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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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Debellemanière G, Mechleb N, Bernier T, Ancel JM, Gauvin M, Wallerstein A, Saad A, Gatinel D. The Development of a Thick-Lens Post-Myopic Laser Vision Correction Intraocular Lens Calculation Formula. Am J Ophthalmol 2024; 262:40-47. [PMID: 37865388 DOI: 10.1016/j.ajo.2023.09.023] [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: 07/21/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE To describe the development of the post-myopic laser vision correction (LVC) version of the PEARL-DGS intraocular lens (IOL) calculation formula and to evaluate its outcomes on an independent test set. DESIGN Retrospective, single-center case series. METHODS A modified lens position prediction algorithm was designed along with methods to predict the posterior corneal curvature radius and correct the corneal power measurement error. A different set of previously operated eyes that underwent LVC was used to evaluate the prediction precision of the post-LVC formula. RESULTS Post-LVC PEARL-DGS formula significantly reduced mean absolute error of prediction in comparison to Haigis-L, Shammas, and American Society of Cataract and Refractive Surgery (ASCRS) average formulas (P < .001). It exhibited similar postoperative refractive precision as the Barrett True-K No History formula (P = .61). CONCLUSION The post-LVC formula development process described in this article performed as well as the state-of-the-art post-LVC formula on the present test set. Further studies are required to assess its efficacy in other independent sets.
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Affiliation(s)
- Guillaume Debellemanière
- Department of Ophthalmology, Rothschild Foundation Hospital (G.D., N.M., A.S., D.G.), Paris, France
| | - Nicole Mechleb
- Department of Ophthalmology, Rothschild Foundation Hospital (G.D., N.M., A.S., D.G.), Paris, France
| | - Timothée Bernier
- Clinique Ophtalmologique Lamartine (T.B., J.-M.A.), Paris, France
| | - Jean-Marc Ancel
- Clinique Ophtalmologique Lamartine (T.B., J.-M.A.), Paris, France
| | - Mathieu Gauvin
- Department of Ophthalmology and Visual Sciences, McGill University (M.G., A.W.), Montreal, Quebec, Canada; LASIK MD (M.G., A.W.), Montreal, Quebec, Canada
| | - Avi Wallerstein
- Department of Ophthalmology and Visual Sciences, McGill University (M.G., A.W.), Montreal, Quebec, Canada; LASIK MD (M.G., A.W.), Montreal, Quebec, Canada
| | - Alain Saad
- Department of Ophthalmology, Rothschild Foundation Hospital (G.D., N.M., A.S., D.G.), Paris, France
| | - Damien Gatinel
- Department of Ophthalmology, Rothschild Foundation Hospital (G.D., N.M., A.S., D.G.), Paris, France.
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Zollet P, Romeo MA, Tripepi D, Vinciguerra P, Vinciguerra R. Camellin-Calossi Formula for Intraocular Lens Power Calculation in Patients With Previous Myopic Laser Vision Correction. J Refract Surg 2024; 40:e156-e163. [PMID: 38466761 DOI: 10.3928/1081597x-20240208-02] [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: 03/13/2024]
Abstract
PURPOSE To assess the performance of the Camellin-Calossi formula in eyes with prior myopic laser vision correction. METHODS This was a retrospective case series. Patients included had a history of uncomplicated myopic laser vision correction and cataract surgery. The primary outcome measures were cumulative distribution of absolute refractive prediction error, absolute refractive prediction error, and refractive prediction error. These parameters were estimated post-hoc using the Camellin-Calossi, Shammas, Haigis-L, Barrett True-K with or without history, Masket, and Modified Masket formulas and their averages starting from biometric data, clinical records, postoperative refraction, and intraocular lens power implanted. RESULTS Seventy-seven eyes from 77 patients were included. The Camellin-Calossi, Shammas, Haigis-L, Barrett True-K No History, Masket, Modified Masket, and Barrett True-K formulas showed a median absolute refractive error (interquartile range) of 0.25 (0.53), 0.51 (0.56), 0.44 (0.65), 0.45 (0.59), 0.40 (0.61), 0.60 (0.70), and 0.55 (0.76), respectively. The proportion of eyes with an absolute refractive error of ±0.25, 0.50, 0.75, 1.00, 1.50, and 2.00 diopters (D) for the Camellin-Calossi formula was 54.5%, 72.7%, 85.7%, 92.2%, 98.7%, and 100%, respectively. The cumulative distribution of the Camellin-Calossi formula showed the best qualitative performances when compared to the others. A statistically significant difference was identified with all of the others except the Haigis-L using a threshold of 0.25, with the Shammas, Modified Masket, and Barrett True-K at a threshold of 0.50 D and the Barrett True-K and Modified Masket at a threshold of 1.00 D. CONCLUSIONS The Camellin-Calossi formula is a valid option for intraocular lens power calculation in eyes with prior myopic laser vision correction. [J Refract Surg. 2024;40(3):e156-e163.].
