 D found that ray-tracing (Okulix), intraoperative aberrometry (Optiwave Refractive Analysis [ORA]), BESSt, and Seitz/Speicher/Savini (Triple-S) (D-K SRK/T), and Fourier-Domain OCT-Based formulas were more predictive than the Wang/Koch/Maloney, Shammas-PL, modified Rosa, Ferrara, and Equivalent K reading at 4.5 mm using the Double-K Holladay 1 formulas. With regard to ranking, the top four formulas as per the surface under the cumulative ranking curve (SUCRA) values for the percentage of eyes with a PE within ±0.50 D were the Okulix, ORA, BESSt, and Triple-S (D-K SRK/T). With regard to MAE, the ORA showed lower errors when compared to the Shammas-PL formula. In this regard, the top four formulas based on the SUCRA values were the Triple-S, BESSt, ORA, and Fourier-Domain OCT-Based formulas. The SToP (SRK/T), ORA, Fourier-Domain OCT-Based, and BESSt formulas had the lowest MedAE. CONCLUSIONS Considering all three outcome measures of highest percentages of eyes with a PE within ±0.50 and ±1.00 D, lowest MAE, and lowest MedAE, the top three no-history formulas for IOL power calculation in eyes with previous myopic corneal laser refractive surgery were: ORA, BESSt, and Triple-S (D-K SRK/T). [J Refract Surg. 2020;36(7):481-490.].
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Accuracy of intraocular lens power calculation formulae after laser refractive surgery in myopic eyes: a meta-analysis. EYE AND VISION 2020; 7:37. [PMID: 32656291 PMCID: PMC7339492 DOI: 10.1186/s40662-020-00188-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 04/06/2020] [Indexed: 12/13/2022]
Abstract
Background To compare the accuracy of intraocular lens power calculation formulae after laser refractive surgery in myopic eyes. Methods We searched the databases on PubMed, EMBASE, Web of Science and the Cochrane library to select relevant studies published between Jan 1st, 2009 and Aug 11th, 2019. Primary outcomes were the percentages of refractive prediction error within ±0.5 D and ±1.0 D. Results The final meta-analysis included 16 studies using seven common methods (ASCRS average, Barrett True-K no history, Double-K SRK/T, Haigis-L, OCT formula, Shammas-PL, and Wang-Koch-Maloney). ASCRS average yielded significantly higher percentage of refractive prediction error within ±0.5 D than Haigis-L, Shammas-PL and Wang-Koch-Maloney (P = 0.009, 0.01, 0.008, respectively). Barrett True-K no history also yielded significantly higher percentage of refractive prediction error within ±0.5 D than Shammas-PL and Wang-Koch-Maloney (P = 0.01, P < 0.0001, respectively), and a similar result was found when comparing OCT formula with Haigis-L and Shammas-PL (P = 0.03, P = 0.01, respectively). Conclusion The ASCRS average or Barrett True-K no history should be used to calculate the intraocular lens power in eyes after myopic laser refractive surgery. The OCT formula if available, can also be a good alternative choice.
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Lawless M, Jiang JY, Hodge C, Sutton G, Roberts TV, Barrett G. Total keratometry in intraocular lens power calculations in eyes with previous laser refractive surgery. Clin Exp Ophthalmol 2020; 48:749-756. [PMID: 32279436 DOI: 10.1111/ceo.13760] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/15/2020] [Accepted: 04/04/2020] [Indexed: 11/30/2022]
Abstract
IMPORTANCE Intraocular lens (IOL) calculations in post-refractive cases remain a concern. Our study identifies improved options for surgeons. BACKGROUND To evaluate and compare the prediction accuracy of IOL power calculation methods after previous laser refractive surgery using standard keratometry (SK), measured posterior corneal astigmatism (PCA) and total keratometry (TK). DESIGN Retrospective consecutive cohort. PARTICIPANTS A total of 50 consecutive patients (72 eyes) at a private institution who underwent cataract surgery with prior laser refractive procedures. METHODS Methods using SK included ASCRS mean, Barrett True-K no history, Haigis-L and Shammas IOL formulae. Barrett True-K using posterior values (True K TK), Haigis and Holladay 1 Double-K methods using TK were also assessed. Post-surgery refraction was undertaken at minimum 3 weeks following surgery. MAIN OUTCOME MEASURES Arithmetic and absolute IOL refractive prediction errors, variances in mean arithmetic IOL prediction error, and percentage of eyes within ±0.25D, ±0.50D, ±0.75D and ±1.00D of refractive prediction errors were compared. RESULTS The Barrett True-K (TK) provided the lowest mean refractive prediction error (RPE) and variance for both prior myopes and hyperopes undergoing cataract surgery. The Barrett True-K (TK) exhibited the highest percentages of eyes within ±0.50D, ±0.75D and ±1.00D of the RPE compared to other formulae for prior myopic patients. CONCLUSIONS AND RELEVANCE Accuracy of IOL power calculations in post-laser eyes can be improved by the addition of posterior corneal values as measured by the IOLMaster 700. The use of total keratometry may supplement outcomes when no prior refraction history is known.
