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Anter AM, Bleeker AR, Shammas HJ, Suraneni S, Kingrey B, Murphy DA, Leal S, Ghalibafan S, Tonk RS, Cooke DL, Riaz KM. Comparison of Legacy and New No-History IOL Power Calculation Formulas in Postmyopic Laser Vision Correction Eyes. Am J Ophthalmol 2024; 264:44-52. [PMID: 38518990 DOI: 10.1016/j.ajo.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/09/2024] [Accepted: 03/15/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE To compare the refractive accuracy of legacy and new no-history formulas in eyes with previous myopic laser vision correction (M-LVC). DESIGN Retrospective cohort study. METHODS Setting: Two academic centers Study Population: 576 eyes (400 patients) with previous M-LVC that underwent cataract surgery between 2019-2023. A SS-OCT biometer was used to obtain biometric measurements, including standard (K), posterior (PK), and total keratometry values (TK). OBSERVATION PROCEDURES Refractive prediction errors were calculated for 11 no-history formulas: two legacy M-LVC formulas, four new M-LVC formulas using K values only, and five new M-LVC formulas using K with PK or TK. MAIN OUTCOME MEASURES Heteroscedastic testing was used to evaluate relative formula performance, and formulas were ranked by root mean square error (RMSE). RESULTS New M-LVC formulas performed better than legacy M-LVC formulas. New M-LVC formulas with PK/TK values performed better than versions without PK/TK values. Among new M-LVC formulas with PK/TK values, EVO 2.0-PK was superior to Hoffer QST-PK (P < 0.005). Among new M-LVC formulas using K only, Pearl DGS-K and EVO 2.0-K were both superior to Hoffer QST-K and Barrett True K NH-K formulas (all P < 0.005). CONCLUSIONS Surgeons should favor using new no-history post M-LVC formulas over legacy post M-LVC formulas whenever possible. The top-performing M-LVC formulas (EVO 2.0-PK, Pearl DGS-PK, and Barrett True K-TK) utilized posterior corneal power values. Among formulas utilizing K alone, the EVO 2.0-K and Pearl DGS-K performed best.
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Affiliation(s)
- Abdelrahman M Anter
- From the Bascom Palmer Eye Institute, University of Miami (A.M.A., S.S., S.L., S.G., R.S.T.), Miami, Florida, USA
| | - Adam R Bleeker
- Dean McGee Eye Institute, University of Oklahoma (A.R.B., B.K., D.A.M., K.M.R.), Oklahoma City, Oklahoma, USA
| | - H John Shammas
- Department of Ophthalmology, University of Southern California, the Keck School of Medicine (H.J.S.), Los Angeles, California, USA; Shammas Eye Medical Center (H.J.S.), Lynwood, California, USA
| | - Sanjana Suraneni
- From the Bascom Palmer Eye Institute, University of Miami (A.M.A., S.S., S.L., S.G., R.S.T.), Miami, Florida, USA
| | - Brandon Kingrey
- Dean McGee Eye Institute, University of Oklahoma (A.R.B., B.K., D.A.M., K.M.R.), Oklahoma City, Oklahoma, USA
| | - David A Murphy
- Dean McGee Eye Institute, University of Oklahoma (A.R.B., B.K., D.A.M., K.M.R.), Oklahoma City, Oklahoma, USA
| | - Sebastian Leal
- From the Bascom Palmer Eye Institute, University of Miami (A.M.A., S.S., S.L., S.G., R.S.T.), Miami, Florida, USA
| | - Seyyedehfatemeh Ghalibafan
- From the Bascom Palmer Eye Institute, University of Miami (A.M.A., S.S., S.L., S.G., R.S.T.), Miami, Florida, USA
| | - Rahul S Tonk
- From the Bascom Palmer Eye Institute, University of Miami (A.M.A., S.S., S.L., S.G., R.S.T.), Miami, Florida, USA
| | - David L Cooke
- Great Lakes Eye Care (D.L.C.), Saint Joseph, Michigan, USA; Department of Neurology and Ophthalmology, College of Osteopathic Medicine, Michigan State University (D.L.C.), East Lansing, Michigan, USA
| | - Kamran M Riaz
- Dean McGee Eye Institute, University of Oklahoma (A.R.B., B.K., D.A.M., K.M.R.), Oklahoma City, Oklahoma, USA.
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Wolffsohn JS, Berkow D, Chan KY, Chaurasiya SK, Fadel D, Haddad M, Imane T, Jones L, Sheppard AL, Vianya-Estopa M, Walsh K, Woods J, Zeri F, Morgan PB. BCLA CLEAR Presbyopia: Evaluation and diagnosis. Cont Lens Anterior Eye 2024; 47:102156. [PMID: 38641525 DOI: 10.1016/j.clae.2024.102156] [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: 04/21/2024]
Abstract
It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power. Both subjective and objective techniques are necessary: subjective techniques (such as patient reported outcome questionnaires and defocus curves) assess the impact of presbyopia on a patient and how the combination of residual objective accommodation and their natural DoF work for them; objective techniques (such as autorefraction, corneal topography and lens imaging) allow the clinician to understand how well a technique is working optically and whether it is the right choice or how adjustments can be made to optimise performance. Techniques to assess visual performance and adverse effects must be carefully conducted to gain a reliable end-point, considering the target size, contrast and illumination. Objective techniques are generally more reliable, can help to explain unexpected subjective results and imaging can be a powerful communication tool with patients. A clear diagnosis, excluding factors such as binocular vision issues or digital eye strain that can also cause similar symptoms, is critical for the patient to understand and adapt to presbyopia. Some corrective options are more permanent, such as implanted inlays / intraocular lenses or laser refractive surgery, so the optics can be trialled with contact lenses in advance (including differences between the eyes) to better communicate with the patient how the optics will work for them so they can make an informed choice.
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Affiliation(s)
- James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom.
| | - David Berkow
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Ka Yin Chan
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Suraj K Chaurasiya
- Department of Contact Lens and Anterior Segment, CL Gupta Eye Institute, Moradabad, India; Department of Optometry and Vision Science, CL Gupta Eye Institute, Moradabad, India
| | - Daddi Fadel
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Mera Haddad
- Faculty of Applied Medical Sciences, Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Tarib Imane
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, United States
| | - Lyndon Jones
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong; Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Amy L Sheppard
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Marta Vianya-Estopa
- Vision and Hearing Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Karen Walsh
- CooperVision Inc., San Ramon, CA, United States
| | - Jill Woods
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fabrizio Zeri
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom; University of Milano-Bicocca, Department of Materials Science, Milan, Italy
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom
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Rodríguez Ortiz H, Flores Ortiz L, Devereux García R, Palacio Pastrana C, Hilario Pérez M, Villanueva Pérez G, Piña Valdez JM, Montalvo Domínguez GY, Gutierrez Díaz LP. Accuracy of intraocular lens power formulas in patients with average keratometry greater than 46 diopters. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024:S2173-5794(24)00136-1. [PMID: 39025231 DOI: 10.1016/j.oftale.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/05/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE To compare the accuracy of Kane, Barrett Universal II, Haigis, and SRK-T formulas in eyes with average keratometry greater than 46 diopters (D). METHODS A retrospective analysis was conducted on 101 eyes of 101 patients with average keratometry greater than 46 D. The absolute prediction error (EA) was obtained for each patient one month after surgery. The mean absolute prediction error (MEA), median absolute prediction error (MedEA) and the percentage of patients with absolute refractive error less than 0.25 D, 0.50 D, and 1.00 D were calculated for each formula analyzed. RESULTS The Kane formula achieved the lowest MEA (0.53 ± 0.43) and the lowest MedEA (0.41), followed by Barrett Universal II (MEA: 0.56 ± 0.42, MedEA: 0.49), SRK-T (MEA: 0.59 ± 0.44, MedEA: 0.54), and Haigis (MEA: 0.77 ± 0.47, MedEA: 0.69), showing a significant difference in the results. It was also observed that the Kane formula was the most accurate, with the highest percentage of patients, with EA less than 0.25 D, 0.50 D, and 1.00 D (30.7%, 54.4%, and 86.1%, respectively), while the Haigis formula was the least accurate (12.9%, 33.7%, and 69.3%, respectively). CONCLUSION In eyes with corneas having average keratometry greater than 46 D, the Kane formula proves to be a useful tool in intraocular lens (IOL) power calculation and demonstrates higher precision compared to the Barrett Universal II, SRK-T, and Haigis formulas.
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Affiliation(s)
- H Rodríguez Ortiz
- Fellow de Ecografía, Clínica Oftalmológica Salauno, Ciudad de México, México.
| | - L Flores Ortiz
- Adscrita de Segmento Anterior, Clínica Oftalmológica Salauno, Ciudad de México, México
| | - R Devereux García
- Adscrito del Servicio de Ecografía, Clínica Oftalmológica Salauno, Ciudad de México, México
| | - C Palacio Pastrana
- Jefa de Enseñanza e Investigación, Clínica Oftalmológica Salauno, Ciudad de México, México
| | - M Hilario Pérez
- Adscrito del Servicio de Ecografía, Clínica Oftalmológica Salauno, Ciudad de México, México
| | - G Villanueva Pérez
- Adscrito del Servicio de Ecografía, Clínica Oftalmológica Salauno, Ciudad de México, México
| | - J M Piña Valdez
- Adscrito del Servicio de Ecografía, Clínica Oftalmológica Salauno, Ciudad de México, México
| | - G Y Montalvo Domínguez
- Adscrito del Servicio de Ecografía, Clínica Oftalmológica Salauno, Ciudad de México, México
| | - L P Gutierrez Díaz
- Adscrito del Servicio de Ecografía, Clínica Oftalmológica Salauno, Ciudad de México, México
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Sun B, Ye Y, Zhao J, Zhou X, Niu L. Comparison of axial length and anterior segment parameters of patients with myopia measured using 2 fourier-domain optical coherent biometry devices. BMC Ophthalmol 2024; 24:289. [PMID: 39014346 PMCID: PMC11253327 DOI: 10.1186/s12886-024-03546-y] [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: 04/13/2024] [Accepted: 06/25/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND This study assessed the agreement of ocular parameters of patients with myopia measured using Colombo intraocular lens (IOL) 2 and IOLMaster 700. METHODS Eighty patients (male, 22; average age, 29.14 ± 7.36 years) with myopia (159 eyes) were included in this study in May 2023. The participants' axial length (AXL), central corneal thickness (CCT), lens thickness (LT), white-to-white distance (WTW), front flat (K1), steep (K2), mean (Km) corneal keratometry, astigmatism (Astig), J0 vector, and J45 vector were measured using the IOLMaster 700 and Colombo IOL 2. The measurements from both devices were compared using the generalized estimating equation, correlation analysis, and Bland-Altman plots. RESULTS With the Colombo IOL 2, lower values for K2 and J0 (odds ratio [OR] = 0.587, p = 0.033; OR = 0.779, p < 0.0001, respectively), and larger values for WTW, Astig, and J45 (OR = 1.277, OR = 1.482, OR = 1.1, all p < 0.0001) were obtained. All ocular measurements by both instruments showed positive correlations, with AXL demonstrating the strongest correlation (r = 0.9996, p < 0.0001). The intraclass correlation coefficients for AXL and CCT measured by both instruments was 0.999 and 0.988 (both p < 0.0001), and Bland-Altman plot showed 95% limits of agreement (LoA) of -0.078 to 0.11 mm and - 9.989 to 13.486 μm, respectively. The maximum absolute 95% LoA for LT, WTW, K1, K2, and J0 were relatively high, achieving 0.829 mm, 0.717 mm, 0.983 D, 0.948 D, and 0.632 D, respectively. CONCLUSIONS In young patients with myopia, CCT and AXL measurements obtained with the Colombo IOL 2 and IOLMaster 700 were comparable. However, WTW, LT, corneal refractive power, and astigmatism values could not be used interchangeably in clinical practice.
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Affiliation(s)
- Bingqing Sun
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, No. 19 Baoqing Road, Shanghai, 200031, China
- NHC Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Centre of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yuhao Ye
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, No. 19 Baoqing Road, Shanghai, 200031, China
- NHC Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Centre of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, No. 19 Baoqing Road, Shanghai, 200031, China
- NHC Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Centre of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, No. 19 Baoqing Road, Shanghai, 200031, China.
- NHC Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China.
- Shanghai Research Centre of Ophthalmology and Optometry, Shanghai, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China.
| | - Lingling Niu
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, No. 19 Baoqing Road, Shanghai, 200031, China.
- NHC Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China.
- Shanghai Research Centre of Ophthalmology and Optometry, Shanghai, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China.
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Yang S, Park C, Byun YS, Chung SH, Kim HS. Comparative accuracy of intraocular lens power calculation formulas when targeting myopia. Heliyon 2024; 10:e33339. [PMID: 39071666 PMCID: PMC11283103 DOI: 10.1016/j.heliyon.2024.e33339] [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: 06/27/2023] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 07/30/2024] Open
Abstract
Purpose This study aims to compare the accuracies of intraocular lens (IOL) power calculation formulas when targeting myopia versus emmetropia. Methods A total of 450 patients were included, with 225 patients targeting emmetropia and 225 patients aiming for approximately -2.0 diopters of myopia. This retrospective analysis utilized data from a single eye of each patient, with preoperative biometric measurements obtained using the IOL Master 700. The study considered established formulas such as Haigis, Hoffer Q, Holladay 1, Holladay 2, and SRK/T, as well as modern formulas including Barrett Universal II, Cooke K6, EVO 2.0, Hill-RBF, Hoffer QST, Kane, Olsen, and PEARL-DGS. Statistical analyses, including Friedman test and post hoc analysis, were employed to compare the accuracy of each IOL power calculation formula between the two groups. Additionally, a multiple regression analysis was conducted to identify variables influencing the accuracy of intraocular lens power calculation formulas. Results In targeting myopia, all IOL formulas tended to exhibit a greater refractive error compared to when targeting emmetropic eyes. Notably, the Haigis, SRK/T, and Holladay 2 formulas were found to be highly influenced by this trend, while the modern formulas were less affected. Conclusion The accuracy of IOL power calculation formulas diminishes when targeting myopia in comparison to emmetropia. However, the modern formulas appear less susceptible to this trend. Consequently, when aiming for myopia, the use of the modern formulas is recommended for enhanced accuracy in IOL power calculation.
