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Gatinel D, Hoffmann PC, Cooke DL, Chingan A, Debellemanière G, Langenbucher A, Wendelstein JA. Leaving trusted paths: Estimating corneal keratometric index in cataract surgery eyes with zero-power implants. Graefes Arch Clin Exp Ophthalmol 2024; 262:2533-2539. [PMID: 38456928 PMCID: PMC11271351 DOI: 10.1007/s00417-024-06435-8] [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: 10/13/2023] [Revised: 01/27/2024] [Accepted: 02/29/2024] [Indexed: 03/09/2024] Open
Abstract
PURPOSE This study aimed to estimate the corneal keratometric index in the eyes of cataract surgery patients who received zero-power intraocular lenses (IOLs). METHODOLOGY This retrospective study analyzed postoperative equivalent spherical refraction and axial length, mean anterior curvature radius and aqueous humor refractive index to calculate the theoretical corneal keratometric index value (nk). Data was collected from 2 centers located in France and Germany. RESULTS Thirty-six eyes were analyzed. The results revealed a mean corneal keratometric index of 1.329 ± 0.005 for traditional axial length (AL) and 1.331 ± 0.005 for Cooke modified axial length (CMAL). Results ranged from minimum values of 1.318/1.320 to maximum values of 1.340/1.340. CONCLUSION The corneal keratometric index is a crucial parameter for ophthalmic procedures and calculations, particularly for IOL power calculation. Notably, the estimated corneal keratometric index value of 1.329/1.331 in this study is lower than the commonly used 1.3375 index. These findings align with recent research demonstrating that the theoretical corneal keratometric index should be approximately 1.329 using traditional AL and 1.331 using CMAL, based on the ratio between the mean anterior and posterior corneal curvature radii (1.22).
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Affiliation(s)
| | | | - David L Cooke
- Great Lakes Eye Care, 2848 Niles Road, Saint Joseph, MI, 49085, USA
- Department of Neurology and Ophthalmology, College of Osteopathic Medicine, Michigan State University, 965 Wilson Rd, East Lansing, MI, 48824, USA
| | | | | | - Achim Langenbucher
- Institute of Experimental Ophthalmology, Saarland University, Kirrberger Str. 100/22, 66424, Homburg, Germany
| | - Jascha A Wendelstein
- Institute of Experimental Ophthalmology, Saarland University, Kirrberger Str. 100/22, 66424, Homburg, Germany.
- Institut Für Refraktive Und Ophthalmo-Chirurgie (IROC), Stockerstrasse 37, CH-8002, Zurich, Switzerland.
- Department for Ophthalmology and Optometry, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020, Linz, Austria.
- Medical Faculty, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria.
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Craig JP, Barsam A, Chen C, Chukwuemeka O, Ghorbani-Mojarrad N, Kretz F, Michaud L, Moore J, Pelosini L, Turnbull AMJ, Vincent SJ, Wang MTM, Ziaei M, Wolffsohn JS. BCLA CLEAR Presbyopia: Management with corneal techniques. Cont Lens Anterior Eye 2024; 47:102190. [PMID: 38851946 DOI: 10.1016/j.clae.2024.102190] [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: 06/10/2024]
Abstract
Corneal techniques for enhancing near and intermediate vision to correct presbyopia include surgical and contact lens treatment modalities. Broad approaches used independently or in combination include correcting one eye for distant and the other for near or intermediate vision, (termed monovision or mini-monovision depending on the degree of anisometropia) and/or extending the eye's depth of focus [1]. This report reviews the evidence for the treatment profile, safety, and efficacy of the current range of corneal techniques for managing presbyopia. The visual needs and expectations of the patient, their ocular characteristics, and prior history of surgery are critical considerations for patient selection and preoperative evaluation. Contraindications to refractive surgery include unstable refraction, corneal abnormalities, inadequate corneal thickness for the proposed ablation depth, ocular and systemic co-morbidities, uncontrolled mental health issues and unrealistic patient expectations. Laser refractive options for monovision include surface/stromal ablation techniques and keratorefractive lenticule extraction. Alteration of spherical aberration and multifocal ablation profiles are the primary means for increasing ocular depth of focus, using surface and non-surface laser refractive techniques. Corneal inlays use either small aperture optics to increase depth of field or modify the anterior corneal curvature to induce corneal multifocality. In presbyopia correction by conductive keratoplasty, radiofrequency energy is applied to the mid-peripheral corneal stroma, leading to mid-peripheral corneal shrinkage and central corneal steepening. Hyperopic orthokeratology lens fitting can induce spherical aberration and correct some level of presbyopia. Postoperative management, and consideration of potential complications, varies according to technique applied and the time to restore corneal stability, but a minimum of 3 months of follow-up is recommended after corneal refractive procedures. Ongoing follow-up is important in orthokeratology and longer-term follow-up may be required in the event of late complications following corneal inlay surgery.