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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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Li L, Yuan L, Yang K, Wu Y, Alafati S, Hua X, Wang Y, Yuan X. Comparison of the accuracy of 9 intraocular lens power calculation formulas after SMILE in Chinese myopic eyes. Sci Rep 2023; 13:20539. [PMID: 37996736 PMCID: PMC10667341 DOI: 10.1038/s41598-023-47990-0] [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: 06/19/2023] [Accepted: 11/21/2023] [Indexed: 11/25/2023] Open
Abstract
As of 2021, over 2.8 million small-incision lenticule extraction (SMILE) procedures have been performed in China. However, knowledge regarding the selection of intraocular lens (IOL) power calculation formula for post-SMILE cataract patients remains limited. This study included 52 eyes of 26 myopic patients from northern China who underwent SMILE at Tianjin Eye Hospital from September 2022 to February 2023 to investigate the suitability of multiple IOL calculation formulas in post-SMILE patients using a theoretical surgical model. We compared the postoperative results obtained from three artificial intelligence (AI)-based formulas and six conventional formulas provided by the American Society of Cataract and Refractive Surgery (ASCRS). These formulas were applied to calculate IOL power using both total keratometry (TK) and keratometry (K) values, and the results were compared to the preoperative results obtained from the Barrett Universal II (BUII) formula for the SMILE patients. Among the evaluated formulas, the results obtained from the Emmetropia Verifying Optical 2.0 Formula with TK (EVO-TK) (0.40 ± 0.29 D, range 0-1.23 D), Barrett True K with K formula (BTK-K, 0.41 ± 0.26 D, range 0.01-1.19 D), and Masket with K formula (Masket-K, 0.44 ± 0.33 D, range 0.02-1.39 D) demonstrated the closest proximity to BUII. Notably, the highest proportion of prediction errors within 0.5 D was observed with the BTK-K (71.15%), EVO-TK (69.23%), and Masket-K (67.31%), with the BTK-K showing a significantly higher proportion than the Masket-K (p < 0.001). Our research indicates that in post-SMILE patients, the EVO-TK, BTK-K, and Masket-K may yield more accurate calculation results. At their current stage in development, AI-based formulas do not demonstrate significant advantages over conventional formulas. However, the application of historical data can enhance the performance of these formulas.
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Affiliation(s)
- Liangpin Li
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Liyun Yuan
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Kun Yang
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Yanan Wu
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Simayilijiang Alafati
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China
| | - Xia Hua
- Tianjin Aier Eye Hospital, Tianjin University, Tianjin, 300190, China
| | - Yan Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China.
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China.
| | - Xiaoyong Yuan
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China.
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China.