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Affiliation(s)
- Soonwon Yang
- Department of Ophthalmology, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
| | - Chanjoon Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
| | - Yong-Soo Byun
- Department of Ophthalmology, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
| | - So-Hyang Chung
- Department of Ophthalmology, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
| | - Hyun Seung Kim
- Department of Ophthalmology, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
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Schallhorn SC, Hettinger KA, Hannan SJ, Venter JA, Teenan D, Schallhorn JM. Effect of residual sphere on uncorrected visual acuity and satisfaction in patients with monofocal and multifocal intraocular lenses. J Cataract Refract Surg 2024; 50:591-598. [PMID: 38350162 PMCID: PMC11146176 DOI: 10.1097/j.jcrs.0000000000001418] [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: 07/06/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
PURPOSE To assess the effect of residual sphere on vision and satisfaction in pseudophakic patients. SETTING Private clinics, United Kingdom. DESIGN Retrospective case series. METHODS A multivariate model evaluated the effect of 1-month residual sphere on outcomes of pseudophakic patients. Odds ratios (ORs) were calculated to assess the relative risk of not achieving ≥20/20 monocular uncorrected distance visual acuity (UDVA), ≥20/50 uncorrected near visual acuity (UNVA), and not being satisfied with vision. ORs were assessed for residual sphere -1.00 to +1.00 diopter (D) in quarter-diopter steps, using 0.00 D as a reference. RESULTS The analysis included 38 828 multifocal and 11 571 monofocal intraocular lenses (IOLs). The residual myopic sphere ≤-0.25 D and hyperopic sphere ≥+0.50 D had a clinically meaningful effect on UDVA. Although monofocal IOLs had an improvement in UNVA with every additional 0.25 D of myopia, the change in ORs with increasing myopia was not significant for multifocal IOLs. The mean improvement in UNVA comparing eyes with 0.00 D and -1.00 D sphere was 0.26 logMAR for monofocal and 0.03 logMAR for multifocal IOLs. Low near-addition IOLs had a slightly higher gain in UNVA with increasing myopia, but the gain was not as substantial as with monofocal IOLs. The effect of ametropia on satisfaction was more pronounced for multifocal IOLs. For every 0.25 D of residual myopia, there was >25% increase in dissatisfied patients. CONCLUSIONS Although myopia improved UNVA in eyes with monofocal IOL, multifocal IOLs did not benefit from residual myopia. Multifocal IOL patients desiring distance vision should be targeted closest to emmetropia, even if it means targeting slight hyperopia.
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Affiliation(s)
- Steven C. Schallhorn
- From the Department of Ophthalmology, University of California, San Francisco, San Francisco, California (S.C. Schallhorn, J.M. Schallhorn); Optical Express, Glasgow, United Kingdom (S.C. Schallhorn, Hettinger, Hannan, Venter, Teenan); Carl Zeiss Meditec, Inc., Dublin, California (S.C. Schallhorn); F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California (J.M. Schallhorn)
| | - Keith A. Hettinger
- From the Department of Ophthalmology, University of California, San Francisco, San Francisco, California (S.C. Schallhorn, J.M. Schallhorn); Optical Express, Glasgow, United Kingdom (S.C. Schallhorn, Hettinger, Hannan, Venter, Teenan); Carl Zeiss Meditec, Inc., Dublin, California (S.C. Schallhorn); F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California (J.M. Schallhorn)
| | - Stephen J. Hannan
- From the Department of Ophthalmology, University of California, San Francisco, San Francisco, California (S.C. Schallhorn, J.M. Schallhorn); Optical Express, Glasgow, United Kingdom (S.C. Schallhorn, Hettinger, Hannan, Venter, Teenan); Carl Zeiss Meditec, Inc., Dublin, California (S.C. Schallhorn); F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California (J.M. Schallhorn)
| | - Jan A. Venter
- From the Department of Ophthalmology, University of California, San Francisco, San Francisco, California (S.C. Schallhorn, J.M. Schallhorn); Optical Express, Glasgow, United Kingdom (S.C. Schallhorn, Hettinger, Hannan, Venter, Teenan); Carl Zeiss Meditec, Inc., Dublin, California (S.C. Schallhorn); F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California (J.M. Schallhorn)
| | - David Teenan
- From the Department of Ophthalmology, University of California, San Francisco, San Francisco, California (S.C. Schallhorn, J.M. Schallhorn); Optical Express, Glasgow, United Kingdom (S.C. Schallhorn, Hettinger, Hannan, Venter, Teenan); Carl Zeiss Meditec, Inc., Dublin, California (S.C. Schallhorn); F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California (J.M. Schallhorn)
| | - Julie M. Schallhorn
- From the Department of Ophthalmology, University of California, San Francisco, San Francisco, California (S.C. Schallhorn, J.M. Schallhorn); Optical Express, Glasgow, United Kingdom (S.C. Schallhorn, Hettinger, Hannan, Venter, Teenan); Carl Zeiss Meditec, Inc., Dublin, California (S.C. Schallhorn); F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California (J.M. Schallhorn)
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Bolo K, Apolo Aroca G, Pardeshi AA, Chiang M, Burkemper B, Xie X, Huang AS, Simonovsky M, Xu BY. Automated expert-level scleral spur detection and quantitative biometric analysis on the ANTERION anterior segment OCT system. Br J Ophthalmol 2024; 108:702-709. [PMID: 37798075 PMCID: PMC10995103 DOI: 10.1136/bjo-2022-322328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 06/14/2023] [Indexed: 10/07/2023]
Abstract
AIM To perform an independent validation of deep learning (DL) algorithms for automated scleral spur detection and measurement of scleral spur-based biometric parameters in anterior segment optical coherence tomography (AS-OCT) images. METHODS Patients receiving routine eye care underwent AS-OCT imaging using the ANTERION OCT system (Heidelberg Engineering, Heidelberg, Germany). Scleral spur locations were marked by three human graders (reference, expert and novice) and predicted using DL algorithms developed by Heidelberg Engineering that prioritise a false positive rate <4% (FPR4) or true positive rate >95% (TPR95). Performance of human graders and DL algorithms were evaluated based on agreement of scleral spur locations and biometric measurements with the reference grader. RESULTS 1308 AS-OCT images were obtained from 117 participants. Median differences in scleral spur locations from reference locations were significantly smaller (p<0.001) for the FPR4 (52.6±48.6 µm) and TPR95 (55.5±50.6 µm) algorithms compared with the expert (61.1±65.7 µm) and novice (79.4±74.9 µm) graders. Intergrader reproducibility of biometric measurements was excellent overall for all four (intraclass correlation coefficient range 0.918-0.997). Intergrader reproducibility of the expert grader (0.567-0.965) and DL algorithms (0.746-0.979) exceeded that of the novice grader (0.146-0.929) for images with narrow angles defined by OCT measurement of angle opening distance 500 µm anterior to the scleral spur (AOD500)<150 µm. CONCLUSIONS DL algorithms on the ANTERION approximate expert-level measurement of scleral spur-based biometric parameters in an independent patient population. These algorithms could enhance clinical utility of AS-OCT imaging, especially for evaluating patients with angle closure and performing intraocular lens calculations.
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Affiliation(s)
- Kyle Bolo
- Roski Eye Institute, Department of Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Galo Apolo Aroca
- Roski Eye Institute, Department of Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Anmol A Pardeshi
- Roski Eye Institute, Department of Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Michael Chiang
- Roski Eye Institute, Department of Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Bruce Burkemper
- Roski Eye Institute, Department of Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Xiaobin Xie
- Eye Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Alex S Huang
- Hamilton Glaucoma Center and Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, California, USA
| | | | - Benjamin Y Xu
- Roski Eye Institute, Department of Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, California, USA
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Li X, Song C, Wang Y, Wang J, Tang Q, Wu Z, Zhou Y, Sun J, Jia Y, Lin Z, Li S. Accuracy of 14 intraocular lens power calculation formulas in extremely long eyes. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06506-w. [PMID: 38758376 DOI: 10.1007/s00417-024-06506-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 04/29/2024] [Accepted: 05/03/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE To compare the accuracy of 14 formulas in calculating intraocular lens (IOL) power in extremely long eyes with axial length (AL) over 30.0 mm. METHODS In this retrospective study, 211 eyes (211 patients) with ALs > 30.0 mm were successfully treated with cataract surgery without complications. Ocular biometric parameters were obtained from IOLMaster 700. Fourteen formulas were evaluated using the optimized A constants: Barrett Universal II (BUII), Kane, Emmetropia Verifying Optical (EVO) 2.0, PEARL-DGS, T2, SRK/T, Holladay 1, Holladay 2, Haigis and Wang-Koch AL adjusted formulas (SRK/Tmodified-W/K, Holladay 1modified-W/K, Holladay 1NP-modified-W/K, Holladay 2modified-W/K, Holladay 2NP-modified-W/K). The mean prediction error (PE) and standard deviation (SD), mean absolute errors (MAE), median absolute errors (MedAE), and the percentage of prediction errors (PEs) within ± 0.25 D, ± 0.50 D, ± 1.00 D were analyzed. RESULTS The Kane formula had the smallest MAE (0.43 D) and MedAE (0.34 D). The highest percentage of PE within ± 0.25 D was for EVO 2.0 (37.91%) and the Holladay 1NP-modified-W/K formulas (37.91%). The Kane formula had the highest percentage of PEs in the range of ± 0.50, ± 0.75, ± 1.00, and ± 2.00 D. There was no significant difference in PEs within ± 0.25, ± 0.50 ± 0.75 and ± 1.00 D between BUII, Kane, EVO 2.0 and Wang-Koch AL adjusted formulas (P > .05) by using Cochran's Q test. The Holladay 2modified-W/K formula has the lowest percentage of hyperopic outcomes (29.38%). CONCLUSIONS The BUII, Kane, EVO 2.0 and Wang-Koch AL adjusted formulas have comparable accuracy for IOL power calculation in eyes with ALs > 30.0 mm.
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Affiliation(s)
- Xinxin Li
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
| | - Chunyuan Song
- Aier Eye Hospital, Jinan University, Guangzhou, 510071, China
| | - Yong Wang
- Wuhan Aier Eye Hospital, Wuhan, 430063, China
| | - Jing Wang
- Shenyang Aier Excellence Eye Hospital, Shenyang, 110001, China
| | | | - Zheming Wu
- Guangzhou Aier Eye Hospital, Guangzhou, 510000, China
| | - Yanwen Zhou
- Liaoning Aier Eye Hospital, Shenyang, 110003, China
| | - Juan Sun
- Hubin Aier Eye Hospital, Binzhou, 256600, China
| | - Yanhong Jia
- Nanning Aier Eye Hospital, Nanning, 530012, China
| | - Zhenlin Lin
- Fuzhou Aier Eye Hospital, Fuzhou, 350000, China
| | - Shaowei Li
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China.
- Beijing Aier Intech Eye Hospital, Beijing, 100021, China.
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Goto S, Maeda N, Ohnuma K, Lawu T, Ogawa K, Sugiyama S, Matsumaru M, Noda T. Impact of segmented optical axial length on the performance of intraocular lens power calculation formulas. J Cataract Refract Surg 2024; 50:492-497. [PMID: 38237070 DOI: 10.1097/j.jcrs.0000000000001397] [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: 07/31/2023] [Accepted: 01/08/2024] [Indexed: 04/24/2024]
Abstract
PURPOSE To investigate the difference between the segmented axial length (AL) and the composite AL on a swept-source optical coherence tomography biometer and to evaluate the subsequent effects on artificial intelligence intraocular lens (IOL) power calculations: the Kane and Hill-RBF 3.0 formulas compared with established vergence formulas. SETTING National Hospital Organization, Tokyo Medical Center, Japan. DESIGN Retrospective case series. METHODS Consecutive patients undergoing cataract surgery with a single-piece IOL were reviewed. The prediction accuracy of the Barrett Universal II, Haigis, Hill-RBF 3.0, Hoffer Q, Holladay 1, Kane, and SRK/T formulas based on 2 ALs were compared for each formula. The heteroscedastic test was used with the SD of prediction errors as the endpoint for formula performance. RESULTS The study included 145 eyes of 145 patients. The segmented AL (24.83 ± 1.89) was significantly shorter than the composite AL (24.88 ± 1.96, P < .001). Bland-Altman analysis revealed a negative proportional bias for the differences between the segmented AL and the composite AL. The SD values obtained by Hoffer Q, Holladay 1, and SRK/T formulas based on the segmented AL (0.52 diopters [D], 0.54 D, and 0.50 D, respectively) were significantly lower than those based on the composite AL (0.57 D, 0.60 D, and 0.52 D, respectively, P < .01). CONCLUSIONS The segmented ALs were longer in short eyes and shorter in long eyes than the composite ALs. The refractive accuracy can be improved in the Hoffer Q, Holladay 1, and SRK/T formulas by changing the composite ALs to the segmented ALs.