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Affiliation(s)
- Jennifer P Craig
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand; College of Health & Life Sciences, Aston University, Birmingham, UK.
| | | | - Connie Chen
- Department of Optometry, Chung Shan Medical University, Taichung City, Taiwan
| | - Obinwanne Chukwuemeka
- Cornea, Contact Lens and Myopia Management Unit, De-Lens Ophthalmics Family and Vision Care Centre, Abuja, Nigeria
| | - Neema Ghorbani-Mojarrad
- School of Optometry and Vision Science, University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, UK
| | | | | | | | | | - Andrew M J Turnbull
- Royal Bournemouth Hospital, University Hospitals Dorset, UK; Faculty of Life and Health Sciences, Ulster University, UK
| | - Stephen J Vincent
- Optometry and Vision Science, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Michael T M Wang
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Mohammed Ziaei
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - James S Wolffsohn
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand; College of Health & Life Sciences, Aston University, Birmingham, UK
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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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Voytsekhivskyy OV. The VRF-L and VRF-GL IOL power calculation methods after radial keratotomy. Eye (Lond) 2024:10.1038/s41433-024-03195-x. [PMID: 38942910 DOI: 10.1038/s41433-024-03195-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 05/15/2024] [Accepted: 06/19/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND To investigate the accuracy of the VRF-L and VRF-GL IOL power calculation methods in cataract surgery after radial keratotomy (RK). METHODS The VRF-L and VRF-GL methods were collated with nine formulas: Barrett True K (No History), Haigis, Hoffer Q, Hoffer Q (Double-K), Holladay 1 (Double-K), Holladay 2 (Double-K), PEARL-DGS (RK), SRK/T (Double-K), and T2 (Double-K). With SS-OCT biometry (IOLMaster 700, Carl Zeiss Meditec), data of 78 eyes from 78 patients with previous RK was included. Optimised lens constants were sourced from the IOL Con website. Subjective refraction was obtained at 4 to 5 months postoperatively. The root mean square absolute error (RMSAE) and median absolute error (MedAE) were chosen as primary outcomes and the percentage of eyes with PEs within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D were analysed. RESULTS Statistical significance (Bootstrap-t test, P < 0.05) was shown by VRF-GL, VRF-L, and Haigis formulas with the lowest RMSAE (0.813 D, 0.816 D and 0.824 D) and MedAE (0.511 D, 0.497 D and 0.533 D) values. The Barrett True K formula was less predictable (0.836 and 0.580, respectively). The VRF-L, VRF-GL, and Haigis achieved the highest percentage of eyes with a PE within ±0.50 D (52.56%, 50.00%, and 46.15%) and ±1.00 D (79.49%, 79.49%, and 80.77% respectively). CONCLUSION The VRF-L and VRF-GL methods demonstrated higher accuracy and were comparable with existing methods in eyes after RK. The Haigis was an alternative option with a higher percentage of eyes with a PE within ±1.00 D (80.77%).
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Affiliation(s)
- Oleksiy V Voytsekhivskyy
- Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Komarov Ave. 3, Medical City, Kyiv, 03680, Ukraine.
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Liu Q, Yang W, Li D, Wang Z, Chen W, Zhai C, Wei W. Total and simulated keratometry measurements using IOLMaster 700 and Pentacam AXL after small incision lenticule extraction. Int Ophthalmol 2024; 44:237. [PMID: 38902457 DOI: 10.1007/s10792-024-03191-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 06/15/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE Calculating the intraocular lens (IOL) in patients after corneal refractive surgery presents a challenge. Because an overestimation of corneal power in cases undergone this surgery leading to a subsequent under-correction of IOL power. However, recent advancements in technology have eliable measurement of total corneal power. The aim of this research was to assess the agreement in simulated keratometry (SimK) and total keratometry (TK) values between IOLMaster 700 and Pentacam AXL. METHODS The study involved 99 patients (99 eyes) undergone small incision lenticule extraction (SMILE) surgery. Each patient underwent scans using IOL Master 700 and Pentacam AXL. The following parameters were recorded: SimK1, SimK2, Total K1 (TK1), and Total K2 (TK2) for IOLMaster 700; and SimK1, SimK2, True Net Power (TNP) K1, TNPK2, Total Corneal Refractive Power (TCRP) K1, and TCRP K2 for Pentacam AXL. Agreement between the two devices was evaluated using Bland-Altman plot, while paired t-test was utilized to compare any differences in the same parameter by both instruments. RESULTS The results revealed a strong correlation between the two devices.Noticeable comparability was identified for all SimK variables. However, there were noticeable differences in TK measurements as well as TK1-TNPK1, TK2-TNP K2, TK1-TCRP K1, and TK2-TCRP K2 parameters when comparing the two devices. The IOLMaster 700 consistently measured steeper values than the Pentacam AXL, with significant and clinically relevant differences of 1.34, 1.37, 0.87, and 0.95 diopters, respectively. CONCLUSION While there was a noticeable correlation between the IOLMaster 700 and Pentacam AXL in SimK measurements, a marked difference was noted in TK values. The two devices cannot be used interchangeably when quantifying TK values.