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Hu Y, Lin L, Zeng D, Wang Y, Zhang R, Zhang Z, Wang Z, Zhang G, Ye X. Accuracy of the FY-L formula in calculating intraocular lens power after small-incision lenticule extraction. Front Med (Lausanne) 2023; 10:1241824. [PMID: 37692774 PMCID: PMC10483841 DOI: 10.3389/fmed.2023.1241824] [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: 06/17/2023] [Accepted: 08/01/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose The study aimed to assess the accuracy of the FY-L formula in calculating intraocular lens (IOL) power after small-incision lenticule extraction (SMILE). Methods For the post-SMILE IOL calculation of the same eye, the IOL power targeting the pre-SMILE eyes' lowest myopic refractive error was used. The FY-L formula, the Emmetropia Verifying Optical Formula (EVO-L), the Barrett True-K no history, and the Shammas-L, respectively, were used to calculate the predicted refractive error of target IOL power. A comparison was made between the change in spherical equivalent induced by SMILE (SMILE-Dif) and the variance between IOL-Dif (IOL-Induced Refractive Error) before and after SMILE. The prediction error (PE) was defined as SMILE-Dif minus IOL-Dif. The proportion of eyes with PEs within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D, the numerical and absolute prediction errors (PEs and AEs), and the median absolute error (MedAE) were compared. Results In total, 80 eyes from 42 patients who underwent SMILE were included in the study. The FY-L formula generated the sample's lowest mean PE (0.06 ± 0.76 D), MAE (0.58 ± 0.50 D), and MedAE (0.47 D), respectively. The PEs in ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D comprised 28.8%, 46.3%, 70.0%, and 87.5%, respectively, for the FY-L formula. Compared to other formulas, the FY-L formula produced the highest value with PEs for the percentage of eyes in ±0.50 D, ±0.75 D, and ±1.00 D. Conclusion This study demonstrates that the FY-L formula provides satisfactory outcomes in estimating the IOL power in the eyes after SMILE.
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Affiliation(s)
| | - Liqun Lin
- Xianyou County General Hospital, Putian, Fujian, China
| | - Danqi Zeng
- Xiamen Eye Center, Xiamen University, Xiamen, Fujian, China
| | - Yan Wang
- Fuzhou Eye Hospital, Fuzhou, Fujian, China
| | - Rong Zhang
- Fuzhou Eye Hospital, Fuzhou, Fujian, China
| | - Zhe Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen, Guangdong, China
- Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Zheng Wang
- Fuzhou Eye Hospital, Fuzhou, Fujian, China
| | - Guangbin Zhang
- Xiamen Eye Center, Xiamen University, Xiamen, Fujian, China
| | - Xiangyu Ye
- Fuzhou Eye Hospital, Fuzhou, Fujian, China
- Xiamen Eye Center, Xiamen University, Xiamen, Fujian, China
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Galvis V, Tello A, Otoya V, Arba-Mosquera S, Villamizar SJ, Translateur A, Morales R. Determination of Corneal Power after Refractive Surgery with Excimer Laser: A Concise Review. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2023; 79:215-220. [PMID: 37993276 DOI: 10.31348/2023/8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Refractive surgery with excimer laser has been a very common surgical procedure worldwide during the last decades. Currently, patients who underwent refractive surgery years ago are older, with a growing number of them now needing cataract surgery. To establish the power of the intraocular lens to be implanted in these patients, it is essential to define the true corneal power. However, since the refractive surgery modified the anterior, but not the posterior surface of the cornea, the determination of the corneal power in this group of patients is challenging. This article reviews the different sources of error in finding the true corneal power in these cases, and comments on several approaches, including the clinical history method as described originally by Holladay, and a modified version of it, as well as new alternatives based on corneal tomography, using devices that are able to measure the actual anterior and posterior corneal curvatures, which have emerged in recent years to address this issue.
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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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Wang L, Koch D. Intraocular lens power calculations in eyes with previous corneal refractive surgery: Challenges, approaches, and outcomes. Taiwan J Ophthalmol 2022; 12:22-31. [PMID: 35399961 PMCID: PMC8988985 DOI: 10.4103/tjo.tjo_38_21] [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: 07/11/2021] [Accepted: 09/10/2021] [Indexed: 11/04/2022] Open
Abstract
In eyes with previous corneal refractive surgery, difficulties in accurately determining corneal refractive power and in predicting the effective lens position create challenges in intraocular lens (IOL) power calculations. There are three categories of methods proposed based on the use of historical data acquired prior to the corneal refractive surgery. The American Society of Cataract and Refractive Surgery postrefractive IOL calculator incorporates many commonly used methods. Accuracy of refractive prediction errors within ± 0.5 D is achieved in 0% to 85% of eyes with previous myopic LASIK/photorefractive keratectomy (PRK), 38.1% to 71.9% of eyes with prior hyperopic LASIK/PRK, and 29% to 87.5% of eyes with previous radial keratotomy. IOLs with negative spherical aberration (SA) may reduce the positive corneal SA induced by myopic correction, and IOLs with zero SA best match corneal SA in eyes with prior hyperopic correction. Toric, extended-depth-of-focus, and multifocal IOLs may provide excellent outcomes in selected cases that meet certain corneal topographic criteria. Further advances are needed to improve the accuracy of IOL power calculation in eyes with previous corneal refractive surgery.