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Affiliation(s)
- So Goto
- From the Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, Tokyo, Japan (Goto, Ogawa, Sugiyama, Matsumaru, Noda); Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan (Goto, Maeda); Herbert Wertheim School Optometry and Vision Science, University of California, Berkeley, California (Goto); Laboratorio de Lente Verde, Sodegaura, Chiba, Japan (Ohnuma); VO, Toda, Saitama, Japan (Lawu)
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10
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Shen X, Chen Z, Jia W, Wang Y, Chen T, Sun Y, Jiang Y. Influencing factors of effective lens position in patients with Marfan syndrome and ectopia lentis. Br J Ophthalmol 2024:bjo-2023-325017. [PMID: 38604620 DOI: 10.1136/bjo-2023-325017] [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: 12/05/2023] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
AIMS The aim of this study was to analyse the effective lens position (ELP) in patients with Marfan syndrome (MFS) and ectopia lentis (EL). METHODS Patients with MFS undergoing lens removal and primary intraocular lens (IOL) implantation were enrolled in the study. The back-calculated ELP was obtained with the vergence formula and compared with the theoretical ELPs. The back-calculated ELP and ELP error were evaluated among demographic and biometric parameters, including axial length (AL), corneal curvature radius (CCR) and white-to-white (WTW). RESULTS A total of 292 eyes from 200 patients were included. The back-calculated ELP was lower in patients undergoing scleral-fixated IOL than those receiving in-the-bag IOL implantation (4.54 (IQR 3.65-5.20) mm vs 4.98 (IQR 4.56-5.67) mm, p<0.001). The theoretical ELP of the SRK/T formula exhibited the highest accuracy, with no difference from the back-calculated ELP in patients undergoing in-the-bag IOL implantation (5.11 (IQR 4.83-5.65) mm vs 4.98 (IQR 4.56-5.67) mm, p=0.209). The ELP errors demonstrated significant correlations with refraction prediction error (PE): a 1 mm ELP error led to PE of 2.42D (AL<22 mm), 1.47D (22 mm≤AL<26 mm) and 0.54D (AL≥26 mm). Multivariate analysis revealed significant correlations of ELP with AL (b=0.43, p<0.001), CCR (b=-0.85, p<0.001) and WTW (b=0.41, p=0.004). CONCLUSION This study provides novel insights into the origin of PE in patients with MFS and EL and potentially refines existing formulas.
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Affiliation(s)
- Xin Shen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Zexu Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - WanNan Jia
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Yalei Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Tianhui Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Yang Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Yongxiang Jiang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
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11
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Aiello F, Rampat R, Gallo Afflitto G, Din N, Mandal N, Maurino V. Zonular dialysis and cataract surgery: results from a UK tertiary eye care referral centre. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024; 59:67-72. [PMID: 36627103 DOI: 10.1016/j.jcjo.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/27/2022] [Accepted: 12/08/2022] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Zonular dialysis (ZD), referred to as the presence of a deficient zonular support for the lenticular capsule, might be the result of several causes and be detected only at the time of cataract surgery. The aim of this study was to evaluate pre-, intra-, and postoperative features of eyes with ZD regardless of the etiology detected during cataract surgery. METHODS A single-centre retrospective observational cohort study was performed at Moorfields Eye Hospital (NHS Foundation Trust, London, U.K.) to identify patients who underwent cataract surgery whose procedure was intraoperatively described as being complicated by ZD between January 1, 2014, and August 22, 2019. Patient characteristics, intraoperative clinical findings, visual and refractive outcomes, and postoperative complications were recorded. RESULTS ZD was identified intraoperatively in 447 eyes. In most cases (213 of 223; 96.8%), patients underwent a phacoemulsification procedure, not requiring any conversion to intracapsular or extracapsular extraction technique. Intraoperative complications increased to 46.2% (103 of 223), with no significant correlation with ZD width. Capsular tension rings (CTRs) were implanted in 43.4% of patients (97 of 223). The use of CTRs correlated with better postoperative visual and refractive outcomes. CONCLUSIONS ZD is a serious complication of cataract surgery requiring prompt intraoperative diagnosis and proper management. While it tends to worsen cataract surgery outcomes, the implantation of CTRs during the surgical procedure seems to be associated with better postoperative visual and refractive results.
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Affiliation(s)
- Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata," Rome, Italy.
| | - Radhika Rampat
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Gabriele Gallo Afflitto
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata," Rome, Italy; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Nizar Din
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Niraj Mandal
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Vincenzo Maurino
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
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12
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Kabata Y, Oki T, Nakano T. Comparison of Refractive Prediction Error by Axial Length in Flanged Intrascleral Intraocular Lens Fixation. Clin Ophthalmol 2024; 18:895-900. [PMID: 38529004 PMCID: PMC10962658 DOI: 10.2147/opth.s455178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/14/2024] [Indexed: 03/27/2024] Open
Abstract
Purpose To evaluate the refractive prediction error in flanged intrascleral intraocular lens (IOL) fixation using the SRK/T formula and compare the axial length using a single IOL. Methods Seventy-six eyes from 70 patients (45 males and 25 females) were included in this study. The mean age at the time of surgery was 73.4 ±12.3 years. The patients underwent flanged IOL fixation using a PN6A (Kowa). All surgeries were performed by two surgeons (Y. K. and T. O.) between Jan 2020 and Dec 2022 at Jikei University Daisan Hospital. IOL power was calculated using the SRK/T formula with IOL Master 700 (Carl Zeiss) as the bag power. The recommended value of 119.0 was used for the A-constant. The actual refractive spherical equivalent was calculated and compared with preoperative predictions. Refractive prediction errors were defined as the deviation of the actual postoperative spherical equivalent refraction in diopters from the predicted preoperative spherical equivalent refraction. The patients were divided into three groups according to axial length: <22.0 mm (short eyes), 22.0-24.5 mm (medium eyes), and >24.5 mm (long eyes), and the refractive prediction errors and mean absolute errors were compared. Results The mean refractive prediction error was -0.20 ± 0.52D. The mean absolute error was 0.44 ± 0.33D. The mean refractive prediction errors were not significantly different between the 22.0-24.5 mm (medium eyes) and >24.5 mm (long eyes) groups. (P=0.06) The mean absolute errors were not significantly different between the two groups (P=0.10). Conclusion The SRK/T formula worked well regardless of whether the eyes were medium or long according to the axial length in the flanged intrascleral IOL fixation.
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Affiliation(s)
- Yoshiaki Kabata
- Department of Ophthalmology, Jikei University School of Medicine, Daisan Hospital, Tokyo, Japan
| | - Tetsutaro Oki
- Department of Ophthalmology, Jikei University School of Medicine, Daisan Hospital, Tokyo, Japan
| | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
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13
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Kim J, Park J, Jo Y. Comparison of the formula accuracy for calculating multifocal intraocular lens power: a single center retrospective study in Korean patients. Sci Rep 2024; 14:4462. [PMID: 38396107 PMCID: PMC10891126 DOI: 10.1038/s41598-024-54889-x] [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: 11/17/2023] [Accepted: 02/18/2024] [Indexed: 02/25/2024] Open
Abstract
This study evaluated the accuracy of newer formulas (Barrett Universal II, EVO 2.0, Kane, Hoffer QST, and PEARL-DGS) and the Haigis formula in Korean patients with the Alcon TFNT multifocal intraocular lens. In total, 3100 randomly selected eyes of 3100 patients were retrospectively reviewed. After constant optimization, the standard deviation (SD) of the prediction error was assessed for the entire group, and the root mean square error was compared for short and long axial length (AL) subgroup analysis. The Cooke-modified AL (CMAL) was experimentally applied to the Haigis formula. All the newer formulas performed well, but they did not significantly outperform the Haigis formula. In addition, all the newer formulas exhibited significant myopic outcomes (- 0.23 to - 0.29 diopters) in long eyes. Application of the CMAL to the Haigis formula with single constant optimization produced similar behavior and higher correlation with the newer formulas. The CMAL-applied triple-optimized Haigis formula yielded a substantially smaller SD, even superior to the Barrett and Hoffer QST formulas. The AL modification algorithms such as the CMAL used in newer formulas to cope with optical biometry's overestimation of the AL in long eyes seemed to overcompensate, particularly in the long eyes of the East Asian population.
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Affiliation(s)
- Jinchul Kim
- Department of Ophthalmology, Miracle Eye Clinic, Teheran-ro, Gangnam-gu, Seoul, 06134, South Korea.
| | - Joonsung Park
- Department of Ophthalmology, Miracle Eye Clinic, Teheran-ro, Gangnam-gu, Seoul, 06134, South Korea
| | - Yoonjung Jo
- Department of Ophthalmology, Miracle Eye Clinic, Teheran-ro, Gangnam-gu, Seoul, 06134, South Korea
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14
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Pollmann AS, Nguyen MTD, Keyeutat M, Danis É, Durr GM, Agoumi Y, Jabbour S. Refractive outcomes of immediately sequential bilateral cataract surgery in eyes with long and short axial lengths. BMC Ophthalmol 2024; 24:77. [PMID: 38378504 PMCID: PMC10877801 DOI: 10.1186/s12886-024-03347-3] [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: 01/20/2024] [Accepted: 02/12/2024] [Indexed: 02/22/2024] Open
Abstract
PURPOSE To report the refractive outcomes of long (≥25.00 mm) and short (≤22.00 mm) axial length (AL) eyes undergoing immediately sequential bilateral cataract surgery (ISBCS). METHODS In this retrospective cohort study, patients who underwent ISBCS were identified and eyes of patients with bilateral long and short ALs were included. Pre- and postoperative biometry, autorefraction, and ocular comorbidities or complications were recorded. The primary outcome was the mean refractive prediction error. RESULTS Thirty-seven patients (74 eyes) with long ALs and 18 patients (36 eyes) with short ALs were included. The means ± standard deviations of the ALs were 26.40 ± 1.38 mm and 21.44 ± 0.46 mm in the long and short AL groups, respectively. In long AL eyes, the mean absolute error from the biometry-predicted refraction was - 0.16 ± 0.46 D, corresponding to 74% of eyes achieving a refraction within ±0.50 D of the predicted value. In short AL eyes, the mean absolute error was - 0.63 ± 0.73 D, corresponding to 44% of eyes achieving a refraction within ±0.50 D of the predicted value. Eight (44.4%) patients with short AL eyes had a myopic deviation greater than ±0.50 D from the predicted result in both eyes. CONCLUSIONS Compared to patients with long AL eyes, ISBCS in patients with short ALs had a wider variance in refractive outcome and a lower rate of achieving a postoperative refraction within ±0.50 D of the predicted target.
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Affiliation(s)
- André S Pollmann
- Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet St, Montréal, Quebec, H2X 3E4, Canada.
| | - Michael Trong Duc Nguyen
- Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet St, Montréal, Quebec, H2X 3E4, Canada
| | - Milime Keyeutat
- Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet St, Montréal, Quebec, H2X 3E4, Canada
| | - Éliane Danis
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Georges M Durr
- Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet St, Montréal, Quebec, H2X 3E4, Canada
| | - Younes Agoumi
- Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet St, Montréal, Quebec, H2X 3E4, Canada
| | - Samir Jabbour
- Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 Sanguinet St, Montréal, Quebec, H2X 3E4, Canada
- Department of Ophthalmology, McGill University, Montréal, Canada
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15
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Mao Y, Li J, Qin Y, Xu Y, Liu L, Cheng H, Wu M. Association of refractive outcome with postoperative anterior chamber depth measured with 3 optical biometers. Int Ophthalmol 2024; 44:62. [PMID: 38345699 DOI: 10.1007/s10792-024-02995-0] [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: 05/28/2023] [Accepted: 10/19/2023] [Indexed: 02/15/2024]
Abstract
PURPOSE This study evaluated the relationship between refractive outcomes and postoperative anterior chamber depth (ACD, measured from corneal epithelium to lens) measured by swept-source optical coherence tomography (SS-OCT), optical low-coherence reflectometry (OLCR), and Scheimpflug devices under the undilated pupil. METHODS Patients undergoing cataract phacoemulsification with intraocular lens (IOL) implantation in a hospital setting were enrolled. Postoperative ACD (postACD) was performed with an SS-OCT device, an OLCR device, and a Scheimpflug device at least 1 month after cataract surgery. After adjusting the mean predicted error to 0, differences in refractive outcomes were calculated with the Olsen formula using actual postACD measured from 3 devices and predicted value. RESULTS Overall, this comparative case study included 69 eyes of 69 patients, and postACD measurements were successfully taken using all 3 devices. The postACD measured with the SS-OCT, OLCR, and Scheimpflug devices was 4.59 ± 0.30, 4.50 ± 0.30, and 4.54 ± 0.32 mm, respectively. Statistically significant differences in postACD were found among 3 devices (P < 0.001), with intraclass correlation coefficients (ICCs) and Bland-Altman showing good agreement. No significant difference in median absolute error was found with the Olsen formula using actual postACD obtained with 3 devices. Percentage prediction errors were within ± 0.50 D in 65% (OLCR), 70% (Scheimpflug), and 67% (SS-OCT) calculated by actual postACD versus 64% by predicted value. CONCLUSION Substantial agreement was found in postACD measurements obtained from the SS-OCT, OLCR, and Scheimpflug devices, with a trend toward comparable refractive outcomes in the Olsen formula. Meanwhile, postACD measurements may be potentially superior for the additional enhancement of refractive outcomes.
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Affiliation(s)
- Yan Mao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China
| | - Jianbing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China
- Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yingyan Qin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China
| | - Yanxin Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China
| | - Liangping Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China
| | - Huanhuan Cheng
- Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Mingxing Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China.
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Lim H, Jang JH, Nam S, Lee K, Kim JY, Tchah H, Lee H. Refractive Predictability between Standard and Total Keratometry during the Femtosecond Laser-Assisted Cataract Surgery with Monofocal Intraocular Lens with Enhanced Intermediate Function. KOREAN JOURNAL OF OPHTHALMOLOGY 2024; 38:9-16. [PMID: 38110185 PMCID: PMC10869425 DOI: 10.3341/kjo.2023.0039] [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: 04/01/2023] [Revised: 11/14/2023] [Accepted: 11/19/2023] [Indexed: 12/20/2023] Open
Abstract
PURPOSE We aimed to compare the accuracy of the intraocular lens (IOL) calculation formula using the standard keratometry (K) and total K (TK) during the femtosecond laser-assisted cataract surgery (FLACS) with a monofocal IOL with enhanced intermediate function using currently used formulas. METHODS A retrospective review of 125 eyes from 125 patients who had undergone FLACS with implantation of monofocal IOL with enhanced intermediate function was conducted. The predicted refractive power was calculated using an optical biometer (IOLmaster 700) according to the K and TK in the Barrett Universal II, SRK/T, Haigis, and Holladay 2 formulas. Absolute prediction error (APE) obtained from the actual postoperative refractive outcomes and the refractive error predicted in each formula was compared one month after surgery. RESULTS Mean APE ranged between 0.29 and 0.39 diopters (D) regardless of the calculation formula and the method of measuring corneal curvature. Significant differences were observed in the APE from the four formulas and the two keratometric measurements (p = 0.014). In a total of 125 eyes from 125 patients, the mean APE was lowest with the Barrett Universal II formula. Across all formulas, both the mean APE and the median APE tended to be lower for K than for TK, although there was no significant difference. Approximately 70% to 80% of the patients were included within 0.5 D of the refractive error across all formulas. The percentage of eyes within 0.5 D of APE outcomes was not statistically different between the K and TK data when using each formula. CONCLUSIONS Keratometric measurements considering the poster corneal curvature did not show any additional advantages when implanting the monofocal IOL with enhanced intermediate function during the FLACS.
