1
|
Schnider C, Yuen L, Rampat R, Zhu D, Dhallu S, Trinh T, Gurnani B, Abdelmaksoud A, Bhogal-Bhamra G, Wolffsohn JS, Naroo SA. BCLA CLEAR presbyopia: Management with intraocular lenses. Cont Lens Anterior Eye 2024; 47:102253. [PMID: 39068141 DOI: 10.1016/j.clae.2024.102253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Cataract surgery including intraocular lens (IOL) insertion, has been refined extensively since the first such procedure by Sir Harold Ridley in 1949. The intentional creation of monovision with IOLs using monofocal IOL designs has been reported since 1984. The first reported implantation of multifocal IOLs was published in 1987. Since then, various refractive and or diffractive multifocal IOLs have been commercialised. Most are concentric, but segmented IOLs are also available. The most popular are trifocal designs (overlaying two diffractive patterns to achieve additional focal planes at intermediate and near distances) and extended depth of focus designs which leave the patient largely spectacle independent with the reduced risk of bothersome contrast reduction and glare. As well as mini-monovision, surgical strategies to minimise the impact of presbyopia with IOLs includes mixing and matching lenses between the eyes and using IOLs whose power can be adjusted post-implantation. Various IOL designs to mimic the accommodative process have been tried including hinge optics, dual optics, lateral shifts lenses with cubic-type surfaces, lens refilling and curvature changing approaches, but issues in maintaining the active mechanism with post-surgical fibrosis, without causing ocular inflammation, remain a challenge. With careful patient selection, satisfaction rates with IOLs to manage presbyopia are high and anatomical or physiological complications rates are no higher than with monofocal IOLs.
Collapse
Affiliation(s)
| | - Leonard Yuen
- ONE Medical Doctors Group & Day Surgical Centre, Quarry Bay, Hong Kong
| | | | - Dagny Zhu
- NVISION Eye Centers Rowland Heights, CA, USA
| | - Sandeep Dhallu
- Department of Clinical, Pharmaceutical and Biological Science, University of Hertfordshire, Hatfield, UK
| | - Tanya Trinh
- Mosman Eye Clinic, Sydney, New South Wales, Australia; Sydney Hospital and Sydney Eye Hospital, New South Wales, Australia
| | - Bharat Gurnani
- Gomabai Netralaya and Research Centre, Neemuch, Madhya Pradesh, India
| | | | | | - James S Wolffsohn
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | - Shehzad A Naroo
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom.
| |
Collapse
|
2
|
Kenny PI, Kozhaya K, Truong P, Wang L, Koch DD, Weikert MP. Performance of IOL calculation formulas that use measured posterior corneal power in eyes following myopic laser vision correction. J Cataract Refract Surg 2024; 50:7-11. [PMID: 37702522 DOI: 10.1097/j.jcrs.0000000000001300] [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: 11/22/2022] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To compare the predictive accuracy of the biometer-embedded Barrett True-K TK and new total corneal power methods of intraocular lens (IOL) power calculation in eyes with prior laser vision correction (LVC) for myopia. SETTING Academic clinical practice. DESIGN Retrospective case series. METHODS IOL power formulas were assessed using measurements from a swept-source optical coherence biometer. Refractive prediction errors were calculated for the Barrett True-K TK, EVO 2.0, Pearl-DGS, and HofferQST, which use both anterior and posterior corneal curvature measurements. These were compared with the Shammas, Haigis-L, Barrett True-K No History (NH), optical coherence tomography, and 4-formula average (AVG-4) on the ASCRS postrefractive calculator, and to the Holladay 1 and 2 with non linear axial length regressions (H1- and H2-NLR). RESULTS The study comprised 85 eyes from 85 patients. Only the Barrett True-K TK and EVO 2.0 had mean numerical errors that were not significantly different from 0. The EVO 2.0, Barrett True-K TK, Pearl-DGS, AVG-4, H2-NLR, and Barrett True-K NH were selected for further pairwise analysis. The Barrett True-K TK and EVO 2.0 demonstrated smaller root-mean-square absolute error compared with the Pearl-DGS, and the Barrett True-K TK also had a smaller mean absolute error than the Pearl-DGS. CONCLUSIONS The Barrett True-K TK and EVO 2.0 formulas had comparable performance to existing formulas in eyes with prior myopic LVC.