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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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Wang L, Koch DD. Intraocular Lens Power Calculations in Eyes with Previous Corneal Refractive Surgery. Ophthalmology 2021; 128:e121-e131. [DOI: 10.1016/j.ophtha.2020.06.054] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/10/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022] Open
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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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15
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Cataract surgery after myopic laser in situ keratomileusis: objective analysis to determine best formula and keratometry to use. J Cataract Refract Surg 2021; 47:465-470. [PMID: 33149048 DOI: 10.1097/j.jcrs.0000000000000472] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/23/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To objectively determine which formula/keratometry combination was best for calculating intraocular lens (IOL) sphere power in eyes with a history of myopic laser in situ keratomileusis (LASIK). SETTING One practice in the United States. DESIGN Retrospective, unmasked, nonrandomized chart review. METHODS Consecutive patients undergoing cataract surgery after previous myopic LASIK were included. Eyes had to have a postoperative refraction at least 3 weeks postoperatively. IOL power was calculated with the ASCRS online postrefractive IOL calculator using anterior keratometry and recalculated using total corneal power (TK). The accuracy of treatment was calculated and compared between different formulas and keratometry methods including intraoperative aberrometry (IA). RESULTS Data from 101 eyes, 44 of which had TK available, were analyzed. Using TK, the Wang-Koch-Maloney formula had the highest percentages of eyes with expected spherical equivalent refractive errors within 0.50 diopter (D) and 1.00 D of plano (57% and 87%, respectively). With anterior keratometry, the Barrett True-K formula had the highest percentages (64% and 92%, respectively) but was not significantly better than the Wang-Koch-Maloney formula, with expected errors within ±0.50 and ±1.00 D (P > .2, McNemar test). Expected sphere results based on IA were not significantly different than for Barrett True-K within ±0.50 D or within ±1.00 D (P > .2, McNemar test). CONCLUSIONS Using TK in existing post-LASIK formulas did not seem beneficial. The formulas might have to be optimized for use with TK. The best expected results were obtained with the Barrett True-K and Haigis-L formulas using anterior keratometry. IA did not seem to materially improve results.
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16
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Intraocular lens power calculation using adjusted corneal power in eyes with prior myopic laser vision correction. Graefes Arch Clin Exp Ophthalmol 2021; 259:3729-3737. [PMID: 34287694 DOI: 10.1007/s00417-021-05309-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/20/2021] [Accepted: 07/01/2021] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To evaluate the prediction accuracy of the intraocular lens (IOL) power calculation using adjusted corneal power according to the posterior/anterior corneal curvature radii ratio in the Haigis formula (Haigis-E) in patients with a history of prior myopic laser vision correction. METHODS Seventy eyes from 70 cataract patients who underwent cataract surgery and had a history of myopic laser vision correction were enrolled. The adjusted corneal power obtained with conventional keratometry (K) was calculated using the posterior/anterior corneal curvature radii ratio measured by a single Scheimpflug camera. In eyes longer than 25.0 mm, half of the Wang-Koch (WK) adjustment was applied. The median absolute error (MedAE) and the percentage of eyes that achieved a postoperative refractive prediction error within ± 0.50 diopters (D) based on the Haigis-E method was compared with those in the Shammas, Haigis-L, and Barrett True-K no-history methods. RESULTS The MedAE predicted using the Haigis-E (0.33 D) was significantly smaller than that obtained using the Shammas (0.44 D), Haigis-L (0.43 D), and Barrett True-K (0.44 D) methods (P < 0.001, P = 0.001, and P = 0.014, respectively). The percentage of eyes within ± 0.50 D of refractive prediction error using the Haigis-E (78.6%) was significantly greater than that produced using the Shammas (57.1%), Haigis-L (58.6%), and Barrett True-K (61.4%) methods (P = 0.025). CONCLUSION IOL power calculation using the adjusted corneal power according to the posterior/anterior corneal curvature radii ratio and modified WK adjustment in the Haigis formula could improve the refraction prediction accuracy after cataract surgery in eyes with prior myopic laser vision correction.