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Affiliation(s)
- Qian Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
| | - Wenli Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China.
| | - Dongjun Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
| | - Ziyang Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
| | - Wei Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
| | - Changbin Zhai
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 Dongjiaomin Ln, Dongcheng District, Beijing, 100730, China
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Debellemanière G, Mechleb N, Bernier T, Ancel JM, Gauvin M, Wallerstein A, Saad A, Gatinel D. The Development of a Thick-Lens Post-Myopic Laser Vision Correction Intraocular Lens Calculation Formula. Am J Ophthalmol 2024; 262:40-47. [PMID: 37865388 DOI: 10.1016/j.ajo.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE To describe the development of the post-myopic laser vision correction (LVC) version of the PEARL-DGS intraocular lens (IOL) calculation formula and to evaluate its outcomes on an independent test set. DESIGN Retrospective, single-center case series. METHODS A modified lens position prediction algorithm was designed along with methods to predict the posterior corneal curvature radius and correct the corneal power measurement error. A different set of previously operated eyes that underwent LVC was used to evaluate the prediction precision of the post-LVC formula. RESULTS Post-LVC PEARL-DGS formula significantly reduced mean absolute error of prediction in comparison to Haigis-L, Shammas, and American Society of Cataract and Refractive Surgery (ASCRS) average formulas (P < .001). It exhibited similar postoperative refractive precision as the Barrett True-K No History formula (P = .61). CONCLUSION The post-LVC formula development process described in this article performed as well as the state-of-the-art post-LVC formula on the present test set. Further studies are required to assess its efficacy in other independent sets.
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Affiliation(s)
- Guillaume Debellemanière
- Department of Ophthalmology, Rothschild Foundation Hospital (G.D., N.M., A.S., D.G.), Paris, France
| | - Nicole Mechleb
- Department of Ophthalmology, Rothschild Foundation Hospital (G.D., N.M., A.S., D.G.), Paris, France
| | - Timothée Bernier
- Clinique Ophtalmologique Lamartine (T.B., J.-M.A.), Paris, France
| | - Jean-Marc Ancel
- Clinique Ophtalmologique Lamartine (T.B., J.-M.A.), Paris, France
| | - Mathieu Gauvin
- Department of Ophthalmology and Visual Sciences, McGill University (M.G., A.W.), Montreal, Quebec, Canada; LASIK MD (M.G., A.W.), Montreal, Quebec, Canada
| | - Avi Wallerstein
- Department of Ophthalmology and Visual Sciences, McGill University (M.G., A.W.), Montreal, Quebec, Canada; LASIK MD (M.G., A.W.), Montreal, Quebec, Canada
| | - Alain Saad
- Department of Ophthalmology, Rothschild Foundation Hospital (G.D., N.M., A.S., D.G.), Paris, France
| | - Damien Gatinel
- Department of Ophthalmology, Rothschild Foundation Hospital (G.D., N.M., A.S., D.G.), Paris, France.
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Oh R, Hyon JY, Jeon HS. Accuracy of the PEARL-DGS Formula for Intraocular Lens Power Calculation in Post-Myopic Laser Refractive Corneal Surgery Eyes. Am J Ophthalmol 2024; 259:79-87. [PMID: 37914063 DOI: 10.1016/j.ajo.2023.10.020] [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: 09/05/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE To investigate the accuracy of the PEARL-DGS formula for intraocular lens (IOL) power calculation in post-myopic laser refractive corneal surgery eyes. DESIGN Retrospective case series. METHODS A total of 139 eyes of 139 patients (mean axial length: 27.4 ± 2.1 mm) who had prior myopic laser refractive corneal surgery and subsequent cataract surgery using Tecnis ZCB00 from March 2018 to February 2023 were included. Refractive outcomes of 5 formulas (Barrett True K, Haigis-L, Hoffer-QST, PEARL-DGS, and Shammas-PL) were evaluated. Prediction error was defined as the difference between the measured and predicted postoperative refractive spherical equivalent using the IOL power actually implanted. Mean prediction error (MPE), median absolute prediction error (MedAE), and mean absolute prediction error were calculated. RESULTS Without constant optimization, the PEARL-DGS resulted in a MPE of +0.05 ± 0.65 diopters (D), whereas the other formulas resulted in myopic shifts. The MedAEs of the formulas were 0.39, 0.53, 0.65, 0.85, and 1.11 D for the PEARL-DGS, Hoffer-QST, Barrett True K, Shammas-PL, and Haigis-L, respectively, in order of magnitude (P < .05). With constant optimization, there were no statistically significant differences in the MedAEs among the 5 formulas (P = .388). CONCLUSIONS In comparison to other IOL formulas, the PEARL-DGS resulted in better refractive outcomes after cataract surgery in post-myopic laser refractive corneal surgery eyes without constant optimization. We suggest that PEARL-DGS be considered as the first choice for IOL power calculation in these eyes when the clinicians do not have their optimized constants.