Collapse
Affiliation(s)
- Peter I Kenny
- From the Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
| | | | | | | | | | | |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Li Y, Li X, Jiang X, Wang Y, Wu T, Xia H, Li X. Comparison of dynamic visual acuity after implantation of toric bifocal or trifocal intraocular lens in age-related cataract patients: a randomized controlled trial. Front Neurosci 2023; 17:1287626. [PMID: 38178838 PMCID: PMC10765614 DOI: 10.3389/fnins.2023.1287626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 11/20/2023] [Indexed: 01/06/2024] Open
Abstract
Purpose To investigate the dynamic visual acuity (DVA) after implantation of toric bifocal or trifocal intraocular lens in age-related cataract patients. Methods This was a prospective randomized controlled trial. Of one hundred and twenty-four patients enrolled and randomized to receive unilateral phacoemulsification and toric trifocal (939 M/MP, Carl Zeiss Meditec AG, Jena, Germany) or toric bifocal (909 M, Carl Zeiss Meditec AG, Jena, Germany) intraocular lenses (IOL) implantation, ninety-nine patients completed the follow-up and were included in final analysis. Postoperatively, uncorrected and corrected distance (UDVA and CDVA), intermediate (UIVA and DCIVA) and near (UNVA and DCNVA) static visual acuity, manifest refraction and uncorrected and corrected distance DVA (UDDVA and CDDVA) at 20, 40 and 80 degrees per second (dps) were evaluated at one week, one month and three months. Results Three months postoperatively, the UDVA were 0.13 ± 0.11 and 0.14 ± 0.13 in the toric trifocal and bifocal IOL group, respectively. Significant better UIVA (trifocal, 0.17 ± 0.13 vs. bifocal, 0.23 ± 0.13, p = 0.037) and DCIVA (trifocal, 0.16 ± 0.11 vs. bifocal, 0.20 ± 0.12, p = 0.048) were observed in patients implanting toric trifocal than bifocal IOL at three months postoperatively. Patients implanted with toric bifocal IOL obtained better CDDVA at 80 dps (0.5607 ± 0.2032) than the trifocal group (0.6573 ± 0.2450, p = 0.039) at three months. Postoperative UDDVA and CDDVA at 20, 40 and 80 dps were significantly associated with age (p < 0.05, respectively) and postoperative static visual acuity (p < 0.05, respectively). Conclusion Toric trifocal IOL provides better static intermediate visual acuity, and toric bifocal IOL implantation provides better distance dynamic visual acuity at high speed.
Collapse
Affiliation(s)
- Yuanting Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
| | - Xiaodan Li
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Beijing, China
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Xiaodan Jiang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
| | - Yuexin Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
| | - Tingyi Wu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
| | - Huaqin Xia
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Beijing, China
| |
Collapse
|
5
|
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.
Collapse
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.
| |
Collapse
|
6
|
Li L, Yuan L, Yang K, Wu Y, Hua X, Wang Y, Yuan X. Comparative analysis of IOL power calculations in postoperative refractive surgery patients: a theoretical surgical model for FS-LASIK and SMILE procedures. BMC Ophthalmol 2023; 23:416. [PMID: 37845633 PMCID: PMC10578000 DOI: 10.1186/s12886-023-03164-0] [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: 07/31/2023] [Accepted: 10/04/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND As the two most prevalent refractive surgeries in China, there is a substantial number of patients who have undergone Femtosecond Laser-assisted In Situ Keratomileusis (FS-LASIK) and Small Incision Lenticule Extraction (SMILE) procedures. However, there is still limited knowledge regarding the selection of intraocular lens (IOL) power calculation formulas for these patients with a history of FS-LASIK or SMILE. METHODS A total of 100 eyes from 50 postoperative refractive surgery patients were included in this prospective cohort study, with 25 individuals (50 eyes) having undergone FS-LASIK and 25 individuals (50 eyes) having undergone SMILE. We utilized a theoretical surgical model to simulate the IOL implantation process in postoperative FS-LASIK and SMILE patients. Subsequently, we performed comprehensive biological measurements both before and after the surgeries, encompassing demographic information, corneal biometric parameters, and axial length. Various formulas, including the Barrett Universal II (BUII) formula, as a baseline, were employed to calculate IOL power for the patients. RESULTS The Barrett True K (BTK) formula, demonstrated an mean absolute error (AE) within 0.5 D for both FS-LASIK and SMILE groups (0.28 ± 0.25 D and 0.36 ± 0.24 D, respectively). Notably, the FS-LASIK group showed 82% of results differing by less than 0.25 D compared to preoperative BUII results. The Barrett True K No History (BTKNH) formula, which also incorporates measured posterior corneal curvature, performed similarly to BTK in both groups. Additionally, the Masket formula, relying on refractive changes based on empirical experience, displayed promising potential for IOL calculations in SMILE patients compared with BTK (p = 0.411). CONCLUSION The study reveals the accuracy and stability of the BTK and BTKNH formulas for IOL power calculations in myopic FS-LASIK/SMILE patients. Moreover, the Masket formula shows encouraging results in SMILE patients. These findings contribute to enhancing the predictability and success of IOL power calculations in patients with a history of refractive surgery, providing valuable insights for clinical practice. Further research and larger sample sizes are warranted to validate and optimize the identified formulas for better patient outcomes.