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17
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Prediction accuracy of IOL calculation formulas using the ASCRS online calculator for a diffractive extended depth-of-focus IOL after myopic laser in situ keratomileusis. J Cataract Refract Surg 2020; 46:1240-1246. [DOI: 10.1097/j.jcrs.0000000000000238] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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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Wang XZ, Cui R, Song XD, Yun B, Qian J, Ding N. Comparison of the accuracy of intraocular lens power calculation formulas for eyes after corneal refractive surgery. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:871. [PMID: 32793715 DOI: 10.21037/atm-20-4624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background In cataract surgery, calculating intraocular lens (IOL) power in patients who have previously received corneal refractive surgery on the same eye presents a clinical challenge. This study aims to compare the accuracy of the Haigis-L, Barrett True-K, and Shammas-PL formulas in predicting the IOL power in eyes following corneal refractive surgery. Methods This study analyzed 32 eyes belonging to 28 patients who underwent cataract surgery and IOL implantation after previously undergoing myopic corneal refractive surgery. The IOL power was calculated using the Haigis-L, Barrett True-K, and Shammas-PL formulas, and the accuracy of the three formulas was compared. Results The Haigis-L, Barrett True-K, and Shammas-PL formulas had a mean arithmetic IOL prediction error of -0.65, -0.39, and -0.46, respectively. The mean numerical errors of the three formulas were significantly different from zero (P<0.001). The smallest median absolute refraction prediction error (median =0.40) belonged to the Barrett True-K formula, which was significantly smaller than that of the Haigis-L formula (median =0.57, P<0.05) but similar to that of the Shammas-PL formula (median =0.49, P>0.05). There was no significant difference in the percentage of eyes within either ±0.50 D or ±1.00 D of the predicted refraction error across the three formulas. Conclusions The Barrett True-K formula can predict IOL power in eyes that have previously undergone myopic corneal refractive surgery better than the Haigis-L formula.
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Affiliation(s)
- Xiao-Zhen Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Rui Cui
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Xu-Dong Song
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Bo Yun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Jin Qian
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Ning Ding
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
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20
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Comparative postoperative topography pattern recognition analysis using axial vs tangential curvature maps. J Cataract Refract Surg 2020; 46:1368-1373. [PMID: 32483077 DOI: 10.1097/j.jcrs.0000000000000264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine prediction accuracy of patient refractive surgery status by novice reviewers based on topography pattern analysis using axial or tangential anterior curvature maps. SETTING Four U.S. academic centers. DESIGN Prospective case-control study. METHODS Image evaluation was performed by novice reviewers (n = 52) at 4 academic institutions. Participants were shown 60 total images from 30 eyes presenting for cataract surgery evaluation with known refractive surgery status, including 12 eyes imaged with Placido-based topography and 18 eyes imaged with Scheimpflug-based tomography. There were 12 eyes with myopic ablations, 12 eyes with hyperopic ablations, and 6 eyes with no previous refractive surgery performed. Each eye was shown in both axial and tangential curvature from either device, reviewed as a single image at a time, and masked to the map type (axial vs tangential). RESULTS For the 52 novice reviewers included, accuracy of pattern identification was 82.9% (517 of 624) for tangential vs 55.0% (343 of 624) for axial maps for eyes with myopic ablation (P < .00001), 90.9% (567 of 624) for tangential vs 58.3% (364 of 624) for axial maps for eyes with hyperopic ablation (P < .00001), and 15.4% (48 of 312) for tangential vs 62.8% (196 of 312) for axial maps for eyes with no ablation (P < .00001). There were no significant differences between Placido and Scheimpflug devices and no significant differences across groups based on year of training. CONCLUSIONS Tangential curvature maps yielded significantly better pattern recognition accuracy compared with axial maps after myopic and hyperopic corneal refractive surgery ablations for novice reviewers. Using tangential curvature maps, especially for challenging cases, should benefit post-LASIK intraocular lens (IOL) calculator selection and, thereby, improve IOL power calculation accuracy.