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Affiliation(s)
- Michael Lawless
- Vision Eye Institute Chatswood, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - James Y Jiang
- Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Chris Hodge
- Vision Eye Institute Chatswood, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Gerard Sutton
- Vision Eye Institute Chatswood, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Timothy V Roberts
- Vision Eye Institute Chatswood, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Graham Barrett
- Lions Eye Institute, Perth, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Western Australia, Australia.,Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
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Luft N, Siedlecki J, Schworm B, Kreutzer TC, Mayer WJ, Priglinger SG, Dirisamer M. Intraocular Lens Power Calculation after Small Incision Lenticule Extraction. Sci Rep 2020; 10:5982. [PMID: 32249851 PMCID: PMC7136233 DOI: 10.1038/s41598-020-63118-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/14/2020] [Indexed: 11/09/2022] Open
Abstract
With more than 1.5 million Small Incision Lenticule Extraction (SMILE) procedures having already been performed worldwide in an ageing population, intraocular lens (IOL) power calculation in post-SMILE eyes will inevitably become a common challenge for ophthalmologists. Since no refractive outcomes of cataract surgery following SMILE have been published, there is a lack of empirical data for optimizing IOL power calculation. Using the ray tracing as the standard of reference - a purely physical method that obviates the need for any empirical optimization - we analyzed the agreement of various IOL power calculation formulas derived from the American Society of Cataract and Refractive Surgeons (ASCRS) post-keratorefractive surgery online calculator. In our study of 88 post-SMILE eyes, the Masket formula showed the smallest mean prediction error [-0.36 ± 0.32 diopters (D)] and median absolute error (0.33D) and yielded the largest percentage of eyes within ±0.50D (70%) in reference to ray tracing. Non-inferior refractive prediction errors and ±0.50D accuracies were achieved by the Barrett True K, Barrett True K No History and the Potvin-Hill formula. Use of these formulas in conjunction with ray tracing is recommended until sufficient data for empirical optimization of IOL power calculation after SMILE is available.
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Affiliation(s)
- Nikolaus Luft
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany. .,SMILE Eyes Clinic, Linz, Austria.
| | - Jakob Siedlecki
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany.,SMILE Eyes Clinic, Linz, Austria
| | - Benedikt Schworm
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany.,SMILE Eyes Clinic, Linz, Austria
| | - Thomas C Kreutzer
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Wolfgang J Mayer
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Siegfried G Priglinger
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany.,SMILE Eyes Clinic, Linz, Austria
| | - Martin Dirisamer
- University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany.,SMILE Eyes Clinic, Linz, Austria
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Goh JHL, Lim ZW, Fang X, Anees A, Nusinovici S, Rim TH, Cheng CY, Tham YC. Artificial Intelligence for Cataract Detection and Management. Asia Pac J Ophthalmol (Phila) 2020; 9:88-95. [PMID: 32349116 DOI: 10.1097/01.apo.0000656988.16221.04] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The rising popularity of artificial intelligence (AI) in ophthalmology is fuelled by the ever-increasing clinical "big data" that can be used for algorithm development. Cataract is one of the leading causes of visual impairment worldwide. However, compared with other major age-related eye diseases, such as diabetic retinopathy, age-related macular degeneration, and glaucoma, AI development in the domain of cataract is still relatively underexplored. In this regard, several previous studies explored algorithms for automated cataract assessment using either slit lamp of color fundus photographs. However, several other study groups proposed or derived new AI-based calculation for pre-cataract surgery intraocular lens power. Along with advancements in digitization of clinical data, data curation for future cataract-related AI developmental work is bound to undergo significant improvements in the foreseeable future. Even though most of these previous studies reported early promising performances, limitations such as lack of robust, high-quality training data, and lack of external validations remain. In the next phase of work, apart from algorithm's performance, it will also be pertinent to evaluate deployment angles, feasibility, efficiency, and cost-effectiveness of these new cataract-related AI systems.