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Affiliation(s)
- Richul Oh
- From the Department of Ophthalmology (R.O., J.Y.H., H.S.J.), Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology (R.O.), Seoul National University Hospital, Seoul, Korea
| | - Joon Young Hyon
- From the Department of Ophthalmology (R.O., J.Y.H., H.S.J.), Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology (J.Y.H., H.S.J.), Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyun Sun Jeon
- From the Department of Ophthalmology (R.O., J.Y.H., H.S.J.), Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology (J.Y.H., H.S.J.), Seoul National University Bundang Hospital, Seongnam, Korea.
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Wei Y, Liu Y, Li H, Song H. Theoretical Accuracy of the Raytracing Method for Intraocular Calculation of Lens Power in Myopic Eyes after Small Incision Extraction of the Lenticule. Klin Monbl Augenheilkd 2024; 241:221-229. [PMID: 37722612 PMCID: PMC10898958 DOI: 10.1055/a-2177-4998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
AIM To evaluate the accuracy of the raytracing method for the calculation of intraocular lens (IOL) power in myopic eyes after small incision extraction of the lenticule (SMILE). METHODS Retrospective study. All patients undergoing surgery for myopic SMILE between May 1, 2020, and December 31, 2020, with Scheimpflug tomography optical biometry were eligible for inclusion. Manifest refraction was performed before and 6 months after refractive surgery. One eye from each patient was included in the final analysis. A theoretical model was invited to predict the accuracy of multiple methods of lens power calculation by comparing the IOL-induced refractive error at the corneal plane (IOL-Dif) and the SMILE-induced change of spherical equivalent (SMILE-Dif) before and after SMILE surgery. The prediction error (PE) was calculated as the difference between SMILE-Dif-IOL-Dif. IOL power calculations were performed using raytracing (Olsen Raytracing, Pentacam AXL, software version 1.22r05, Wetzlar, Germany) and other formulae with historical data (Barrett True-K, Double-K SRK/T, Masket, Modified Masket) and without historical data (Barrett True-K no history, Haigis-L, Hill Potvin Shammas PM, Shammas-PL) for the same IOL power and model. In addition, subgroup analysis was performed in different anterior chamber depths, axial lengths, back-to-front corneal radius ratio, keratometry, lens thickness, and preoperative spherical equivalents. RESULTS A total of 70 eyes of 70 patients were analyzed. The raytracing method had the smallest mean absolute PE (0.26 ± 0.24 D) and median absolute PE (0.16 D), and also had the largest percentage of eyes within a PE of ± 0.25 D (64.3%), ± 0.50 D (81.4%), ± 0.75 D (95.7%), and ± 1.00 D (100.0%). The raytracing method was significantly better than Double-K SRK/T, Haigis, Haigis-L, and Shammas-PL formulae in postoperative refraction prediction (all p < 0.001), but not better than the following formulae: Barrett True-K (p = 0.314), Barrett True-K no history (p = 0.163), Masket (p = 1.0), Modified Masket (p = 0.806), and Hill Potvin Shammas PM (p = 0.286). Subgroup analysis showed that refractive outcomes exhibited no statistically significant differences in the raytracing method (all p < 0.05). CONCLUSION Raytracing was the most accurate method in predicting target refraction and had a good consistency in calculating IOL power for myopic eyes after SMILE.
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Affiliation(s)
- Yinjuan Wei
- Department of Cataract, Tianjin Eye Hospital, Tianjin, China
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin, China
| | - Yianzhu Liu
- Department of Cataract, Tianjin Eye Hospital, Tianjin, China
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin, China
| | - Hongyu Li
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China
| | - Hui Song
- Department of Cataract, Tianjin Medical University Eye Hospital, Tianjin, China
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Hu J, Zhang WP, Cao DM, Lei Q. Research progress on prediction of postoperative intraocular lens position. Indian J Ophthalmol 2024; 72:S176-S182. [PMID: 38271414 DOI: 10.4103/ijo.ijo_1839_23] [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: 07/12/2023] [Accepted: 11/09/2023] [Indexed: 01/27/2024] Open
Abstract
With the progress in refractive cataract surgery, more intraocular lens (IOL) power formulas have been introduced with the aim of reducing the postoperative refractive error. The postoperative IOL position is critical to IOL power calculations. Therefore, the improvements in postoperative IOL position prediction will enable better selection of IOL power and postoperative refraction. In the past, the postoperative IOL position was mainly predicted by preoperative anterior segment parameters such as preoperative axial length (AL), anterior chamber depth (ACD), and corneal curvature. In recent years, some novel methods including the intraoperative ACD, crystalline lens geometry, and artificial intelligence (AI) of prediction of postoperative IOL position have been reported. This article attempts to give a review about the research progress on prediction of the postoperative IOL position.