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Affiliation(s)
- Hyunah Lim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Hyuck Jang
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sanghyu Nam
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Koeun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hungwon Tchah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Nilsen C, Gundersen M, Graae Jensen P, Gundersen KG, Potvin R, Utheim ØA, Gjerdrum B. The Significance of Dry Eye Signs on Preoperative Keratometry Measurements in Patients Scheduled for Cataract Surgery. Clin Ophthalmol 2024; 18:151-161. [PMID: 38259819 PMCID: PMC10800283 DOI: 10.2147/opth.s448168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Purpose The primary objective was to investigate if subjects with dry eyes had increased variability of keratometry measurements prior to cataract surgery compared to subjects with non-dry eyes. Secondary objectives were to determine which separate signs affected keratometry. Patients and Methods This study was part of a prospective interventional randomized controlled trial. After dry eye diagnostics were performed (signs only) subjects were divided into sign of dry eye (SDE) positive and negative groups. To investigate variability, we performed two keratometry measurements for each subject with three different optical biometers: Anterion (OCT optical biometer), Eyestar (combined OCT and reflection-based optical biometer), and Lenstar (reflection based-optical biometer). Results One hundred and thirty-one subjects were available for analysis. The variability of astigmatism was significantly higher for subjects with hyperosmolarity compared to normal eyes for the Lenstar, as was the percentage of eyes with variability of astigmatism greater than 0.25 D. The percentage of eyes with variability of average K greater than 0.25 D was higher for subjects with non-invasive keratograph break-up time <10 seconds (NIKBUT positive) compared to normal eyes for the Lenstar. Conclusion Combined diagnostic criteria (signs only) showed no statistically significant differences for keratometry measurements between SDE positive and negative. Eyes with hyperosmolarity and NIKBUT positive showed statistically higher variability of keratometry measurements compared to normal eyes for Lenstar, but not for the Anterion or Eyestar biometers.
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Affiliation(s)
| | | | | | | | | | - Øygunn A Utheim
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
- The Norwegian Dry Eye Clinic, Oslo, Norway
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18
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Narang R, Agarwal A. Refractive cataract surgery. Curr Opin Ophthalmol 2024; 35:23-27. [PMID: 37962881 DOI: 10.1097/icu.0000000000001005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
PURPOSE OF REVIEW The aim of this study to provide an overview of recent publications and opinions in refractive cataract surgery. RECENT FINDINGS With the advent of intraocular lenses (IOLs) on different platforms, the surgeon has a wide arena of types of IOL to choose, depending on the patient's visual requirement. Optimization of the tear film, integrating tomography and topography devices for appropriate keratometry values, biometry, use of advanced formulas for IOL power calculation and application of newer IOLs can help achieve target refraction in cases scheduled for cataract surgery. Intraoperative aberrometry can be a useful aid for cataract surgery in postrefractive cases and can help minimize residual postoperative astigmatism. SUMMARY Evolvement and rapid advancement of technology allows to impart desired refractive outcomes in most of the cases postcataract surgery. Appropriate preoperative and intraoperative factors should be considered to achieve the desired postoperative outcome.
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Affiliation(s)
- Rhea Narang
- SMT. NHL Medical College, Ahmedabad, Gujarat
| | - Ashvin Agarwal
- Dr Agarwal's Eye Hospital & Research Centre, Chennai, Tamil Nadu, India
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Ferguson TJ, Randleman JB. Cataract surgery following refractive surgery: Principles to achieve optical success and patient satisfaction. Surv Ophthalmol 2024; 69:140-159. [PMID: 37640272 DOI: 10.1016/j.survophthal.2023.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
A growing number of patients with prior refractive surgery are now presenting for cataract surgery. Surgeons face a number of unique challenges in this patient population that tends to be highly motivated to retain or regain functional uncorrected acuity postoperatively. Primary challenges include recognition of the specific type of prior surgery, use of appropriate intraocular lens (IOL) power calculation formulas, matching IOL style with spherical aberration profile, the recognition of corneal imaging patterns that are and are not compatible with toric and/or presbyopia-correcting lens implantation, and surgical technique modifications, which are particularly relevant in eyes with prior radial keratotomy or phakic IOL implantation. Despite advancements in IOL power formulae, corneal imaging, and IOL options that have improved our ability to achieve targeted postoperative refractive outcomes, accuracy and predictability remain inferior to eyes that undergo cataract surgery without a history of corneal refractive surgery. Thus, preoperative evaluation of patients who will and will not be candidates for postoperative refractive surgical enhancements is also paramount. We provide an overview of the specific challenges in this population and offer evidence-based strategies and considerations for optimizing surgical outcomes.
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Affiliation(s)
| | - J Bradley Randleman
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
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20
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Urizar MP, Gambra E, de Castro A, de la Peña Á, Pascual D, Cetinkaya O, Marcos S, Curatolo A. Long-range frequency-domain optical delay line based on a spinning tilted mirror for low-cost ocular biometry. BIOMEDICAL OPTICS EXPRESS 2023; 14:6521-6541. [PMID: 38420323 PMCID: PMC10898555 DOI: 10.1364/boe.501889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 03/02/2024]
Abstract
Optical biometers are routinely used to measure intraocular distances in ophthalmic applications such as cataract surgery planning or myopia monitoring. However, due to their high cost and reduced transportability, access to them for screening and surgical planning is still limited in low-resource and remote settings. To increase patients' access to optical biometry we propose a novel low-cost frequency-domain optical delay line (FD-ODL) based on an inexpensive stepper motor spinning a tilted mirror, for integration into a time-domain (TD)-biometer, amenable to a compact footprint. In the proposed FD-ODL, the axial scan range and the A-scan rate are decoupled from one another, as the former only depends on the spinning mirror tilt angle, while the A-scan rate only depends on the motor shaft rotational speed. We characterized the scanning performance and specifications for two spinning mirror tilt angles, and compared them to those of the standard, more expensive FD-ODL implementation, employing a galvanometric scanner for group delay generation. A prototype of the low-cost FD-ODL with a 1.5 deg tilt angle, resulting in an axial scan range of 6.61 mm and an A-scan rate of 10 Hz was experimentally implemented and integrated in a dual sample beam optical low-coherence reflectometry (OLCR) setup with a detour unit to replicate the measurement window around the anterior segment and the retina. The intraocular distances of a model eye were measured with the proposed low-cost biometer and found to be in good agreement with those acquired by a custom swept-source optical coherence tomography (SS-OCT) system and two commercial biometers, validating our novel design.
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Affiliation(s)
- María Pilar Urizar
- 2EyesVision S.L., Madrid, Spain
- Instituto de Óptica ‘Daza de Valdés’, Consejo Superior de Investigaciones Científicas (IO, CSIC), Madrid, Spain
| | | | - Alberto de Castro
- Instituto de Óptica ‘Daza de Valdés’, Consejo Superior de Investigaciones Científicas (IO, CSIC), Madrid, Spain
| | - Álvaro de la Peña
- Instituto de Óptica ‘Daza de Valdés’, Consejo Superior de Investigaciones Científicas (IO, CSIC), Madrid, Spain
| | - Daniel Pascual
- Instituto de Óptica ‘Daza de Valdés’, Consejo Superior de Investigaciones Científicas (IO, CSIC), Madrid, Spain
| | - Onur Cetinkaya
- International Centre for Translational Eye Research (ICTER), and Institute of Physical Chemistry, Polish Academy of Sciences (IPC-PAS), Warsaw, Poland
| | - Susana Marcos
- Instituto de Óptica ‘Daza de Valdés’, Consejo Superior de Investigaciones Científicas (IO, CSIC), Madrid, Spain
- The Institute of Optics and Flaum Eye Institute, Center for Visual Sciences, University of Rochester, New York, USA
| | - Andrea Curatolo
- Instituto de Óptica ‘Daza de Valdés’, Consejo Superior de Investigaciones Científicas (IO, CSIC), Madrid, Spain
- International Centre for Translational Eye Research (ICTER), and Institute of Physical Chemistry, Polish Academy of Sciences (IPC-PAS), Warsaw, Poland
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21
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Kim NH, Gim Y, Choi KR, Suh W, Jun RM, Han KE. Comparison of intraocular lens power calculation formulas in patients with a history of acute primary angle-closure attack. BMC Ophthalmol 2023; 23:482. [PMID: 38001418 PMCID: PMC10675974 DOI: 10.1186/s12886-023-03232-5] [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: 08/31/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND To compare the accuracy of nine intraocular lens (IOL) power calculation formulas, including three traditional formulas (SRK/T, Haigis, and Hoffer Q) and six new-generation formulas (Barrett Universal II [BUII], Hill-Radial Basis Function [RBF] 3.0, Kane, Emmetropia verifying optical [EVO], Ladas Super, and Pearl-DGS) in patients who underwent cataract surgery after acute primary angle closure (APAC). METHODS In this retrospective cross-sectional study, 44 eyes of 44 patients (APAC) and 60 eyes of 60 patients (control) were included. We compared the mean absolute error, median absolute error (MedAE), and prediction error after surgery. Subgroup analyses were performed on whether axial length (AL) or preoperative laser peripheral iridotomy affected the postoperative refractive outcomes. RESULTS In the APAC group, all formulas showed higher MedAE and more myopic shift than the control group (all P < 0.05). In APAC eyes with AL ≥ 22 mm, there were no differences in MedAEs according to the IOL formulas; however, in APAC eyes with AL < 22 mm, Haigis (0.49 D) showed lower MedAE than SRK/T (0.82 D) (P = 0.036) and Hill-RBF 3.0 (0.54 D) showed lower MedAE than SRK/T (0.82 D), Hoffer Q (0.75 D) or Kane (0.83 D) (P = 0.045, 0.036 and 0.027, respectively). Pearl-DGS (0.63 D) showed lower MedAE than Hoffer Q (0.75 D) and Kane (0.83 D) (P = 0.045 and 0.036, respectively). Haigis and Hill-RBF 3.0 showed the highest percentage (46.7%) of eyes with PE within ± 0.5 D in APAC eyes with AL < 22 mm. Iridectomized eyes did not show superior precision than the non-iridotomized eyes in the APAC group. CONCLUSIONS Refractive errors in the APAC group were more myopic than those in the control group. Haigis and Hill-RBF 3.0 showed high precision in the eyes with AL < 22 mm in the APAC group.
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Affiliation(s)
- Na Hyun Kim
- The Institute of Ophthalmology and Optometry, Department of Ophthalmology, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, South Korea
| | - Yujin Gim
- The Institute of Ophthalmology and Optometry, Department of Ophthalmology, Ewha Womans University College of Medicine, Seoul Hospital, Seoul, South Korea
| | - Kyu-Ryong Choi
- The Institute of Ophthalmology and Optometry, Department of Ophthalmology, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, South Korea
| | - Wool Suh
- The Institute of Ophthalmology and Optometry, Department of Ophthalmology, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, South Korea
| | - Roo Min Jun
- The Institute of Ophthalmology and Optometry, Department of Ophthalmology, Ewha Womans University College of Medicine, Seoul Hospital, Seoul, South Korea
| | - Kyung Eun Han
- The Institute of Ophthalmology and Optometry, Department of Ophthalmology, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, South Korea.
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22
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Zhou Y, Dai M, Sun L, Tang X, Zhou L, Tang Z, Jiang J, Xia X. The accuracy of intraocular lens power calculation formulas based on artificial intelligence in highly myopic eyes: a systematic review and network meta-analysis. Front Public Health 2023; 11:1279718. [PMID: 38026369 PMCID: PMC10670805 DOI: 10.3389/fpubh.2023.1279718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To systematically compare and rank the accuracy of AI-based intraocular lens (IOL) power calculation formulas and traditional IOL formulas in highly myopic eyes. Methods We screened PubMed, Web of Science, Embase, and Cochrane Library databases for studies published from inception to April 2023. The following outcome data were collected: mean absolute error (MAE), percentage of eyes with a refractive prediction error (PE) within ±0.25, ±0.50, and ±1.00 diopters (D), and median absolute error (MedAE). The network meta-analysis was conducted by R 4.3.0 and STATA 17.0. Results Twelve studies involving 2,430 adult myopic eyes (with axial lengths >26.0 mm) that underwent uncomplicated cataract surgery with mono-focal IOL implantation were included. The network meta-analysis of 21 formulas showed that the top three AI-based formulas, as per the surface under the cumulative ranking curve (SUCRA) values, were XGBoost, Hill-RBF, and Kane. The three formulas had the lowest MedAE and were more accurate than traditional vergence formulas, such as SRK/T, Holladay 1, Holladay 2, Haigis, and Hoffer Q regarding MAE, percentage of eyes with PE within ±0.25, ±0.50, and ±1.00 D. Conclusions The top AI-based formulas for calculating IOL power in highly myopic eyes were XGBoost, Hill-RBF, and Kane. They were significantly more accurate than traditional vergence formulas and ranked better than formulas with Wang-Koch AL modifications or newer generations of formulas such as Barrett and Olsen. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022335969.