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New method for intraocular lens power calculation using a rotating Scheimpflug camera in eyes with corneal refractive surgery. Sci Rep 2020; 10:8992. [PMID: 32488057 PMCID: PMC7265558 DOI: 10.1038/s41598-020-65827-y] [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: 01/21/2020] [Accepted: 05/07/2020] [Indexed: 11/08/2022] Open
Abstract
To introduce and evaluate a refraction-based method for calculating the correct power of the intraocular lens (IOL) in eyes with corneal refractive surgery and to compare the results here to previously published methods. Retrospective review of medical records was done. Group 1 was used to derive two formulas. From the relevant IOL calculation and postoperative refractive data, the refraction-derived K values (Krd) were calculated using a linear regression analysis. The values obtained with the two formulas were compared to previously published methods in group 2 to validate the results. The following methods were evaluated: Haigis-L, Barrett True-K (no history), Potvin-Hill, BESSt 2, Scheimpflug total corneal refractive power (TCRP) 4 mm (Haigis), Scheimpflug total refractive power (TRP) 4 mm (Haigis), modified Scheimpflug TCRP 4 mm (Haigis), and modified Scheimpflug TRP 4 mm (Haigis). The modified TCRP 4 mm Krd (Haigis) had good outcomes, with 60% and 90% of eyes within ±0.50 D and ±1.00 D of the refractive target, respectively. A new method using modified Scheimpflug total corneal refractive power in the 4.0 mm zone appeared to be an accurate method for determining IOL power in eyes with corneal refractive surgery.
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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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Intraocular Lens power calculation after laser refractive surgery: A Meta-Analysis. Sci Rep 2020; 10:2645. [PMID: 32060303 PMCID: PMC7021678 DOI: 10.1038/s41598-020-59487-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/23/2020] [Indexed: 01/11/2023] Open
Abstract
There are an increasing number of people who have had refractive surgery now developing cataract. To compare the accuracy of different intraocular lens (IOL) power calculation formulas after laser refractive surgery (photorefractive keratectomy or laser in situ keratomileusis), a comprehensive literature search of PubMed and EMBASE was conducted to identify comparative cohort studies and case series comparing different formulas: Haigis-L, Shammas-PL, SRK/T, Holladay 1 and Hoffer Q. Seven cohort studies and three observational studies including 260 eyes were identified. There were significant differences when Hoffer Q formula compared with SRK/T, Holladay 1. Holladay 1 formula produced less prediction error than SRK/T formula in double-K method. Hoffer Q formula performed best among SRK/T and Holladay 1 formulas in total and single-K method. In eyes with previous data, it is recommended to choose double-K formula except SRK/T formula. In eyes with no previous data, Haigis-L formula is recommended if available, if the fourth formula is unavailable, single-k Hoffer Q is a good choice.
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Savini G, Hoffer K, Barboni P, Balducci N, Schiano-Lomoriello D. Validation of the SToP formula for calculating intraocular lens power in eyes with previous myopic excimer laser surgery. J Cataract Refract Surg 2019; 45:1562-1567. [DOI: 10.1016/j.jcrs.2019.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 06/01/2019] [Accepted: 06/17/2019] [Indexed: 01/06/2023]
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Pan C, Tan W, Hua Y, Lei X. Corneal power measurement with a new aberrometer/corneal topographer in eyes after small incision lenticule extraction for myopia. Int Ophthalmol 2019; 39:2815-2824. [PMID: 31134424 DOI: 10.1007/s10792-019-01128-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 05/22/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess corneal power measurements obtained by the OPD SCAN III Topographer in eyes with prior myopic small incision lenticule extraction (SMILE) surgery. METHODS Sixty untreated myopic eyes of sixty subjects and forty previous myopic SMILE surgery eyes of forty subjects were consecutively enrolled in the present study. Manifest refraction, OPD SCAN III and Pentacam HR were performed. Keratometric measurements assessed by OPD SCAN III-simulated keratometry, average pupil power and effective central corneal power (ECCP) were compared with mean keratometry (Km) obtained by Pentacam HR in the untreated group and the clinical history method (CHM) in the treated group. RESULTS In the untreated group, no statistically significant differences were revealed between all corneal power measurements obtained with OPD SCAN III and Km. In the treated group, all the corneal power measurements were statistically different from the CHM except for the Haigis method and the Shammas method, while ECCP had a statistically but not clinically significant overestimation of 0.42 D with 95% limit of agreement (LOA) of - 0.81 D to 1.64 D. The three modified ECCP had better prediction performance with narrower 95% of LOA lying in (- 1.20, 1.20 D) (- 1.22, 1.23 D) and (- 0.90, 1.00 D), respectively. CONCLUSIONS The ECCP provided with OPD SCAN III could be used as an alternative option for the CHM after specific modifications in eyes with previous myopic SMILE surgery when the preoperative data are unavailable considering the narrowest agreement between the modified ECCP and the CHM. Otherwise, caution must be raised considering the wide LOA.