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Affiliation(s)
- Jun Hu
- Department of Glaucoma and Cataract, Aier Eye Hospital of Wuhan University, Wuhan, Hubei Province, China
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Savage DE, Pantanelli SM. An update on intraocular lens power calculations in eyes with previous laser refractive surgery. Curr Opin Ophthalmol 2024; 35:34-43. [PMID: 37820078 DOI: 10.1097/icu.0000000000001004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
PURPOSE OF REVIEW There is an ever-growing body of research regarding intraocular lens (IOL) power calculations following photorefractive keratectomy (PRK), laser-assisted in-situ keratomileusis (LASIK), and small-incision lenticule extraction (SMILE). This review intends to summarize recent data and offer updated recommendations. RECENT FINDINGS Postmyopic LASIK/PRK eyes have the best refractive outcomes when multiple methods are averaged, or when Barrett True-K is used. Posthyperopic LASIK/PRK eyes also seem to do best when Barrett True-K is used, but with more variable results. With both aforementioned methods, using measured total corneal power incrementally improves results. For post-SMILE eyes, the first nontheoretical data favors raytracing. SUMMARY Refractive outcomes after cataract surgery in eyes with prior laser refractive surgery are less accurate and more variable compared to virgin eyes. Surgeons may simplify their approach to IOL power calculations in postmyopic and posthyperopic LASIK/PRK by using Barrett True-K, and employing measured total corneal power when available. For post-SMILE eyes, ray tracing seems to work well, but lack of accessibility may hamper its adoption.
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Affiliation(s)
- Daniel E Savage
- Department of Ophthalmology, David and Ilene Flaum Eye Institute
- Center for Visual Science, University of Rochester, Rochester, New York
| | - Seth M Pantanelli
- Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania, USA
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11
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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: 0] [Impact Index Per Article: 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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12
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Li L, Yuan L, Yang K, Wu Y, Alafati S, Hua X, Wang Y, Yuan X. Comparison of the accuracy of 9 intraocular lens power calculation formulas after SMILE in Chinese myopic eyes. Sci Rep 2023; 13:20539. [PMID: 37996736 PMCID: PMC10667341 DOI: 10.1038/s41598-023-47990-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/21/2023] [Indexed: 11/25/2023] Open
Abstract
As of 2021, over 2.8 million small-incision lenticule extraction (SMILE) procedures have been performed in China. However, knowledge regarding the selection of intraocular lens (IOL) power calculation formula for post-SMILE cataract patients remains limited. This study included 52 eyes of 26 myopic patients from northern China who underwent SMILE at Tianjin Eye Hospital from September 2022 to February 2023 to investigate the suitability of multiple IOL calculation formulas in post-SMILE patients using a theoretical surgical model. We compared the postoperative results obtained from three artificial intelligence (AI)-based formulas and six conventional formulas provided by the American Society of Cataract and Refractive Surgery (ASCRS). These formulas were applied to calculate IOL power using both total keratometry (TK) and keratometry (K) values, and the results were compared to the preoperative results obtained from the Barrett Universal II (BUII) formula for the SMILE patients. Among the evaluated formulas, the results obtained from the Emmetropia Verifying Optical 2.0 Formula with TK (EVO-TK) (0.40 ± 0.29 D, range 0-1.23 D), Barrett True K with K formula (BTK-K, 0.41 ± 0.26 D, range 0.01-1.19 D), and Masket with K formula (Masket-K, 0.44 ± 0.33 D, range 0.02-1.39 D) demonstrated the closest proximity to BUII. Notably, the highest proportion of prediction errors within 0.5 D was observed with the BTK-K (71.15%), EVO-TK (69.23%), and Masket-K (67.31%), with the BTK-K showing a significantly higher proportion than the Masket-K (p < 0.001). Our research indicates that in post-SMILE patients, the EVO-TK, BTK-K, and Masket-K may yield more accurate calculation results. At their current stage in development, AI-based formulas do not demonstrate significant advantages over conventional formulas. However, the application of historical data can enhance the performance of these formulas.