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Affiliation(s)
- Yi Zhou
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Minhui Dai
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lingyu Sun
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiangyi Tang
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ling Zhou
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhiyao Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jian Jiang
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaobo Xia
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Hong Y, Sun Y, Xiao B, Ainiwaer M, Ji Y. A Bayesian network meta-analysis on comparisons of intraocular lens power calculation methods for paediatric cataract eyes. Eye (Lond) 2023; 37:3313-3321. [PMID: 37019996 PMCID: PMC10630436 DOI: 10.1038/s41433-023-02510-2] [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: 09/24/2022] [Revised: 01/27/2023] [Accepted: 03/16/2023] [Indexed: 04/07/2023] Open
Abstract
The study aimed to compare and rank the accuracy of formulas for calculating intraocular lens (IOL) power in paediatric eyes in a systematic way. A literature search was conducted in Pubmed, Web of Science, Cochrane Library, and EMBASE by December 2021. Combined with traditional and network meta-analysis, we analysed the percentages of paediatric eyes with prediction error (PE) within ±0.50 dioptres (D) and ±1.00 D as the outcome measurements among different formulas. Subgroup analyses stratified by age were also undertaken. Thirteen studies with 1781 eyes comparing 8 calculation formulas were included. For the traditional meta-analysis results, Sanders-Retzlaff-Kraff theoretical (SRK/T) (risk ratios (RR), 1.15; 95% confidence intervals (CI), 1.03-1.30) performed significantly better than the SRKII formula for the percentage of eyes with PE within ±0.50 D. In addition, SRK/T (RR, 1.10; 95% CI, 1.02-1.18) and Holladay 1(RR, 1.15; 95% CI, 1.01-1.30) both performed significantly better than the SRKII formula for the percentage of eyes with PE within ±1.00 D. Considering the ranking based on the surface under the cumulative ranking curve (SUCRA) by Bayesian method, the top four formulas were Barrett Universal II (UII), Haigis, Holladay 1, and SRK/T on the percentage of PE within ±0.50 D, whereas the top four formulas were Barrett UII, Holladay 1, SRK/T, and Hoffer Q formulas on the percentage of PE within ±1.00D. Concerning both outcome measurements of rank probabilities, the top three Barrett UII, SRK/T, and Holladay 1 formulas were considered to provide more accuracy for IOL power calculation in paediatric cataract eyes, and Barrett UII tends to perform better in older children.
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Affiliation(s)
- Yingying Hong
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Yang Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Binghe Xiao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Maierdanjiang Ainiwaer
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Yinghong Ji
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China.
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Müller M, Wortmann C, Paul J, Pawlowicz K, Hemkeppler E, Kohnen T, Böhm M. Anterior eye parameters and lens thickness measured by an intraoperative OCT and a swept-source OCT: comparison of hyperopic, emmetropic and myopic eyes. Eye (Lond) 2023; 37:3360-3366. [PMID: 37076687 PMCID: PMC10630446 DOI: 10.1038/s41433-023-02506-y] [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: 05/23/2022] [Revised: 01/04/2023] [Accepted: 03/09/2023] [Indexed: 04/21/2023] Open
Abstract
PURPOSE To evaluate if anterior chamber depth (ACD) and lens thickness (LT) measured by two different devices are affected by different eye lengths. METHODS ACD and LT of 251 eyes (44 hyperopic, 60 myopic, 147 emmetropic) of 173 patients received with an iOCT-guided femtosecond laser-assisted lens surgery (FLACS) and the IOL Master 700 were compared. RESULTS ACD measured with the IOL Master 700 was -0.026 ± 0.125 mm smaller (p = 0.001) than that with the iOCT for all eye-groups (hyperopic: p = 0.601, emmetropic: p = 0.003; myopic: p = 0.094). However, differences in all groups were not clinically relevant. LT measurements (all eyes: -0.0642 ± 0.0504 mm) shows a statistically significant difference in all evaluated groups (p < 0.001). Only myopic eyes showed a clinically relevant difference in LT. CONCLUSION The two devices show no clinically relevant differences in the eye-length groups (myopic, emmetropic, and hyperopic) for all ACD measurements. LT data shows a clinically relevant difference only for the group of myopic eyes.
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Affiliation(s)
- Michael Müller
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | | | - Julia Paul
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | | | - Eva Hemkeppler
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | - Thomas Kohnen
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.
| | - Myriam Böhm
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
- Harvard Medical School, Boston, MA, USA
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Aiello F, Gallo Afflitto G, Leviste K, Swaminathan SS, Yoo SH, Findl O, Maurino V, Nucci C. Immediate sequential vs delayed sequential bilateral cataract surgery: systematic review and meta-analysis. J Cataract Refract Surg 2023; 49:1168-1179. [PMID: 37276258 DOI: 10.1097/j.jcrs.0000000000001230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/29/2023] [Indexed: 06/07/2023]
Abstract
The main aim of this systematic review and meta-analysis was to evaluate the safety and efficacy profile of immediate sequential bilateral cataract surgery (ISBCS) compared with delayed sequential bilateral cataract surgery (DSBCS). MEDLINE Ovid, EMBASE, and CENTRAL databases were searched. Outcome measures were postoperative visual acuity, postoperative spherical equivalent (refractive outcome), endophthalmitis, corneal edema, pseudophakic macular edema, and posterior capsule rupture (PCR). 13 articles met criteria for final inclusion. A total of 11 068 622 participants (18 802 043 eyes) were included. No statistically significant differences between ISBCS and DSBCS were identified in all the postoperative outcomes evaluated. However, a higher risk for PCR was identified in the ISBCS group from the pooled analysis of nonrandomized studies (risk ratio, 1.34, 95% CI, 1.08-1.67, P = .0081). In our view, the ISBCS approach has an acceptable safety-efficacy profile, comparable with DSBCS. Future investigations are warranted, with a focus on the analysis of risk factors for surgical complications, patient-reported outcome-measures, and cost effectiveness.
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Affiliation(s)
- Francesco Aiello
- From the Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata," Rome, Italy (Aiello, Gallo Afflitto, Nucci); Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida (Gallo Afflitto, Leviste, Swaminathan, Yoo); Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom (Maurino); Vienna Institute for Research in Ocular Surgery (VIROS), Hanusch Hospital, Vienna, Austria (Findl)
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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.
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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
| | - 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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Ma Y, Lin Y, Li Y, Hu Z, Qiu K. Accuracy of new intraocular lens calculation formulas in Chinese eyes with short axial lengths. Front Med (Lausanne) 2023; 10:1257873. [PMID: 37881634 PMCID: PMC10597710 DOI: 10.3389/fmed.2023.1257873] [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: 07/13/2023] [Accepted: 09/26/2023] [Indexed: 10/27/2023] Open
Abstract
Purpose To compare the measurement accuracy of new/updated intraocular lens (IOL) power calculation methods, namely, Kane, Emmetropia Verifying Optical (EVO), with existing methods (Barrett Universal II, Olsen, Haigis, Hoffer Q, Holladay 1, SRK/T) in Chinese eyes with axial lengths ≤ 22.5 mm. Methods The study included data from patients who underwent uneventful cataract surgery with the insertion of ZCB00 IOL. Refractive prediction errors were determined by calculating the difference between postoperative refraction and the predicted refraction using each formula. Various parameters were evaluated, including mean prediction error (ME), mean absolute error (MAE), median absolute error (MedAE), and the percentage of eyes with prediction errors (PE) within different ranges. Results The study enrolled 38 eyes of 38 patients, and the Barrett Universal II formula demonstrated the lowest MAE and MedAE among the tested formulas. Post hoc analysis using Wilcoxon signed-rank pairwise comparisons for non-parametric samples with Bonferroni correction revealed no significant difference in postoperative refractive prediction among all the formulas (P > 0.05). The percentage of eyes with PE within ± 0.5 D was as follows: Barrett Universal II, 81.58%; Haigis, 78.95%; EVO, 76.32%; Olsen, 76.32%; Holladay I, 73.68%; SRK/T, 71.05%; Kane, 68.42%; and Hoffer Q, 65.79%. Conclusion The Barrett Universal II formula was more accurate than the other formulas for Chinese eyes with AL ≤ 22.5 mm.
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Affiliation(s)
| | | | | | | | - Kunliang Qiu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
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Lapid-Gortzak R, Kohnen T, Israeli N, Mitsel P, Shmukler V. New Nitinol-based Thermomechanically Adjustable IOL Technology. J Refract Surg 2023; 39:662-667. [PMID: 37824305 DOI: 10.3928/1081597x-20230908-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
PURPOSE To evaluate the feasibility of new adjustable intraocular lens (IOL) technology. METHODS The foldable adjustable IOL consists of a nitinol mechanism placed in a haptic-optic cradle. Heating actuators on the nitinol mechanism with a continuous green laser achieve controlled movement of the mechanism and optic. Activation occurs in controlled steps: rotation in 1-degree steps over 360 degrees, and anterior posterior movement in 0.25-diopter (D) steps with a range of +1.50 D. The IOL was tested in vitro and in vivo in a rabbit eye. Foldability and unfolding were demonstrated through a 2.6-mm cartridge. RESULTS The adjustable lens mechanism was successfully tested in vitro and in vivo. Activation resulted in a change in optic position relative to the haptics and the capsular bag. Activation of the lever and ratchet mechanism showed radial advancement of the IOL clockwise and counterclockwise. In vivo rotatory movement was achieved after activation by the argon laser at 1 week after implantation. Anterior to posterior movement was accomplished by activating the circular spring actuator mechanism in the laboratory model. Uneventful folding and unfolding were performed. CONCLUSIONS A new adjustable IOL with a mechanism that responds in measured steps had been shown to move as planned after activation by argon laser. This was successful in the laboratory in both radial and anterior posterior movement. The radial movement was also proven in vivo in an animal model. Further refinement of the prototype is currently being undertaken. [J Refract Surg. 2023;39(10):662-667.].
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Shin JH, Kim SH, Oh S, Lee KM. Factors Associated with Refractive Prediction Error after Phacotrabeculectomy. J Clin Med 2023; 12:5706. [PMID: 37685774 PMCID: PMC10488334 DOI: 10.3390/jcm12175706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
PURPOSE To compare refractive prediction errors between phacotrabeculectomy and phacoemulsification. METHODS Refractive prediction error was defined as the difference in spherical equivalent between the predicted value using the Barrett Universal II formula and the actual value obtained at postoperative one month. Forty-eight eyes that had undergone phacotrabeculectomy (19 eyes, open-angle glaucoma; 29 eyes, angle-closure glaucoma) were matched with 48 eyes that had undergone phacoemulsification by age, average keratometry value and axial length (AL), and their prediction errors were compared. The factors associated with prediction errors were analyzed by multivariable regression analyses. RESULTS The phacotrabeculectomy group showed a larger absolute prediction error than the phacoemulsification group (0.51 ± 0.37 Diopters vs. 0.38 ± 0.22 Diopters, p = 0.033). Larger absolute prediction error was associated with longer AL (p = 0.010) and higher intraocular pressure (IOP) difference (p = 0.012). Hyperopic shift (prediction error > 0) was associated with shallower preoperative anterior chamber depth (ACD) (p = 0.024) and larger IOP difference (p = 0.031). In the phacotrabeculectomy group, the prediction error was inversely correlated with AL: long eyes showed myopic shift and short eyes hyperopic shift (p = 0.002). CONCLUSIONS Surgeons should be aware of the possibility of worse refractive outcomes when planning phacotrabeculectomy, especially in eyes with high preoperative IOP, shallow ACD, and/or extreme AL.
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Affiliation(s)
- Jung Hye Shin
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul 07061, Republic of Korea;
- Department of Ophthalmology, Seoul National University Hospital, Seoul 07061, Republic of Korea
| | - Seok Hwan Kim
- The One Seoul Eye Clinic, Seoul 06027, Republic of Korea;
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul 07061, Republic of Korea;
| | - Kyoung Min Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul 07061, Republic of Korea;
- Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul 07061, Republic of Korea
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Barber KM, O’Connor S, Mackinder P, Chih A, Jones B. Rotational stability and refractive outcomes of the DFT/DATx15 toric, extended depth of focus intraocular lens. Int Ophthalmol 2023; 43:2737-2747. [PMID: 36894823 PMCID: PMC10371906 DOI: 10.1007/s10792-023-02673-7] [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: 10/07/2022] [Accepted: 02/20/2023] [Indexed: 03/11/2023]
Abstract
PURPOSE To quantitatively assess postoperative rotational stability and visual acuity with the DFT/DATx15 extended depth of focus (EDOF) toric intraocular lens (IOL). METHODS In this prospective case series, thirty-five patients with a calculated IOL power between + 15.0 D and + 25.0 D, corneal astigmatism between 0.75 D and 2.25 D, and no significant ocular pathology underwent cataract surgery. Primary outcome was rotational stability of the IOL at 1 month post-operatively. Secondary outcomes included residual refractive astigmatism, absolute residual astigmatism prediction error, and monocular distance and intermediate visual acuities. RESULTS Mean absolute postoperative IOL rotation was 1.1 ± 0.2 degrees, with no rotation of more than 3 degrees at the final visit. Monocular mean best spectacle-corrected distance visual acuity (BSCDVA) improved from logMAR 0.27 ± 0.030 to 0.078 ± 0.017 (P < .001). Monocular uncorrected distance visual acuity (UCDVA) improved from 0.93 ± 0.096 to 0.18 ± 0.022 (P < .001). Best spectacle-corrected intermediate visual acuity (DSCIVA) was 0.17 ± 0.025, and uncorrected intermediate visual acuity (UCIVA) was 0.27 ± 0.040. Residual regular astigmatic refractive error was 0.21 ± 0.047 D. CONCLUSIONS The toric DFT/DATx15 EDOF lens showed excellent rotational stability and effective and predictable correction of astigmatism. Its refractive outcomes and safety profile were similar to those identified in prior studies of the non-toric DFT/DAT015 EDOF IOL. A small difference in monocular BSCDVA, of uncertain clinical significance, was found when comparing these outcomes with prior DFT/DAT015 data. The trial was retrospectively registered on November 5, 2021 (TRN NCT05119127).