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Affiliation(s)
- Jocelyn Hui Lin Goh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- School of Chemical and Biomedical Engineering, Division of Bioengineering, Nanyang Technological University, Singapore
| | - Zhi Wei Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Xiaoling Fang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology, Shanghai Eye Disease Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Ayesha Anees
- Institute of High Performance Computing, A∗STAR, Singapore
| | - Simon Nusinovici
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tyler Hyungtaek Rim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
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Hamill EB, Wang L, Chopra HK, Hill W, Koch DD. Intraocular lens power calculations in eyes with previous hyperopic laser in situ keratomileusis or photorefractive keratectomy. J Cataract Refract Surg 2019; 43:189-194. [PMID: 28366365 DOI: 10.1016/j.jcrs.2016.11.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 10/30/2016] [Accepted: 11/07/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the accuracy of 7 intraocular lens (IOL) calculation formulas in patients with previous hyperopic laser in situ keratomileusis (LASIK) or excimer laser photorefractive keratectomy (PRK). DESIGN Retrospective case series. SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, and private practice, Mesa, Arizona, USA. METHODS The 7 formulas evaluated were the adjusted Atlas 0-3, Masket, Modified Masket, Haigis-L, Shammas-PL, Barrett True-K, and Barrett True-K No-History. The Masket and Modified Masket were calculated using the single-K version of Holladay 1 and Hoffer Q formulas; the adjusted Atlas 0-3 was calculated using the double-K version of Holladay 1 and Hoffer Q. The IOL power predicted by each formula was calculated by targeting the postoperative manifest refraction. The IOL prediction error was obtained by subtracting the predicted IOL power from the implanted IOL power. The mean IOL prediction error, median absolute refractive prediction error, and percentages of eyes within ±0.50 diopter (D) and ±1.00 D of the predicted refraction were calculated. RESULTS Twenty-one eyes of 21 patients were evaluated. There were no significant differences in the median absolute refractive prediction error or percentages of eyes within ±0.50 D or ±1.00 D of the predicted refraction between formulas or methods. The IOL mean prediction errors were comparable between the Holladay 1 and Hoffer Q calculations for all formulas except for a greater error for the double-K version of the Hoffer Q of the adjusted Atlas 0-3. CONCLUSION In eyes that had hyperopic LASIK or PRK, there were no significant differences in the accuracy between the 7 IOL calculation formulas.
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Affiliation(s)
- Eric B Hamill
- From the Cullen Eye Institute (Hamill, Wang, Chopra, Hill, Koch), Baylor College of Medicine, Houston, Texas, and East Valley Ophthalmology (Hill), Mesa, Arizona, USA; Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Li Wang
- From the Cullen Eye Institute (Hamill, Wang, Chopra, Hill, Koch), Baylor College of Medicine, Houston, Texas, and East Valley Ophthalmology (Hill), Mesa, Arizona, USA; Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Hayley K Chopra
- From the Cullen Eye Institute (Hamill, Wang, Chopra, Hill, Koch), Baylor College of Medicine, Houston, Texas, and East Valley Ophthalmology (Hill), Mesa, Arizona, USA; Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Warren Hill
- From the Cullen Eye Institute (Hamill, Wang, Chopra, Hill, Koch), Baylor College of Medicine, Houston, Texas, and East Valley Ophthalmology (Hill), Mesa, Arizona, USA; Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Douglas D Koch
- From the Cullen Eye Institute (Hamill, Wang, Chopra, Hill, Koch), Baylor College of Medicine, Houston, Texas, and East Valley Ophthalmology (Hill), Mesa, Arizona, USA; Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China.