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Affiliation(s)
- Liangpin Li
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Liyun Yuan
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Kun Yang
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Yanan Wu
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Simayilijiang Alafati
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China
| | - Xia Hua
- Tianjin Aier Eye Hospital, Tianjin University, Tianjin, 300190, China
| | - Yan Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China.
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China.
| | - Xiaoyong Yuan
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China.
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China.
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13
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Lago CM, de Castro A, Marcos S. Computational simulation of the optical performance of an EDOF intraocular lens in post-LASIK eyes. J Cataract Refract Surg 2023; 49:1153-1159. [PMID: 37458453 DOI: 10.1097/j.jcrs.0000000000001260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/07/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE To evaluate computationally the optical performance of AcrySof IQ Vivity extended depth-of-focus (EDOF) intraocular lenses (IOLs) in post-laser in situ keratomileusis (LASIK) eyes. SETTING Visual Optics and Biophotonics Laboratory, Madrid, Spain. DESIGN Experimental study. METHODS Computer pseudophakic eye models were implemented using reported post-LASIK corneal aberrations (refractive corrections from -7.5 to +4.5 diopters [D]) and virtually implanted with monofocal (AcrySof IQ) or EDOF (AcrySof IQ Vivity) IOLs. Retinal image quality was quantified through visual Strehl (VS). The depth of focus (DOF) was calculated from the through-focus VS curves. Halos were estimated from the light spread in the image of a pinhole. Those quantitative parameters were obtained for 5.0 and 3.0 mm pupil diameters. RESULTS Simulated virgin eyes showed VS of 0.89/0.99 with monofocal IOLs and 0.74/0.52 with EDOF IOLs for 5.0/3.0 mm pupils at best focus. VS decreased with induced spherical aberration (SA) by 25% and with induced SA + coma by 61% on average (3.0 mm pupils). The DOF was 2.50 D in virgin eyes with EDOF IOLs, 1.66 ± 0.30 and 2.54 ± 0.31 D ( P < .05) on average in post-LASIK eyes for 3.0 mm pupils, monofocal and EDOF IOLs, respectively. Halos were more sensitive to SA induction for 5.0 mm pupils, and induction of positive SA (myopic LASIK) resulted in reduced halos with the EDOF when compared with the monofocal IOLs, by 1.62 (SA) and 1.86 arc min (SA + coma), on average. CONCLUSIONS Computer post-LASIK pseudophakic eye models showed that the DOF was less dependent on the presence of SA and coma with EDOF IOLs and that halos were reduced with EDOF IOLs compared with the monofocal IOL for a range of SA.
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Affiliation(s)
- Carmen M Lago
- From the Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Madrid, Spain (Lago, de Castro, Marcos); 2Eyes Vision SL, Madrid, Spain (Lago); Center for Visual Sciences, The Institute of Optics and Flaum Eye Institute, University of Rochester, Rochester, New York (Marcos)
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14
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Yoon SH, Song JR, Lee SH, Eom Y, Hyon JY, Jeon HS. Actual anterior-posterior corneal radius ratio in eyes with prior myopic laser vision correction according to axial length. Sci Rep 2023; 13:14267. [PMID: 37652933 PMCID: PMC10471610 DOI: 10.1038/s41598-023-41062-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
We retrospectively evaluate the actual anterior-posterior (AP) corneal radius ratio in eyes with previous laser correction for myopia (M-LVC) according to axial length (AL) using biometry data exported from swept-source optical coherence tomography between January 2018 and October 2021 in a tertiary hospital (1018 eyes with a history of M-LVC and 19,841 control eyes). The AP ratio was significantly higher in the LVC group than in the control group. Further, it was significantly positively correlated with AL in the LVC group. We also investigated the impact of the AP ratio, AL and keratometry (K) on the absolute prediction error (APE) in 39 eyes that underwent cataract surgery after M-LVC. In linear regression analyses, there were significant correlations between APE and AL/TK, while APE and AP ratio had no correlation. The APE was significantly lower in the Barrett True-K with total keratometry (Barrett True-TK) than in the Haigis-L formula on eyes with AL above 26 mm and K between 38 and 40 D. In conclusion, in eyes with previous M-LVC, AP ratio increases with AL. The Barrett True-K or Barrett True-TK formulas are recommended rather than Haigis-L formula in M-LVC eyes with AL above 26 mm and K between 38 and 40D.
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Affiliation(s)
- Seung Hee Yoon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Ryong Song
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Republic of Korea
| | - Seung Hyen Lee
- Department of Ophthalmology, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Republic of Korea
| | - Youngsub Eom
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA
| | - Joon Young Hyon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Republic of Korea
| | - Hyun Sun Jeon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.