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Affiliation(s)
- Kevin M. Barber
- Central Florida Eye Specialists, 968 International Parkway, Lake Mary, FL 32746 USA
| | - Sara O’Connor
- Central Florida Eye Specialists, 968 International Parkway, Lake Mary, FL 32746 USA
| | - Philip Mackinder
- Central Florida Eye Specialists, 968 International Parkway, Lake Mary, FL 32746 USA
| | - Andreea Chih
- Central Florida Eye Specialists, 968 International Parkway, Lake Mary, FL 32746 USA
| | - Brian Jones
- Central Florida Eye Specialists, 968 International Parkway, Lake Mary, FL 32746 USA
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Zou M, Lian Z, Young CA, Liu S, Zhang X, Zheng D, Jin G. Improving Effective Lens Position Prediction for Transscleral Fixation of Intraocular Lens Among Congenital Ectopia Lentis Patients. Am J Ophthalmol 2023; 252:121-129. [PMID: 36972739 DOI: 10.1016/j.ajo.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/25/2023] [Accepted: 03/18/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE To introduce a method of predicting effective lens position (ELP) among congenital ectopia lentis (CEL) patients undergoing transscleral fixation of intraocular lens (IOL), and evaluate its effect on improving refractive outcome by utilizing the Sanders-Retzlaff-Kraff / theoretical (SRK/T) formula. DESIGN Retrospective cross-sectional study. METHODS A training set (93 eyes) and validation set (25 eyes) was included. Z value as the distance between the iris plane and a hypothetic postoperative IOL position was introduced in this study. The Z-modified ELP consisted of corneal height (Ch) and Z (ELP = Ch + Z), and Ch was calculated by keratometry (Km) and white-to-white (WTW). The value of Z was identified by linear regression formula with the involvement of axial length (AL), Km, WTW, age, and gender. The comparison of mean (MAE) and mediate absolute error (MedAE) among Z-modified SRK/T formula, SRK/T, Holladay I, and Hoffer Q formula was performed to evaluate the performance of Z-modified SRK/T formula. RESULTS Z value was associated with AL, K, WTW, and age (Z = offset + 15.1093 × lg (AL) + 0.0953899 × Km - 0.3910268 × WTW + 0.0164197 × Age - 19.34804). The Z-modified ELP has good accuracy with no difference to back-calculated ELP. The accuracy of Z-modified SRK/T formula was better than other formulas (P < .001) as the MAE was 0.24 ± 0.19 diopter (D) and MedAE was 0.22 D (95% CI: 0.01-0.57 D). Sixty-four percent of eyes had a refractive error smaller than ±0.25 D, and none of the subjects had a prediction error greater than ±0.75 D. CONCLUSIONS ELP of CEL can be accurately predicted by AL, Km, WTW, and age. Z-modified SRK/T formula improved on the current formula by improving predicting accuracy of ELP and may serve as a promising formula for CEL patients with transscleral fixation of IOL.
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Affiliation(s)
- Minjie Zou
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University (M.Z., Z.L., S.L., X.Z., D.Z., G.J.), Guangzhou, Guangdong, China
| | - Zhangkai Lian
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University (M.Z., Z.L., S.L., X.Z., D.Z., G.J.), Guangzhou, Guangdong, China
| | | | - Siyuan Liu
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University (M.Z., Z.L., S.L., X.Z., D.Z., G.J.), Guangzhou, Guangdong, China
| | - Xinyu Zhang
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University (M.Z., Z.L., S.L., X.Z., D.Z., G.J.), Guangzhou, Guangdong, China
| | - Danying Zheng
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University (M.Z., Z.L., S.L., X.Z., D.Z., G.J.), Guangzhou, Guangdong, China.
| | - Guangming Jin
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University (M.Z., Z.L., S.L., X.Z., D.Z., G.J.), Guangzhou, Guangdong, China.
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Lee Y, Kim MK, Oh JY, Choi HJ, Yoon CH. Intraocular lens power calculation in eyes with a shallow anterior chamber depth and normal axial length. PLoS One 2023; 18:e0288554. [PMID: 37498877 PMCID: PMC10374127 DOI: 10.1371/journal.pone.0288554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 06/29/2023] [Indexed: 07/29/2023] Open
Abstract
We compared the accuracy of three intraocular lens (IOL) calculation formulas in eyes with a shallow anterior chamber depth (ACD) and normal axial length (AXL) and control eyes. We retrospectively reviewed eyes with a shallow ACD (<2.5 mm from the corneal epithelium) with normal AXL (22.5≤AXL<24.0 mm) and controls (3.0≤ACD<3.5 mm and normal AXL). Prediction error (PE) and median absolute error (MedAE) were evaluated with SRK/T, Barrett Universal II (BUII), and Kane formulas after adjusting the mean PE to zero for all patients. Percentages of eyes achieving a PE within 0.25 to 1.00 D, and correlations between ACD, lens thickness (LT), and PE were analyzed. Thirty-five shallow ACD and 63 control eyes were included. PE in the shallow ACD group showed more hyperopic results with BUII and Kane but not with SRK/T compared to controls. Within the shallow ACD group, PE showed more hyperopic results in BUII and Kane compared to SRK/T. However, the standard deviation (SD) of PE among formulas was not different. In the shallow ACD group, SRK/T showed a higher percentage of PE within 0.25 D than BUII and Kane, but the percentages within 0.50 to 1.00 D were similar. PE was negatively correlated with ACD in BUII and Kane, and positively correlated with LT in all formulas. BUII and Kane may induce slight hyperopic shift in eyes with a shallow ACD and normal AXL. However, the performance of the three formulas was comparable in the shallow ACD group in terms of MedAE, the SD of PE, and the percentage of eyes achieving PE within 0.50 D.
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Affiliation(s)
- Yunjin Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
| | - Joo Youn Oh
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
| | - Hyuk Jin Choi
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
- Department of Ophthalmology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Chang Ho Yoon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
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Jiang Y, Shen Y, Chen X, Niu L, Li B, Cheng M, Lei Y, Xu Y, Wang C, Zhou X, Wang X. Artificial intelligence-based refractive error prediction and EVO-implantable collamer lens power calculation for myopia correction. EYE AND VISION (LONDON, ENGLAND) 2023; 10:22. [PMID: 37121995 PMCID: PMC10150472 DOI: 10.1186/s40662-023-00338-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/16/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Implantable collamer lens (ICL) has been widely accepted for its excellent visual outcomes for myopia correction. It is a new challenge in phakic IOL power calculation, especially for those with low and moderate myopia. This study aimed to establish a novel stacking machine learning (ML) model for predicting postoperative refraction errors and calculating EVO-ICL lens power. METHODS We enrolled 2767 eyes of 1678 patients (age: 27.5 ± 6.33 years, 18-54 years) who underwent non-toric (NT)-ICL or toric-ICL (TICL) implantation during 2014 to 2021. The postoperative spherical equivalent (SE) and sphere were predicted using stacking ML models [support vector regression (SVR), LASSO, random forest, and XGBoost] and training based on ocular dimensional parameters from NT-ICL and TICL cases, respectively. The accuracy of the stacking ML models was compared with that of the modified vergence formula (MVF) based on the mean absolute error (MAE), median absolute error (MedAE), and percentages of eyes within ± 0.25, ± 0.50, and ± 0.75 diopters (D) and Bland-Altman analyses. In addition, the recommended spheric lens power was calculated with 0.25 D intervals and targeting emmetropia. RESULTS After NT-ICL implantation, the random forest model demonstrated the lowest MAE (0.339 D) for predicting SE. Contrarily, the SVR model showed the lowest MAE (0.386 D) for predicting the sphere. After TICL implantation, the XGBoost model showed the lowest MAE for predicting both SE (0.325 D) and sphere (0.308 D). Compared with MVF, ML models had numerically lower values of standard deviation, MAE, and MedAE and comparable percentages of eyes within ± 0.25 D, ± 0.50 D, and ± 0.75 D prediction errors. The difference between MVF and ML models was larger in eyes with low-to-moderate myopia (preoperative SE > - 6.00 D). Our final optimal stacking ML models showed strong agreement between the predictive values of MVF by Bland-Altman plots. CONCLUSION With various ocular dimensional parameters, ML models demonstrate comparable accuracy than existing MVF models and potential advantages in low-to-moderate myopia, and thus provide a novel nomogram for postoperative refractive error prediction and lens power calculation.
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Affiliation(s)
- Yinjie Jiang
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yang Shen
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xun Chen
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Lingling Niu
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Boliang Li
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Mingrui Cheng
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yadi Lei
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Chongyang Wang
- Research and Development Department, Shanghai MediWorks Precision Instruments Company Limited, Shanghai, China
| | - Xingtao Zhou
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Eye Ear Nose and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China.
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
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Zhang Y, Zhang Q, Li SZ, He MG, Wang NL. Anterior segment measurements and determinants of angle width with short, medium, and long axial lengths in a rural Chinese population. Heliyon 2023; 9:e14174. [PMID: 36923839 PMCID: PMC10009089 DOI: 10.1016/j.heliyon.2023.e14174] [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: 11/05/2022] [Revised: 02/20/2023] [Accepted: 02/23/2023] [Indexed: 03/04/2023] Open
Abstract
Purpose To report the anterior segment measurements and investigate the determinants of angle width with short, medium, and long axial length (AL) in a rural Chinese population. Design Observational, population-based, cross-sectional study. Methods Subjects aged ≥35 years who underwent complete ocular examinations during the follow-up of the Handan Eye Study were included. Ocular data of the right eye were analyzed. Anterior segment parameters were obtained and stratified by age and sex. AL was categorized into short (<22.0 mm), medium (22.0-23.5 mm), and long (>23.5 mm) subgroups. Linear regression analyses were performed to identify the parameters associated with angle width (angle opening distance at 500 μm from the scleral spur (SS) [AOD500]). Results The final analysis included 4435 subjects (58.0 [49.0, 64.0] years old, 44.1% males). Smaller AOD500 was significantly associated with female sex (P = 0.032), larger iris thickness at 750 μm from the SS (IT750) (P < 0.001), larger lens vault (LV) (P < 0.001), and smaller anterior chamber volume (ACV) (P < 0.001) in the short AL subgroup; larger sphere equivalent (SE), IT750, iris curvature (IC), and LV and smaller ACV (all P < 0.001) in the medium AL subgroup; and larger SE, IT750, IA, IC, and LV and smaller ACV (all P < 0.001) in the long AL subgroup. Conclusions Our study provides the anterior segment parameters of a large rural Chinese population. IT750, ACV, and LV were found to be the most important factors associated with angle width.
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Affiliation(s)
- Ye Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qing Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Ophthalmology, Beijing, China
| | - Si Zhen Li
- Nanjing Tongren Hospital, Jiangsu, China
| | - Ming Guang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia.,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Ning Li Wang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Ophthalmology, Beijing, China
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35
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Maroun A, El Shami M, Hoyek S, Antoun J. Comparison of the accuracy of nine intraocular lens power calculation formulas using partial coherence interferometry. J Fr Ophtalmol 2023; 46:341-347. [PMID: 36746741 DOI: 10.1016/j.jfo.2022.09.031] [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: 04/09/2022] [Revised: 07/31/2022] [Accepted: 09/19/2022] [Indexed: 02/05/2023]
Abstract
Cataract surgery is the most performed procedure in the world. To achieve the target refraction, several intraocular lens (IOL) power calculation formulas have been developed to improve the accuracy of IOL power predictions. We compared the accuracy of 9 IOL power calculation formulas (SRK/T, Hoffer Q, Holladay 1, Haigis, Barrett Universal II, Kane, EVO 2.0, Ladas Super formula and Hill-RBF 3.0) using partial coherence interferometry (PCI). We collected data from patients who underwent uncomplicated cataract surgery with implantation of 1 of 3 IOL types currently used in our center. All preoperative biometric measurements were performed using PCI. Prediction errors (PE) were deduced from refractive outcomes evaluated 3 months after surgery. The mean prediction error (ME), mean absolute prediction error (MAE), median absolute prediction error (MedAE), and standard deviation of prediction error (SD) were calculated, as well as the percentage of eyes with a PE within ± 0.25, ± 0.50, ± 0.75 and ± 1.00D for each formula. We included 126 eyes of 126 patients. Kane achieved the lowest MAE and SD across the entire sample as well as the highest percentage of PE within ± 0.50D and was shown to be more accurate than Haigis and Hoffer Q (P<001). For an axial length of more than 26.0mm, EVO 2.0 and Barrett obtained the lowest MAEs, with EVO 2.0 and Kane showing a higher percentage of prediction at ±0.50D compared to old generation formulas except for SRK/T (P=04). All investigated formulas achieved good results; there was a tendency toward better outcomes with new generation formulas, especially in atypical eyes.
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Affiliation(s)
- A Maroun
- Faculty of medicine, Saint Joseph University, P.O. Box 17-5208, Mar Mikhael, 1104 2020 Beirut, Lebanon.
| | - M El Shami
- Faculty of medicine, Saint Joseph University, P.O. Box 17-5208, Mar Mikhael, 1104 2020 Beirut, Lebanon; Department of neurological surgery, University of Pittsburgh, Pennsylvania, United States of America
| | - S Hoyek
- Faculty of medicine, Saint Joseph University, P.O. Box 17-5208, Mar Mikhael, 1104 2020 Beirut, Lebanon
| | - J Antoun
- Faculty of medicine, Saint Joseph University, P.O. Box 17-5208, Mar Mikhael, 1104 2020 Beirut, Lebanon; Department of ophthalmology, Hôtel-Dieu de France Hospital, Beirut, Lebanon
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Cicinelli MV, Buchan JC, Nicholson M, Varadaraj V, Khanna RC. Cataracts. Lancet 2023; 401:377-389. [PMID: 36565712 DOI: 10.1016/s0140-6736(22)01839-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/03/2022] [Accepted: 09/15/2022] [Indexed: 12/24/2022]
Abstract
94 million people are blind or visually impaired globally, and cataract is the most common cause of blindness worldwide. However, most cases of blindness are avoidable. Cataract is associated with decreased quality of life and reduced life expectancy. Most cases of cataract occur after birth and share ageing and oxidative stress as primary causes, although several non-modifiable and modifiable risk factors can accelerate cataract formation. In most patients, phacoemulsification with intraocular lens implantation is the preferred treatment and is highly cost-effective. There has been an increase in the use of comprehensive cataract surgical services, including diagnoses, treatment referrals, and rehabilitation. However, global inequity in surgical service quality is still a limitation. Implementation of preoperative risk assessment, risk reduction strategies, and new surgical technologies have made cataract surgery possible at an earlier stage of cataract severity with the expectation of good refractive outcomes. The main challenge is making the service that is currently available to some patients accessible to all by use of universal health coverage.