Collapse
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
| | - 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.
| |
Collapse
|
7
|
Wendelstein J, Heath M, Riaz KM, Seiler T, Cooke DL, Langenbucher A, Hoffmann P, Kohnen T. Biometry and Intraocular Lens Power Calculation in Eyes with Prior Laser Vision Correction (LVC) - A Review. Klin Monbl Augenheilkd 2022; 239:971-981. [PMID: 35973684 DOI: 10.1055/a-1896-0881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND An intraocular lens (IOL) calculation in eyes that have undergone laser vision correction (LVC) poses a significant clinical issue in regards to both patient expectation and accuracy. This review aims to describe the pitfalls of IOL power calculation after LVC and give an overview of the current methods of IOL power calculation after LVC. REVIEW Problems after LVC derive from the measurement of anterior corneal radii, central corneal thickness, asphericity, and the predicted effective lens position. A central issue is that most conventional 3rd generation formulas estimate lens position amongst other parameters on keratometry, which is altered in post-LVC eyes. CONCLUSION An IOL power calculation results in eyes with prior LVC that are notably impaired in eyes without prior surgery. Effective corneal power including anterior corneal curvature, posterior corneal curvature, CCT (central corneal thickness), and asphericity is essential. Total keratometry in combination with the Barrett True-K, EVO (emmetropia verifiying optical formula), or Haigis formula is relatively uncomplicated and seems to provide good results, as does the Barrett True-K formula with anterior K values. The ASCRS ( American Society of Cataract and Refractive Surgery) calculator combines results of various formulae and averages results, which allows a direct comparison between the different methods. Tomography-based raytracing and the Kane and the Castrop formulae need to be evaluated by future studies.
Collapse
Affiliation(s)
- Jascha Wendelstein
- IROC, Institut für Refraktive und Ophthalmo-Chirurgie, Zürich, Switzerland.,Abteilung für Augenheilkunde und Optometrie, Johannes Kepler Universität Linz, Linz, Austria.,Institut für Experimentelle Ophthalmologie, Universität des Saarlandes, Homburg/Saar, Germany
| | - Michael Heath
- College of Medicine, University of Oklahoma, Norman, Oklahoma, United States
| | - Kamran M Riaz
- University of Oklahoma, Dean McGee Eye Institute, Oklahoma City, Oklahoma, United States
| | - Theo Seiler
- IROC, Institut für Refraktive und Ophthalmo-Chirurgie, Zürich, Switzerland.,Universitätsklinik für Augenheilkunde, Inselspital, Bern, Switzerland.,Klinik für Augenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - David L Cooke
- Great Lakes Eye Care, Saint Joseoph, United States.,Department of Neurology and Ophthalmology, Michigan State University, East Lansing, Michigan, United States
| | - Achim Langenbucher
- Institut für Experimentelle Ophthalmologie, Universität des Saarlandes, Homburg/Saar, Germany
| | - Peter Hoffmann
- Augen- und Laserklinik Castrop-Rauxel, Castrop-Rauxel, Germany
| | - Thomas Kohnen
- Klinik für Augenheilkunde, Goethe-Universität, Frankfurt, Germany
| |
Collapse
|
8
|
Zeng Z, Ye X, Chen Q, Jia C, Zhang G. Intraocular lens power calculation after two different successive corneal refractive surgeries. Am J Ophthalmol Case Rep 2022; 26:101547. [PMID: 35514797 PMCID: PMC9062137 DOI: 10.1016/j.ajoc.2022.101547] [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: 03/08/2021] [Revised: 02/06/2022] [Accepted: 04/18/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To report two challenging intraocular lens power calculation cases with patients each underwent different successive corneal refractive surgeries, respectively. Observations Biometry data, including the Back to Front corneal radii ratio (B/F ratio), were collected by Lenstar, IOL Master, and Pentacam AXL for Case 1 (received radial keratotomy (RK) and photorefractive keratectomy (PRK)) and Case 2 (received RK and laser-assisted in situ keratomileusis (LASIK)). The IOL power calculation was determined by several methods, including Shammas, Haigis-L, and Barrett True-K, which are available in the American Society of Cataract and Refractive Surgery online calculator and Pentacam AXL. The Barrett True-K (no history, post-RK) was more accurate in Case 1 (increased B/F ratio), whereas the Shammas, Haigis-L, and Barrett True-K (no history, post-LASIK/PRK) were more accurate in Case 2 (decreased B/F ratio). Conclusion and importance The B/F ratio may be a factor to be considered when selecting the IOL power calculation formula for patients who undergo two different corneal refractive surgeries. The further study focusing on this issue should be performed to clarify the results in the future.