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15
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Helaly HA, Elhady AM, Elnaggar OR. Accuracy of Traditional and Modern Formulas for Intraocular Lens Power Calculation After Radial Keratotomy Using Standard Keratometry. Clin Ophthalmol 2023; 17:2589-2597. [PMID: 37671334 PMCID: PMC10476658 DOI: 10.2147/opth.s417336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/25/2023] [Indexed: 09/07/2023] Open
Abstract
Purpose To compare the accuracy of multiple traditional and modern intraocular lens (IOL) power calculation formulas in post-radial keratotomy (RK) patients undergoing cataract surgery. Methods This retrospective case series included 50 eyes with prior RK who underwent routine phacoemulsification surgery with single-piece acrylic IOL implantation (A constant = 118.8). Outcomes of multiple formulas were calculated. Included formulas were SRK/T, Holladay 1, Holladay 2, Haigis, Barrett True-K, Haigis and Barrett True-K (target refraction of 0.50 D), Barrett Universal II, Kane, PEARL-DGS, Shammas no history, DK SRK/T, DK SRK/T (target refraction of 0.50 D), Double K (DK) Holladay 1, and DK Holladay 1 (target refraction of 0.50 D). Averages of multiple combinations of best-performing single formulas were calculated. Primary outcome is mean absolute error (MAE). Results Haigis (with -0.50 D target refraction) and DK SRK/T showed the lowest mean and median absolute errors (MedAE) followed by Haigis, Barrett True-K, and Barrett True-K (with -0.50 D target refraction). Combinations of 3, 4, or 5 of best performing single formulas yielded good results with >60% of cases within +0.50 D of intended refraction and MAE around 0.50 D. The best performing formulas with flatter K readings were PEARL-DGS and Haigis (with additional -0.50 D target refraction) with MAE of 0.72 + 0.71 D and 0.70 + 0.70 D, respectively, followed by Barrett True-K (with intended -0.50 D target refraction) with MAE of 0.75 + 0.63 D. Conclusion Using an average of three or more Haigis (with -0.50 D target refraction), the Barrett True-K, DK Holladay 1, and DK SRK/T formulas showed better outcomes than using a single formula for IOLMaster 700 standard K readings. The PEARL-DGS formula showed better accuracy in eyes with flatter K readings (<38 D).
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Affiliation(s)
- Hany Ahmed Helaly
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Amr Mohamed Elhady
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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16
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Hu Y, Lin L, Zeng D, Wang Y, Zhang R, Zhang Z, Wang Z, Zhang G, Ye X. Accuracy of the FY-L formula in calculating intraocular lens power after small-incision lenticule extraction. Front Med (Lausanne) 2023; 10:1241824. [PMID: 37692774 PMCID: PMC10483841 DOI: 10.3389/fmed.2023.1241824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/01/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose The study aimed to assess the accuracy of the FY-L formula in calculating intraocular lens (IOL) power after small-incision lenticule extraction (SMILE). Methods For the post-SMILE IOL calculation of the same eye, the IOL power targeting the pre-SMILE eyes' lowest myopic refractive error was used. The FY-L formula, the Emmetropia Verifying Optical Formula (EVO-L), the Barrett True-K no history, and the Shammas-L, respectively, were used to calculate the predicted refractive error of target IOL power. A comparison was made between the change in spherical equivalent induced by SMILE (SMILE-Dif) and the variance between IOL-Dif (IOL-Induced Refractive Error) before and after SMILE. The prediction error (PE) was defined as SMILE-Dif minus IOL-Dif. The proportion of eyes with PEs within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D, the numerical and absolute prediction errors (PEs and AEs), and the median absolute error (MedAE) were compared. Results In total, 80 eyes from 42 patients who underwent SMILE were included in the study. The FY-L formula generated the sample's lowest mean PE (0.06 ± 0.76 D), MAE (0.58 ± 0.50 D), and MedAE (0.47 D), respectively. The PEs in ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D comprised 28.8%, 46.3%, 70.0%, and 87.5%, respectively, for the FY-L formula. Compared to other formulas, the FY-L formula produced the highest value with PEs for the percentage of eyes in ±0.50 D, ±0.75 D, and ±1.00 D. Conclusion This study demonstrates that the FY-L formula provides satisfactory outcomes in estimating the IOL power in the eyes after SMILE.