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Affiliation(s)
- Maria Vittoria Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - John C Buchan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Maneck Nicholson
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | | | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, Hyderabad, India; Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India; School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia; School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
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37
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Wei W, Lin H, Zheng X, Wang S, Bai S, Zhao Z. Refractive outcomes of scleral-sutured posterior chamber intraocular lenses in post-traumatic eyes. Int Ophthalmol 2023; 43:423-429. [PMID: 35997929 DOI: 10.1007/s10792-022-02439-7] [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: 12/13/2021] [Accepted: 07/05/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE To evaluate the refractive outcomes of scleral-sutured IOL 2 mm posterior to the limbus in post-traumatic eyes using SRK/T formula. METHODS This single-center retrospective case series included 35 eyes from 35 post-traumatic patients undergoing scleral-suture of ErgomaX IOLs by a single experienced surgeon. Preoperative predicted refraction, procedure-related complications, and postoperative spherical equivalent (SE) at least 1 month after surgery were recorded. The prediction error (PE) was calculated as the difference between the postoperative SE and preoperative predicted refraction. RESULTS Of the 35 post-traumatic patients, 28 patients were aphakia without capsular support, and 7 patients were traumatic lens dislocation or subluxation. The mean age at surgery was 56.03 ± 14.56 years and 28 patients were men (80%). The mean postoperative spherical equivalent (SE) and postoperative astigmatism were - 1.23 ± 0.82 D and 1.57 ± 1.14 D, respectively. The mean prediction error (ME) of SRK/T formula was - 0.17 D. The mean absolute error (MAE) was 0.48D. The prediction accuracy was 60.0% for refractive errors of ± 0.50 D and 85.7% for refractive errors of ± 1.00D. Multiple linear regression analyses revealed that IOL power has positive correlation with PE. CONCLUSION Assumption of in-the-bag IOL position when calculating IOL (52501TY, ErgomaX) power for standardizing scleral-sutured IOL 2 mm posterior to the limbus demonstrates acceptable refractive outcomes. The accuracy of IOL power calculation using the SRK/T formula for eyes needing low IOL power or high IOL power may be affected by the uncertain position of postoperative IOL and further studies are needed.
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Affiliation(s)
- Wenlong Wei
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | | | - Xuanli Zheng
- Wenzhou Medical University, Wenzhou, 325027, China
| | - Siyi Wang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | - Shengsheng Bai
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | - Zhenquan Zhao
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China.
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Jaarsma-Coes MG, Ferreira TA, Marinkovic M, Vu THK, van Vught L, van Haren GR, Rodrigues MF, Klaver YLB, Verbist BM, Luyten GPM, Rasch CRN, Beenakker JWM. Comparison of Magnetic Resonance Imaging-Based and Conventional Measurements for Proton Beam Therapy of Uveal Melanoma. Ophthalmol Retina 2023; 7:178-188. [PMID: 35840053 DOI: 10.1016/j.oret.2022.06.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Conventionally, ocular proton therapy (PT) is planned using measurements obtained by an ophthalmologist using ultrasound, fundoscopy, biometry, and intraoperative assessments. Owing to the recent advances in magnetic resonance imaging (MRI) of uveal melanoma (UM), it is possible to acquire high-resolution 3-dimensional images of the eye, providing the opportunity to incorporate MRI in ocular PT planning. In this study, we described how these measurements can be obtained using MRI, compared the MRI-based measurements with conventional ophthalmic measurements, and identified potential pitfalls for both modalities. DESIGN Cross-sectional study. SUBJECTS Data from 23 consecutive patients with UM treated with PT were retrospectively evaluated. METHODS Magnetic resonance imaging-based measurements of axial length, tumor height and basal diameter, and marker-tumor distances were compared with the conventional ophthalmic measurements, and discrepancies were evaluated in a multidisciplinary setting. MAIN OUTCOME MEASURES Tumor prominence and basal diameters on MRI and ultrasound, axial length on MRI and biometry, tumor-marker distances on MRI and measured intraoperatively. RESULTS The mean absolute differences of the tumor height and basal diameter measurements between ultrasound and MRI were 0.57 mm and 1.44 mm, respectively. Larger absolute differences in height and basal diameter were observed when the full tumor extent was not visible on ultrasound (0.92 mm and 1.67 mm, respectively) compared with when the full tumor extent was visible (0.44 mm and 1.15 mm, respectively). When the full tumor was not visible on ultrasound, MRI was considered more reliable. Tumor-marker distances measured using MRI and intraoperative techniques differed < 1 mm in 55% of the markers. For anteriorly located and mushroom-shaped tumors (25% of the markers), MRI provided more accurate measurements. In flat UM (15% of the markers), however, it was difficult to delineate the tumor on MRI. The mean absolute difference in axial length between optical biometry and MRI was 0.50 mm. The presence of the tumor was found to influence optical biometry in 15 of 22 patients; the remaining patients showed a better agreement (0.30 mm). Magnetic resonance imaging-based biometry was considered more reliable in patients with UM. CONCLUSIONS Magnetic resonance imaging allowed for the 3-dimensional assessment of the tumor and surrounding tissue. In specific patients, it provided a more reliable measurement of axial length, tumor dimensions, and marker-tumor distances and could contribute to a more accurate treatment planning. Nevertheless, a combined evaluation remains advised, especially for flat UM.
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Affiliation(s)
- Myriam G Jaarsma-Coes
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Teresa A Ferreira
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marina Marinkovic
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - T H Khanh Vu
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Luc van Vught
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Guido R van Haren
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Myra F Rodrigues
- HollandPTC, Delft, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Yvonne L B Klaver
- HollandPTC, Delft, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Berit M Verbist
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; HollandPTC, Delft, The Netherlands
| | - Gregorius P M Luyten
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Coen R N Rasch
- HollandPTC, Delft, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan-Willem M Beenakker
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
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Zhang Y, Zhang Q, Li SZ, He MG, Li SN, Wang NL. Anterior Segment Characteristics and Risk Factors for Primary Angle Closure Disease With Long Axial Lengths: The Handan Eye Study. Invest Ophthalmol Vis Sci 2023; 64:8. [PMID: 36633876 PMCID: PMC9840442 DOI: 10.1167/iovs.64.1.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Purpose To investigate the anterior segment characteristics of primary angle closure disease (PACD) with long axial length (AL) compared with that of those with short and medium AL and explore the risk factors associated with AC with different AL levels. Methods This observational cross-sectional study enrolled subjects aged 35 years or older who completed the follow-up examinations of the Handan Eye Study and dichotomized them into normal and PACD groups. Ocular data of the right eye were analyzed. AL was categorized into short (<22.0 mm), medium (22.0-24.0 mm), or long (>24.0 mm) subgroups. Demographic and anterior segment parameters of PACD subjects were compared between the three AL subgroups. Logistic regression analysis was performed to identify the risk factors for PACD in the three subgroups. Results Data from 715 PACD and 1446 normal subjects were analyzed. Only 6.6% of the PACD eyes had long AL, with lower spherical equivalent, larger anterior chamber depth (P < 0.001), and smaller lens thickness (P < 0.001) than those with short and medium AL. No significant differences were found for angle opening distance and iris parameters on comparing the values of eyes with long AL with that of those with short and medium AL. Significant risk factors for the development of PACD with long AL were peripheral iris thickness, anterior chamber width, and lens vault. Conclusions PACD with long AL was uncommon. A thicker peripheral iris, larger lens vault, and smaller ACW contributed to angle closure in these patients.
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Affiliation(s)
- Ye Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University; Beijing, China
| | - Qing Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University; Beijing, China,Beijing Institute of Ophthalmology, Beijing, China
| | - Si Zhen Li
- Nanjing Tongren Hospital, Jiangsu, China
| | - Ming Guang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Shu Ning Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University; Beijing, China
| | - Ning Li Wang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University; Beijing, China,Beijing Institute of Ophthalmology, Beijing, 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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Kaufman AR, Pineda R. Intraoperative aberrometry: an update on applications and outcomes. Curr Opin Ophthalmol 2023; 34:48-57. [PMID: 36484210 DOI: 10.1097/icu.0000000000000915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW There is now a large body of experience with intraoperative aberrometry. This review aims to synthesize available data regarding intraoperative aberrometry applications and outcomes. RECENT FINDINGS The Optiwave Refractive Analysis (ORA) System utilizes Talbot-moiré interferometry and is the only commercially available intraoperative aberrometry device. There are few studies that include all-comers undergoing intraoperative aberrometry-assisted cataract surgery, as most studies examine routine patients only or atypical eyes only. In non-post-refractive cases, studies have consistently shown a small but statistically significant benefit in spherical equivalent refractive outcome for intraoperative aberrometry versus preoperative calculations. In studies examining axial length extremes, most studies have shown intraoperative aberrometry to perform similarly to preoperative calculations. Amongst post-refractive cases, post-myopic ablation cases appear to benefit the most from intraoperative aberrometry. For toric intraocular lenses (IOLs), intraoperative aberrometry may be used for refining IOL power (toricity and spherical equivalent) and alignment, and most studies show intraoperative aberrometry to achieve low postoperative residual astigmatism. SUMMARY Intraoperative aberrometry can be utilized as an adjunct to preoperative planning and surgeon's judgment to optimize cataract surgery refractive outcomes. Non-post-refractive cases, post-myopic ablation eyes, and toric intraocular lenses may have the greatest demonstrated benefit in intraoperative aberrometry studies to date, but other eyes may also benefit from intraoperative aberrometry use.
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Affiliation(s)
- Aaron R Kaufman
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
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Changes in ocular biological parameters after cycloplegia based on dioptre, age and sex. Sci Rep 2022; 12:22470. [PMID: 36577765 PMCID: PMC9797549 DOI: 10.1038/s41598-022-25462-1] [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: 08/18/2022] [Accepted: 11/30/2022] [Indexed: 12/29/2022] Open
Abstract
The effects of cycloplegia on ocular biological parameters in children have been extensively studied, but few studies have compared these parameters between different refractive states, ages, and sexes. Therefore, the purpose of this study was to investigate the changes in ocular biometry before and after cycloplegia in different groups based on dioptre, age and sex. We examined a total of 2049 participants in this cross-sectional study. A comprehensive eye examination was conducted before cycloplegia. Cycloplegia was implemented with the application of atropine or tropicamide. Ocular biological parameters were evaluated after cycloplegia, including axial length (AL), mean keratometry (K), flat keratometry (K1), steep keratometry (K2), central corneal thickness (CCT), anterior chamber depth (ACD) and white-to-white (WTW) distance. All the participants were categorized based on dioptre, age and sex. Statistical analysis was performed with paired t tests and Wilcoxon signed-rank tests. Regarding dioptre, AL was found to be increased significantly in the Fs, Ast and FA (p < 0.05) postcycloplegia groups. We observed significant increases in K, K1, K2 and ACD in the Fs group (p < 0.05) after cycloplegia. Regarding age, we found significant increases in AL, CCT and ACD in group 1 (p < 0.05), but AL decreased significantly in groups 2 and 3 (p < 0.05) postcycloplegia. There were no significant changes found in K, K1 and K2 in the three groups after cycloplegia (p > 0.05). Regarding sex, AL and WTW were found to decrease significantly among males and increase significantly among females (p < 0.05) postcycloplegia, while K, K1 and K2 showed the opposite trends. This study showed that there were differences in some ocular biological parameters after cycloplegia across different groups; in particular, there were significant differences in AL, CCT and ACD. Attention should be devoted to the influence of cycloplegia in clinical work.
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McLintock C, Niyazmand H, Seo S, Barrett G, Kumar Nilagiri V, Karimian S, McKelvie J. Agreement between a new swept-source ocular coherence tomography and a Placido disc-dual Scheimpflug ocular biometric devices. Eur J Ophthalmol 2022; 33:11206721221143160. [PMID: 36475915 DOI: 10.1177/11206721221143160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE To evaluate the agreement between two biometry devices, the Heidelberg Anterion and the Galilei G6 Lens Professional. METHODS Eyes were scanned with both biometry devices. Analysis of inter-device agreement was conducted for the following metrics: flat (K1), steep (K2) and mean K (Km) for anterior, posterior and total cornea, lens thickness (LT), central corneal thickness (CCT), anterior chamber depth (ACD), white to white (WTW) and axial length (AL). Generalised Estimating Equations were used to account for inter-eye correlation. Bland-Altman analysis was conducted to derive the mean difference (MD) and limits of agreement (LoA) between devices. Differences were deemed clinically significant if they would result in a change in post-operative refraction of 0.25D or more. RESULTS 159 eyes of 91 patients were included. For the anterior cornea, no significant MD was found for K1 (-0.11D) and K2 (-0.10D), although a significant MD was found for Km (-0.10D). For posterior cornea, while there were no significant MDs between devices, the LoAs were wide for both posterior K1(-0.70, 0.68) and posterior K2 (-1.01, 1.29). For total corneal power, significant MDs were found in K1 (0.36D), and Km (0.26D) but not for K2 (0.17D). Significant MDs were found for LT (0.179mm), CCT (-0.005mm), ACD (-0.111mm) and WTW (-0.158mm), but not for AL (-0.021mm, p > 0.05).Conclusion: There are statistically but not clinically significant differences between Anterion and Galilei G6 Lens Professional in anterior Km, LT, CCT, ACD and WTW. Measurements of the posterior and total cornea are not interchangeable between devices.