Collapse
|
9
|
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.
Collapse
|
10
|
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
|
11
|
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.].
Collapse
|
12
|
Lwowski C, Van Keer K, Adas M, Schwarz L, Hinzelmann L, Pawlowicz K, Kohnen T. Ray-tracing Calculation Using Scheimpflug Tomography of Diffractive Extended Depth of Focus IOLs Following Myopic LASIK. J Refract Surg 2021; 37:231-239. [PMID: 34038658 DOI: 10.3928/1081597x-20210114-02] [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] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate a ray-tracing formula for intraocular lens (IOL) calculation of diffractive extended depth of focus IOLs after myopic laser in situ keratomileusis (LASIK) compared to formulas from an established online calculator. METHODS This retrospective, consecutive case series included patients after cataract surgery with implantation of an extended depth of focus (EDOF) IOL (AT LARA, Carl Zeiss Meditec; Symfony, Johnson & Johnson) and a history of myopic LASIK. Preoperative assessments included biometry (IOLMaster; Carl Zeiss Meditec) and corneal tomography, including true net power (TNP) (Pentacam; Oculus Optikgeräte GmbH). To evaluate the measurements, the simulated keratometry values (SimK) were compared to the TNP. Regarding IOL calculation, the mean prediction error, mean and median absolute prediction error (MAE and MedAE), and number of eyes within ±0.50, ±1.00, and ±2.00 diopters (D) from the Haigis-L, Shammas, and Barrett True K No History formulas to the Potvin-Hill and Haigis with TNP (Pentacam) formulas were compared. RESULTS Thirty-six eyes matched the inclusion criteria with a mean spherical equivalent of -6.26 ± 3.25 diopters (D) preoperatively and -0.79 ± 0.75 D postoperatively. The mean difference from SimK and TNP was significantly different from zero (P < .001; -1.24 ± 0.81 D). The best performing formulas by MedAE were the Potvin-Hill and Barrett True K No History (0.39 ± 0.78 and 0.64 ± 1.00 D). The formula with the most eyes within ±0.50 D was the Potvin-Hill (64%), followed by the Barrett True K No History (44%). For MAE and percentage of eyes within ±0.50 D, the Potvin-Hill formula was significantly better than the Haigis-L, Shammas, and Haigis-TNP formulas (P < .05). CONCLUSIONS Calculation of IOLs in patients who had LASIK remains less predicable than calculations for virgin eyes. Using ray-tracing to calculate diffractive EDOF IOLs after myopic LASIK, the Potvin-Hill formula outperformed established formulas in terms of the percentage within target refraction and the MAE. [J Refract Surg. 2021;37(4):231-239.].
Collapse
|
13
|
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]
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
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.
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Abstract
Patients undergoing lens surgery nowadays have the option to choose between different intraocular lens (IOL) options depending on the ocular situation and personal preferences. For example, it is possible to implant a toric IOL to compensate for extensive corneal distortion or a multifocal IOL to have good visual acuity at various distances. The high level of competition in the lens market leads to fast development of new lens models giving patients the advantage to choose between a variety of options. This review article presents the most commonly used premium IOL options namely, aspheric, toric and multifocal IOLs and a summary of the current study situation for the different lens types. Compared to standard lenses, these lenses can improve uncorrected distance and near visual acuity; however, in some patients the added benefit can be only marginal and this is then an unnecessary cost factor for the patient. Furthermore, if inclusion and exclusion criteria are not respected the special forms of lenses can even lead to a poorer overall result.
Collapse
Affiliation(s)
- Mehdi Shajari
- Augenklinik, Ludwig-Maximilians-Universität München, Mathildenstr. 8, 80336, München, Deutschland.
| | - Siegfried Priglinger
- Augenklinik, Ludwig-Maximilians-Universität München, Mathildenstr. 8, 80336, München, Deutschland
| | - Thomas Kreutzer
- Augenklinik, Ludwig-Maximilians-Universität München, Mathildenstr. 8, 80336, München, Deutschland
| |
Collapse
|
18
|
Christopher KL, Miller DC, Patnaik JL, Lynch AM, Davidson RS, Taravella MJ. Comparison of Visual Outcomes of Extended Depth of Focus Lenses in Patients With and Without Previous Laser Refractive Surgery. J Refract Surg 2020; 36:28-33. [DOI: 10.3928/1081597x-20191204-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 11/19/2019] [Indexed: 11/20/2022]
|