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ASCRS calculator formula accuracy in multifocal intraocular lens implantation in hyperopic corneal refractive laser surgery eyes. J Cataract Refract Surg 2019; 45:582-586. [DOI: 10.1016/j.jcrs.2018.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 11/25/2018] [Accepted: 12/04/2018] [Indexed: 11/18/2022]
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Savini G, Abbate R, Hoffer KJ, Mularoni A, Imburgia A, Avoni L, D’Eliseo D, Schiano-Lomoriello D. Intraocular lens power calculation in eyes with keratoconus. J Cataract Refract Surg 2019; 45:576-581. [DOI: 10.1016/j.jcrs.2018.11.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/16/2018] [Accepted: 11/22/2018] [Indexed: 11/25/2022]
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Hua Y, Pan C, Wang Q. Assessment of total corneal power after myopic corneal refractive surgery in Chinese eyes. Int Ophthalmol 2019; 39:2467-2475. [PMID: 30825050 DOI: 10.1007/s10792-019-01089-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 02/23/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To develop a new regression formula based on the Gaussian thick lens formula and to verify the accuracy of the regression formula. METHODS In this prospective study, 207 eyes of 207 myopic subjects and 133 eyes of 67 postoperative subjects were included. For the 133 postoperative eyes, 127 eyes underwent laser-assisted in situ keratomileusis, and 6 eyes underwent photorefractive keratectomy. Subjective refraction and Pentacam HR were performed preoperatively and postoperatively, and IOLMaster was performed in the postoperative group. SimK, keratometry based on the Gaussian optic formula (KGOF), KCHM obtained using the clinical history method, and the regression formulas KRF1 and KRF2 were calculated. RESULTS (1) A statistically significant difference (t = 155.164, P = 0.000) between SimK and KGOF of 1.24 ± 0.12 D was observed, and there was a good correlation between SimK and KGOF (r = 0.996, P = 0.000). The first regression formula (KRF1 = 0.351 + 1.021 × KGOF) was obtained using linear regression. (2) Statistically significant differences (t = 19.114, - 25.184, 4.702, and all P = 0.000) between SimK and KCHM, KGOF and KCHM and KRF1 and KCHM of 0.75 ± 0.45 D, 0.96 ± 0.44 D and 0.18 ± 0.43 D, respectively, were obtained. Good correlations between SimK and KCHM, KGOF and KCHM and KRF1 and KCHM (all r ≧ 0.977, all Ps = 0.000) were also observed. The regression formula (KRF2 = - 1.204 + 1.027 × KRF1) was obtained using linear regression. (3) Six methods were used for the prediction of IOL power in the postoperative group. The highest results were obtained from the Shammas formula (without preoperative data) combining Km (obtained by IOLMaster) followed by the KCHM and KRF2 combining Haigis formula. The third was obtained from the KCHM and KRF2 combining Hoffer Q formula; and the smallest was the Km combining Haigis formula. CONCLUSION The IOL power predicted by KRF2 in eyes after myopic CRS may be accurate.
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Affiliation(s)
- Yanjun Hua
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yishan Road, Xuhui District, Shanghai, 200233, China.
| | | | - Qinmei Wang
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, 325000, China.
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Cho K, Lim DH, Yang CM, Chung ES, Chung TY. Comparison of Intraocular Lens Power Calculation Methods Following Myopic Laser Refractive Surgery: New Options Using a Rotating Scheimpflug Camera. KOREAN JOURNAL OF OPHTHALMOLOGY 2019; 32:497-505. [PMID: 30549474 PMCID: PMC6288016 DOI: 10.3341/kjo.2018.0008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/10/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate and compare published methods of calculating intraocular lens (IOL) power following myopic laser refractive surgery. Methods We performed a retrospective review of the medical records of 69 patients (69 eyes) who had undergone myopic laser refractive surgery previously and subsequently underwent cataract surgery at Samsung Medical Center in Seoul, South Korea from January 2010 to June 2016. None of the patients had pre-refractive surgery biometric data available. The Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug total corneal refractive power (TCRP) 3 and 4 mm (SRK-T and Haigis), Scheimpflug true net power, and Scheimpflug true refractive power (TRP) 3 mm, 4 mm, and 5 mm (SRK-T and Haigis) methods were employed. IOL power required for target refraction was back-calculated using stable post-cataract surgery manifest refraction, and implanted IOL power and formula accuracy were subsequently compared among calculation methods. Results Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug TCRP 4 mm (Haigis), Scheimpflug true net power 4 mm (Haigis), and Scheimpflug TRP 4 mm (Haigis) formulae showed high predictability, with mean arithmetic prediction errors and standard deviations of −0.25 ± 0.59, −0.05 ± 1.19, 0.00 ± 0.88, −0.26 ± 1.17, 0.00 ± 1.09, −0.71 ± 1.20, and 0.03 ± 1.25 diopters, respectively. Conclusions Visual outcomes within 1.0 diopter of target refraction were achieved in 85% of eyes using the calculation methods listed above. Haigis-L, Barrett True-K (no history), and Scheimpflug TCRP 4 mm (Haigis) and TRP 4 mm (Haigis) methods showed comparably low prediction errors, despite the absence of historical patient information.