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Affiliation(s)
- Cameron McLintock
- Department of Ophthalmology, 1966Princess Alexandra hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD 4102, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Hamed Niyazmand
- Division of Optometry, School of Allied Health, Faculty of Health and Medical Sciences, 2720The University of Western Australia, QEII Health Campus, Nedlands, 6009, Western Australia, Australia
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Shiney Seo
- Department of Ophthalmology, 1966Princess Alexandra hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD 4102, Australia
| | - Graham Barrett
- 10111Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | | | - Sahar Karimian
- Rockingham Medical Research Centre, Rockingham, Perth, Australia
| | - James McKelvie
- Department of Ophthalmology, 1415University of Auckland, Auckland, New Zealand
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Lender R, Mirsky D, Greenberger R, Boim Z, Ben-Yaakov L, Kashtan C, Naffar I, Shine S, Chowers I, Ben-Eli H. Evaluation of three biometric devices: ocular parameters and calculated intraocular lens power. Sci Rep 2022; 12:19478. [PMID: 36376354 PMCID: PMC9663510 DOI: 10.1038/s41598-022-24017-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
Cataract surgery is among the most common medical procedures, and accurate ocular biometry measurements are key for successful visual outcome. The current study evaluated data obtained by the Eyestar 900, Anterion, IOLMaster700 biometers and the Pentacam corneal topographer. Compared values were axial length (AL), anterior chamber depth (ACD), steep- and flat-K, cylinder and axis. Clinical impact was assessed by calculating intraocular lens (IOL) power using the mean values of every parameter and the Barrett and Kane formulas, stratified by device and amount of cylinder. IOL was re-calculated for each device substituting Pentacam K-values. This study included 196 eyes (98 participants) of cataract surgery candidates. When comparing the IOLMaster to the Eyestar (157 eyes), no difference was found in mean AL or ACD measurements (P > 0.05). Steep-K measurements differed between these devices and the Pentacam (P = 0.01). AL and ACD measurements differed between the IOLMaster and Anterion (38 eyes; P < 0.05). Strong correlations (range 0.72-0.99) were found between all four devices. Bland-Altman analysis demonstrated excellent agreement between biometry devices other than ACD between the IOLMaster and Eyestar. Calculated IOL power was 0.50-1.00 diopter (D) lower with the IOLMaster. Cylinder power was 0.75D higher in all biometers when Pentacam K-values were substituted.
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Affiliation(s)
- Rivkah Lender
- grid.17788.310000 0001 2221 2926Department of Ophthalmology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Devora Mirsky
- grid.17788.310000 0001 2221 2926Department of Ophthalmology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Riki Greenberger
- grid.17788.310000 0001 2221 2926Department of Ophthalmology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Zipora Boim
- grid.17788.310000 0001 2221 2926Department of Ophthalmology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Lee Ben-Yaakov
- grid.17788.310000 0001 2221 2926Department of Ophthalmology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Chaya Kashtan
- grid.17788.310000 0001 2221 2926Department of Ophthalmology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ibrahim Naffar
- grid.17788.310000 0001 2221 2926Department of Ophthalmology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Shira Shine
- grid.17788.310000 0001 2221 2926Department of Ophthalmology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Itay Chowers
- grid.17788.310000 0001 2221 2926Department of Ophthalmology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Hadas Ben-Eli
- grid.17788.310000 0001 2221 2926Department of Ophthalmology, Hadassah Hebrew University Medical Center, Jerusalem, Israel ,grid.443085.e0000 0004 0366 7759Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
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Bettach E, Weill Y, Aronovitz Y, Zadok D, Gelman E, Abulafia A. Advantageous effect of pupil dilation on the quality of optical biometry axial length measurement in individuals with dense cataract. J Cataract Refract Surg 2022; 48:1248-1252. [PMID: 35514045 DOI: 10.1097/j.jcrs.0000000000000964] [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: 03/05/2022] [Accepted: 04/28/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the effect of pharmacologic pupil dilation on the quality of axial length (AL) measurement in patients with dense cataracts and previous low-quality AL measurements performed without dilation. SETTING Shaare-Zedek Medical Center, Jerusalem, Israel. DESIGN Retrospective case series. METHODS All participants underwent swept-source optical coherence tomographic (SS-OCT) biometry. Those with low-quality AL measurements due to dense cataract underwent an additional SS-OCT biometric evaluation after pupil dilation, and the AL measurement of the same eye was recorded. RESULTS 2076 patients underwent SS-OCT during the study period, and 177 (8.52%) had low-quality AL measurements because of dense cataract. 79 (44.63%, mean age 72.53 ± 13.27 years, 43 females) of those 177 patients underwent repeat SS-OCT biometric imaging after pharmacologic pupil dilation, and formed the study group. After pupil dilation, high-quality AL measurements were successfully obtained in 60 (75.95%) of the 79 eyes. The mean SD of the AL measurements decreased significantly ( P &lt; .001), and the number of successful OCT scans per measurement increased significantly ( P &lt; .001) after pupil dilation. The mean difference of the AL before and after pupil dilation was 0.03 ± 0.07 mm ( P &lt; .001). CONCLUSIONS Pharmacologic pupil dilation improved the quality of SS-OCT biometrically measured AL in patients with low-quality AL measurement due to dense cataract. These results could potentially improve postoperative refractive outcomes after cataract surgery and reduce the need of additional AL measurements by more complicated alternative means in this group.
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Affiliation(s)
- Emmanuel Bettach
- From the Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel, affiliated to the Hebrew University, Jerusalem, Israel
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Omoto M, Sugawara K, Torii H, Yotsukura E, Masui S, Shigeno Y, Nishi Y, Negishi K. Investigating the Prediction Accuracy of Recently Updated Intraocular Lens Power Formulas with Artificial Intelligence for High Myopia. J Clin Med 2022; 11:jcm11164848. [PMID: 36013086 PMCID: PMC9410068 DOI: 10.3390/jcm11164848] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/09/2022] [Accepted: 08/13/2022] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to investigate the prediction accuracy of intraocular lens (IOL) power formulas with artificial intelligence (AI) for high myopia. Cases of highly myopic patients (axial length [AL], >26.0 mm) undergoing uncomplicated cataract surgery with at least 1-month follow-up were included. Prediction errors, absolute errors, and percentages of eyes with prediction errors within ±0.25, ±0.50, and ±1.00 diopters (D) were compared using five formulas: Hill-RBF3.0, Kane, Barrett Universal II (BUII), Haigis, and SRK/T. Seventy eyes (mean patient age at surgery, 64.0 ± 9.0 years; mean AL, 27.8 ± 1.3 mm) were included. The prediction errors with the Hill-RBF3.0 and Kane formulas were statistically different from the BUII, Haigis, and SRK/T formulas, whereas there was not a statistically significant difference between those with the Hill-RBF3.0 and Kane. The absolute errors with the Hill-RBF3.0 and Kane formulas were smaller than that with the BUII formula, whereas there was not a statistically significant difference between the other formulas. The percentage within ±0.25 D with the Hill-RBF3.0 formula was larger than that with the BUII formula. The prediction accuracy using AI (Hill-RBF3.0 and Kane) showed excellent prediction accuracy. No significant difference was observed in the prediction accuracy between the Hill-RBF3.0 and Kane formulas.
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Li C, Wang M, Feng R, Liang F, Liu X, He C, Fan S. Comparison of Formula-Specific Factors and Artificial Intelligence Formulas with Axial Length Adjustments in Bilateral Cataract Patients with Long Axial Length. Ophthalmol Ther 2022; 11:1869-1881. [PMID: 35917084 PMCID: PMC9437155 DOI: 10.1007/s40123-022-00551-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 07/18/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction To evaluate and compare the effectiveness for reducing the prediction error (PE) of the second eye using formula-specific factors, artificial intelligence (AI) formulas (PEARL-DGS and Kane), and the Cooke-modified axial length (CMAL) methods in bilateral cataract patients with long axial length (AL). Methods A total of 98 patients with long AL who underwent sequential bilateral cataract surgeries were retrospectively enrolled. The second-eye IOL power was calculated by the formula-specific factors, AI formulas, and CMAL methods when the first eye suffered from refraction surprise. The correction factors of eight formulas were calculated by regression analysis. Results There was a significant correlation between bilateral preoperative biometric parameters (P < 0.05) as well as bilateral PE (P < 0.05). The Kane formula displayed the lowest median absolute error (MedAE) and highest proportion of PE within ± 0.50 and ± 1.00 D compared with other formulas for the first eye. For the second-eye refinement, all three methods could reduce the second-eye MedAE. The formula-specific correction factors were 0.250, 0.331, 0.343, 0.394, 0.409, 0.452, 0.503, and 0.520 for Kane, Barrett Universal II (BUII), PEARL-DGS, Holladay 2, Holladay 1, Haigis, Hoffer Q, and SRK/T, respectively. The new AI-based Kane and PEARL-DGS with or without the CMAL methods could improve the refractive outcomes of the second eye in sequential bilateral cataract patients with long AL. The Kane, BUII, and PEARL-DGS with specific correction factors displayed higher accuracy compared with the other two methods (P < 0.05). Conclusions The new AI-based Kane and PEARL-DGS with or without the CMAL methods could improve the refractive outcomes of the second eye in sequential bilateral cataract patients with long AL. Notably, the Kane, PEARL-DGS, and BUII with specific correction factors displayed higher accuracy. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-022-00551-6.
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Affiliation(s)
- Chuang Li
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Mingwei Wang
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Rui Feng
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Feiyan Liang
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Xialin Liu
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Chang He
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China.
| | - Shuxin Fan
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China.
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48
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Lanza M, Ruggiero A, Ha J, Simonelli F, Kane JX. Accuracy of Formulas for Intraocular Lens Power Calculation After Myopic Refractive Surgery. J Refract Surg 2022; 38:443-449. [PMID: 35858195 DOI: 10.3928/1081597x-20220602-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the accuracy of the following intraocular lens (IOL) power formulas: Barrett True-K No History (BTKNH), Emmetropia Verifying Optical 2.0 Post Myopic LASIK/PRK (EVO 2.0), Haigis-L, American Society of Cataract and Refractive Surgery (ASCRS) average, and Shammas, designed for patients who have undergone previous myopic refractive surgery, independent of preexisting clinical history and corneal tomographic measurements. METHODS Data from 302 eyes of 302 patients who previously underwent myopic refractive surgery and had cataract surgery done by a single surgeon with only one IOL type inserted were included. The predicted refraction was calculated for each of the formulas and compared with the actual refractive outcome to give the prediction error. Subgroup analysis based on the axial length and mean keratometry was performed. RESULTS On the basis of mean absolute prediction error (MAE), the formulas were ranked as follows: Haigis-L (0.61 diopters [D]), ASCRS average (0.63 D), BTKNH (0.67 D), EVO 2.0 (0.68 D), and Shammas (0.69 D). The Haigis-L had a statistically significant lower MAE compared with all formulas (P < .05) except the ASCRS average. Hyperopic mean prediction errors were seen in all formulas for axial lengths of greater than 30 mm or mean keratometry values of 35.00 diopters or less. CONCLUSIONS The Haigis-L and the ASCRS average formulas provided the most accurate results in the overall population evaluated in this study. Moreover, according to data observed, it is important to be careful handling very long eyes and very flat corneas because hyperopic refractions could be more common. [J Refract Surg. 2022;38(7):443-449.].
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49
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Goggin M. Toric intraocular lenses: Evidence‐based use. Clin Exp Ophthalmol 2022; 50:481-489. [PMID: 35584257 PMCID: PMC9543206 DOI: 10.1111/ceo.14106] [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: 04/15/2022] [Revised: 05/10/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022]
Abstract
Uncorrected refractive astigmatism degrades visual acuity. Spherical intraocular lenses (IOLs) leave astigmatic errors resident in the cornea manifest in refractive astigmatism. Toric IOLs, correcting for this corneal astigmatism, contribute to spectacle‐free vision in the pseudophakic eye. This review provides information to assist surgeons in a rational choice of eyes suitable for toric IOL implantation, methods of IOL cylinder power calculation, surgical techniques for toric IOLs and management of complications. With appropriate application of this information, correction of visually detrimental astigmatism can be achieved routinely.
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Affiliation(s)
- Michael Goggin
- The Queen Elizabeth Hospital University of Adelaide Woodville South South Australia Australia
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50
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Paritekar P, Nayak A, Umesh Y, Sirivella I, Manoharan S, Khatib Z. Comparison of newer Kane formula with Sanders Retzlaff Kraff/Theoretical and Barrett Universal II for calculation of intraocular lens power in Indian eyes. Indian J Ophthalmol 2022; 70:1203-1207. [PMID: 35326016 PMCID: PMC9240510 DOI: 10.4103/ijo.ijo_2014_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: To compare the efficacy of Kane formula with Sanders Retzlaff Kraff/Theoretical (SRK/T) and Barrett Universal II in predicting intraocular lens (IOL) power in Indian eyes. Methods: This retrospective study conducted in a tertiary care eye hospital. Data from patients having uneventful cataract surgery with Tecnis ZCB00 IOL implantation were obtained from Lenstar and electronic medical records. Eyes were divided into subgroups based on axial length (AL) as short (<22.0 mm), medium (22–24 mm), and long (>24 mm). The predicted refractive outcome for each patient was calculated after optimizing the lens constant. Prediction error was calculated by subtracting the predicted spherical equivalent from achieved spherical equivalent 1 week post-surgery. The mean absolute error (MAE) and median absolute error (MedAE) and percentage of eyes within 0.25, 0.5, 1, and 2 D were calculated for each formula. Friedman test, Cochrane Q test were used for statistical analysis. Results: Out of the 350 eyes included in the study, we found that without lens constant optimization, Barrett formula performed better than SRK/T and Kane (P < 0.0001). Over the entire range of axial lengths, Kane formula performed slightly inferior compared to Barrett and SRK-T, both of which performed equally well (P = 0.006). On subgroup analysis, Kane formula performed inferiorly for medium eyes as compared to the other two. No significant differences were noted between the formulae for short and long eyes Conclusion: Kane formula did not outperform Barrett Universal II and SRK/T in Indian eyes.
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Affiliation(s)
| | - Akshay Nayak
- Department of Cataract, Sankara Eye Hospital, Bengaluru, India
| | - Y Umesh
- Department of Cataract, Sankara Eye Hospital, Bengaluru, India
| | | | | | - Zain Khatib
- Department of Cataract, Sankara Eye Hospital, Bengaluru, India
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