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Affiliation(s)
- Chao Pan
- Hankou Aier Eye Hospital, 34 Machang Road, Jianghan District, Wuhan, Hubei Province, China
| | - Weina Tan
- Hankou Aier Eye Hospital, 34 Machang Road, Jianghan District, Wuhan, Hubei Province, China
| | - Yanjun Hua
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China
| | - Xiaohua Lei
- Hankou Aier Eye Hospital, 34 Machang Road, Jianghan District, Wuhan, Hubei Province, 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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Agarwal S, Thornell EM. Cataract surgery with a small-aperture intraocular lens after previous corneal refractive surgery: Visual outcomes and spectacle independence. J Cataract Refract Surg 2018; 44:1150-1154. [DOI: 10.1016/j.jcrs.2018.06.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/18/2018] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
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Intraocular lens power calculation using a Placido disk–Scheimpflug tomographer in eyes that had previous myopic corneal excimer laser surgery. J Cataract Refract Surg 2018; 44:935-941. [DOI: 10.1016/j.jcrs.2018.05.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/03/2018] [Accepted: 05/07/2018] [Indexed: 01/04/2023]
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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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Fisher B, Potvin R. Clinical outcomes with distance-dominant multifocal and monofocal intraocular lenses in post-LASIK cataract surgery planned using an intraoperative aberrometer. Clin Exp Ophthalmol 2018; 46:630-636. [PMID: 29360197 PMCID: PMC6100005 DOI: 10.1111/ceo.13153] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/31/2017] [Accepted: 01/08/2018] [Indexed: 11/29/2022]
Abstract
IMPORTANCE Studies evaluating the clinical benefits of intraoperative aberrometry (IA) in cataract surgery are limited. BACKGROUND The study was designed to determine whether IA improved clinical outcomes of post-laser in situ keratomileusis (LASIK) cataract surgery with different intraocular lenses (IOLs) implanted. DESIGN A retrospective chart review of clinical outcomes from one surgeon at one surgical centre was conducted. It included post-LASIK cataract surgeries where IA was used for the confirmation of IOL power, with either a distant-dominant multifocal IOL or a monofocal IOL implanted. PARTICIPANTS Records for 44 eyes of 31 patients were analysed. METHODS Differences in visual acuity (VA) and refractions by lens type were compared, and the effects of IA were evaluated. MAIN OUTCOME MEASURES Uncorrected distance VA and the percentage of eyes with a spherical equivalent refraction within 0.5D of the intended correction were the primary outcome measures. RESULTS There was no statistically significant difference in the percentage of eyes with uncorrected distance VA of 20/25 or better between IOL groups (P = 0.41). More eyes in the multifocal group had a refraction within 0.50D of intended (P = 0.03). In 39% of cases, the preoperative and IA power calculations suggested the same IOL power. When not equal, the IA results were not significantly more likely to be 'best' (P = 0.08). CONCLUSIONS AND RELEVANCE Results suggest that a history of previous LASIK is not a contraindication to use of distant-dominant multifocal IOLs. IA did not appear to improve clinical outcomes in post-LASIK eyes, although a positive trend was evident.