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Affiliation(s)
- Kyuyeon Cho
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chan Min Yang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Tae Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Vrijman V, Abulafia A, van der Linden JW, van der Meulen IJ, Mourits MP, Lapid-Gortzak R. Evaluation of Different IOL Calculation Formulas of the ASCRS Calculator in Eyes After Corneal Refractive Laser Surgery for Myopia With Multifocal IOL Implantation. J Refract Surg 2019; 35:54-59. [DOI: 10.3928/1081597x-20181119-01] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 11/26/2018] [Indexed: 11/20/2022]
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Comparison of Different Corneal Power Readings From Pentacam in Post-laser In Situ Keratomileusis Eyes. Eye Contact Lens 2018; 44 Suppl 2:S370-S375. [PMID: 29944499 DOI: 10.1097/icl.0000000000000503] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare the various Pentacam-measured K-readings with the clinical history method (CHM) in eyes that have undergone myopic laser in situ keratomileusis (LASIK). METHODS In this prospective study, Pentacam examination was performed in 71 eyes 1 month after myopic LASIK. The true net power (TNP) 4 mm, total corneal refractive power (TCRP) 4 mm, equivalent K-reading (EKR) 4.0 mm, and EKR 4.5 mm obtained from the same scan were compared with the K derived from CHM. RESULTS The average baseline spherical equivalence was -5.44±2.38 D. After LASIK, the mean KCHM was 37.67±2.13 D, TCRP4mm was 37.14±1.79 D, TNP4mm was 36.88±1.76 D, EKR4.0mm was 37.58±1.94 D, and EKR4.5mm was 37.51±1.94 D. TCRP4mm, TNP4mm, and EKR4.5mm showed a statistically significant deviation from the KCHM, with the mean error being 0.53 D, 0.79 D, and 0.16 D, respectively (P<0.05). Only the EKR4.0mm showed no statistically significant difference from the KCHM (mean error 0.09 D, P=0.23). The EKR4.0mm also had the narrowest 95% limits of agreement (LoA) (-1.10 to +1.28 D), whereas both TCRP4mm and TNP4mm had a wider LoA (-0.88 to +1.95 D and -0.62 to +2.20 D, respectively). All four Pentacam K-readings had a strong and statistically significant correlation with the KCHM. CONCLUSIONS Using the CHM as reference, the EKR4.0mm demonstrated the closest agreement when compared with the EKR4.5mm, TNP4mm, and TCRP4mm obtained from the same scan.
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Lanza M, Koprowski R, Bifani Sconocchia M. Improving accuracy of corneal power measurement with partial coherence interferometry after corneal refractive surgery using a multivariate polynomial approach. Biomed Eng Online 2018; 17:108. [PMID: 30103748 PMCID: PMC6090680 DOI: 10.1186/s12938-018-0542-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/09/2018] [Indexed: 11/16/2022] Open
Abstract
Background To improve accuracy of IOLMaster (Carl Zeiss, Jena, Germany) in corneal power measurement after myopic excimer corneal refractive surgery (MECRS) using multivariate polynomial analysis (MPA). Methods One eye of each of 403 patients (mean age 31.53 ± 8.47 years) was subjected to MECRS for a myopic defect, measured as spherical equivalent, ranging from − 9.50 to − 1 D (mean − 4.55 ± 2.20 D). Each patient underwent a complete eye examination and IOLMaster scan before surgery and at 1, 3 and 6 months follow up. Axial length (AL), flatter keratometry value (K1), steeper keratometry value (K2), mean keratometry value (KM) and anterior chamber depth measured from the corneal endothelium to the anterior surface of the lens (ACD) were used in a MPA to devise a method to improve accuracy of KM measurements. Results Using AL, K1, K2 and ACD measured after surgery in polynomial degree 2 analysis, mean error of corneal power evaluation after MECRS was + 0.16 ± 0.19 D. Conclusions MPA was found to be an effective tool in devising a method to improve precision in corneal power evaluation in eyes previously subjected to MECRS, according to our results.