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Affiliation(s)
- Bret Fisher
- Eye Center of North Florida, Panama City, Florida, USA
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33
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Koprowski R, Lanza M, Irregolare C. Corneal power evaluation after myopic corneal refractive surgery using artificial neural networks. Biomed Eng Online 2016; 15:121. [PMID: 27846894 PMCID: PMC5111354 DOI: 10.1186/s12938-016-0243-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 11/09/2016] [Indexed: 11/30/2022] Open
Abstract
Background Efficacy and high availability of surgery techniques for refractive defect correction increase the number of patients who undergo to this type of surgery. Regardless of that, with increasing age, more and more patients must undergo cataract surgery. Accurate evaluation of corneal power is an extremely important element affecting the precision of intraocular lens (IOL) power calculation and errors in this procedure could affect quality of life of patients and satisfaction with the service provided. The available device able to measure corneal power have been tested to be not reliable after myopic refractive surgery. Methods Artificial neural networks with error backpropagation and one hidden layer were proposed for corneal power prediction. The article analysed the features acquired from the Pentacam HR tomograph, which was necessary to measure the corneal power. Additionally, several billion iterations of artificial neural networks were conducted for several hundred simulations of different network configurations and different features derived from the Pentacam HR. The analysis was performed on a PC with Intel® Xeon® X5680 3.33 GHz CPU in Matlab® Version 7.11.0.584 (R2010b) with Signal Processing Toolbox Version 7.1 (R2010b), Neural Network Toolbox 7.0 (R2010b) and Statistics Toolbox (R2010b). Results and conclusions A total corneal power prediction error was obtained for 172 patients (113 patients forming the training set and 59 patients in the test set) with an average age of 32 ± 9.4 years, including 67% of men. The error was at an average level of 0.16 ± 0.14 diopters and its maximum value did not exceed 0.75 dioptres. The Pentacam parameters (measurement results) providing the above result are tangential anterial/posterior. The corneal net power and equivalent k-reading power. The analysis time for a single patient (a single eye) did not exceed 0.1 s, whereas the time of network training was about 3 s for 1000 iterations (the number of neurons in the hidden layer was 400).
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Affiliation(s)
- Robert Koprowski
- Department of Biomedical Computer Systems, Faculty of Computer Science and Materials Science, Institute of Computer Science, University of Silesia, ul. Będzińska 39, 41-200, Sosnowiec, Poland.
| | - Michele Lanza
- Dipartimento Multidisciplinare di Scienze Mediche, Chirurgiche e Odontoiatriche, Seconda Università di Napoli, Naples, Italy.,Centro Grandi Apparecchiature, Seconda Università di Napoli, Naples, Italy
| | - Carlo Irregolare
- Centro Grandi Apparecchiature, Seconda Università di Napoli, Naples, Italy
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Alio JL, Abdelghany AA, Abdou AA, Maldonado MJ. Cataract surgery on the previous corneal refractive surgery patient. Surv Ophthalmol 2016; 61:769-777. [PMID: 27423631 DOI: 10.1016/j.survophthal.2016.07.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 07/05/2016] [Accepted: 07/07/2016] [Indexed: 11/26/2022]
Abstract
Cataract surgery in cases with previous corneal refractive surgery may be a major challenge for the ophthalmologist. The refractive outcome of the case deserves special attention in the preoperative planning process, which should be tailored for the type of prior refractive procedure: incisional, ablative under a flap, or on the corneal surface. Avoiding refractive surprise after cataract surgery in these cases is principally dependent on the accuracy of the intraocular lens calculation, together with the selection of the appropriate biometric formula for each case. Modern techniques for cataract surgery help surgeons to move toward the goal of cataract surgery as a refractive procedure free from refractive error. We give practical guidelines for the cataract surgeon in the management of these challenging cases.
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Affiliation(s)
- Jorge L Alio
- Vissum Corporación, Alicante, Spain; Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain.
| | - Ahmed A Abdelghany
- Ophthalmology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Ahmed A Abdou
- Ophthalmology Department, AUH, Assiut University, Assiut, Egypt
| | - M J Maldonado
- IOBA-Eye Institute, Valladolid, Spain; Division of Ophthalmology, University of Valladolid, Valladolid, Spain
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