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Affiliation(s)
- Michele Lanza
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Campania University "Luigi Vanvitelli", Via de Crecchio 16, 80100, Naples, Italy.
| | - Robert Koprowski
- Department of Biomedical Computer Systems, Faculty of Computer Science and Materials Science, Institute of Computer Science, University of Silesia, Sosnowiec, Poland
| | - Mario Bifani Sconocchia
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Campania University "Luigi Vanvitelli", Via de Crecchio 16, 80100, Naples, Italy
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Savini G, Hoffer KJ. Intraocular lens power calculation in eyes with previous corneal refractive surgery. EYE AND VISION 2018; 5:18. [PMID: 30038922 PMCID: PMC6053834 DOI: 10.1186/s40662-018-0110-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 06/22/2018] [Indexed: 01/14/2023]
Abstract
Background This review aims to explain the reasons why intraocular lens (IOL) power calculation is challenging in eyes with previous corneal refractive surgery and what solutions are currently available to obtain more accurate results. Review After IOL implantation in eyes with previous LASIK, PRK or RK, a refractive surprise can occur because i) the altered ratio between the anterior and posterior corneal surface makes the keratometric index invalid; ii) the corneal curvature radius is measured out of the optical zone; and iii) the effective lens position is erroneously predicted if such a prediction is based on the post-refractive surgery corneal curvature. Different methods are currently available to obtain the best refractive outcomes in these eyes, even when the perioperative data (i.e. preoperative corneal power and surgically induced refractive change) are not known. In this review, we describe the most accurate methods based on our clinical studies. Conclusions IOL power calculation after myopic corneal refractive surgery can be calculated with a variety of methods that lead to relatively accurate outcomes, with 60 to 70% of eyes showing a prediction error within 0.50 diopters.
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Affiliation(s)
| | - Kenneth J Hoffer
- 2Stein Eye Institute, University of California, Los Angeles, CA USA.,St. Mary's Eye Center, Santa Monica, CA USA
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Calculation of Unknown Preoperative K Readings in Postrefractive Surgery Patients. J Ophthalmol 2018; 2018:3120941. [PMID: 29607215 PMCID: PMC5828239 DOI: 10.1155/2018/3120941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 12/20/2017] [Indexed: 11/17/2022] Open
Abstract
Purpose To determine the unknown preoperative K readings (Kpre) to be used in history-based methods, for intraocular lens (IOL) power calculation in patients who have undergone myopic photorefractive keratectomy (PRK). Methods A regression formula generated from the left eyes of 174 patients who had undergone PRK for myopia or for myopic astigmatism was compared with other methods in 168 right eyes. The Pearson index and paired t-test were utilized for statistical analysis. Results The differences between Kpre and those obtained with the other methods were as follows: 0.61 ± 0.94 D (range: −3.94 to 2.05 D, p < 0.01) subtracting the effective treatment, 0.01 ± 0.86 D (range: −2.61 to 2.34 D, p = 0.82) with Rosa's formula, −0.02 ± 1.31 D (range: −3.43 to 3.68 D, p = 0.82) with the current study formula, and −0.43 ± 1.40 D (range: −3.98 to 3.12 D, p < 0.01) utilizing a mean K (Km) of 43.5 D. Conclusions These formulas may permit the utilization of history-based methods, that is, the double-K method in calculating the IOL power following PRK when Kpre are unknown.
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Vrijman V, van der Linden JW, van der Meulen IJ, Mourits MP, Lapid-Gortzak R. Multifocal intraocular lens implantation after previous hyperopic corneal refractive laser surgery. J Cataract Refract Surg 2018; 44:466-470. [DOI: 10.1016/j.jcrs.2018.01.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 01/01/2018] [Accepted: 01/31/2018] [Indexed: 10/17/2022]
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Jung S, Jung J. Comparison of Intraocular Lens Power Calculation Methods after Refractive Surgery Provided by the ASCRS. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.9.827] [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]
Affiliation(s)
- Soyeon Jung
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
| | - Jiwon Jung
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
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Wei P, Wang Y, Chan TC, Ng AL, Cheng GP, Jhanji V. Determining total corneal power after small-incision lenticule extraction in myopic eyes. J Cataract Refract Surg 2017; 43:1450-1457. [DOI: 10.1016/j.jcrs.2017.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 08/10/2017] [Accepted: 08/13/2017] [Indexed: 10/18/2022]
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