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Affiliation(s)
| | - Liqun Lin
- Xianyou County General Hospital, Putian, Fujian, China
| | - Danqi Zeng
- Xiamen Eye Center, Xiamen University, Xiamen, Fujian, China
| | - Yan Wang
- Fuzhou Eye Hospital, Fuzhou, Fujian, China
| | - Rong Zhang
- Fuzhou Eye Hospital, Fuzhou, Fujian, China
| | - Zhe Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen, Guangdong, China
- Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Zheng Wang
- Fuzhou Eye Hospital, Fuzhou, Fujian, China
| | - Guangbin Zhang
- Xiamen Eye Center, Xiamen University, Xiamen, Fujian, China
| | - Xiangyu Ye
- Fuzhou Eye Hospital, Fuzhou, Fujian, China
- Xiamen Eye Center, Xiamen University, Xiamen, Fujian, China
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17
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De Bernardo M, Cione F, Capasso L, Coppola A, Rosa N. A formula to improve the reliability of optical axial length measurement in IOL power calculation. Sci Rep 2022; 12:18845. [PMID: 36344612 PMCID: PMC9640640 DOI: 10.1038/s41598-022-23665-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
To verify the influence of axial length (AL) variations after cataract surgery in IOL power calculation. Patients underwent ophthalmic evaluation before surgery, including optical biometry with IOLMaster 500. Same exams were repeated 2 months after surgery: AL of operated eye was evaluated using two modes (pseudophakic/aphakic options). Mean Keratometry and AL changes were analyzed. Furthermore, refractive prediction error (PE) was back-calculated with Barrett Universal-II, Hoffer-Q, Holladay-1 and SRK/T formulas. To eliminate any systematic error, the mean error (ME) was zeroed-out for each formula. MEs and median absolute errors (MedAEs) of PEs were analyzed. Two-hundred-one operated eyes of 201 patients and 201 opposite eyes were evaluated. In operated eyes, mean AL difference was - 0.11 ± 0.07 mm (p < 0.001) with pseudophakic option and 0.00 ± 0.07 mm (p = 0.922) with aphakic option. There were not-statistically significant differences between MedAE of PEs calculated after zeroing-out the ME with different ALs (p > 0.05). Instead, only MEs of PEs obtained with postoperative ALs-pseudophakic option were not-statistically different from zero (p > 0.05). AL measurement change after cataract surgery is probably due to a systematic error in optical biometer in case of phakic eyes. A correction factor applied to preoperative AL could eliminate any systematic error in IOL power calculation without modifying the lens constant.
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Affiliation(s)
- Maddalena De Bernardo
- grid.11780.3f0000 0004 1937 0335Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via Salvador Allende 1, Baronissi, Salerno, Italy
| | - Ferdinando Cione
- grid.11780.3f0000 0004 1937 0335Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via Salvador Allende 1, Baronissi, Salerno, Italy
| | - Luigi Capasso
- Corneal Transplant Unit, ASL Napoli 1, Naples, Italy
| | - Alessia Coppola
- grid.11780.3f0000 0004 1937 0335Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via Salvador Allende 1, Baronissi, Salerno, Italy
| | - Nicola Rosa
- grid.11780.3f0000 0004 1937 0335Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via Salvador Allende 1, Baronissi, Salerno, Italy
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18
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Soare C, Patel DS, Ionides A. Cataract surgery outcomes in eyes with previous radial keratotomy. Eye (Lond) 2022; 36:1804-1809. [PMID: 34376819 PMCID: PMC9391422 DOI: 10.1038/s41433-021-01716-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/13/2021] [Accepted: 07/22/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study shows the visual and refractive outcomes of cataract surgery in patients with previous radial keratotomy (RK). SUBJECTS/METHODS This is a retrospective case series of 100 eyes (65 patients) with previous RK who had undergone routine cataract surgery with a monofocal intraocular lens implant (IOL) at Moorfields Eye Hospital, London, United Kingdom, between January 2004 and December 2018. RESULTS Mean age at the time of surgery was 59.8 years; 39% eyes had ocular copathology. Best-corrected visual acuity (LogMAR; median, interquartile range) improved from 0.30 (0.22, 0.55) to 0.06 (-0.02, 0.21) in eyes without copathology, and from 0.56 (0.30, 1.00) to 0.20 (0.00, 0.20) in eyes with copathology. Haigis formula (19 eyes) resulted in a median prediction error of -0.31 D (-1.07, +0.05), versus -0.55 D (-1.23, +0.22) for Double-K SRK/T (55 eyes) and +0.93 D (0.20, 2.31) for SRK/T (18 eyes). At the final follow-up, 52.6% eyes were within 0.5 D and 68.4% within 1 D of the predicted spherical equivalent for Haigis, versus 32.7% and 52.7% for Double-K SRK/T, and 27.8% and 38.9% for SRK/T. The most frequent complication was RK incision dehiscence (8%). CONCLUSIONS Although the best-corrected visual acuity outcomes compare with the UK national benchmarks, significantly fewer eyes with previous RK achieved the level of unaided distance visual acuity to allow spectacle independence. Surgeons should be aware of the increased likelihood of wound dehiscence and plan surgery accordingly. Haigis formula tended to have a better predictability of the postoperative spherical equivalent and, since introduced, was the preferred choice for IOL calculation in this group of patients.
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Affiliation(s)
- Cristina Soare
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
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19
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Wendelstein J, Heath M, Riaz KM, Seiler T, Cooke DL, Langenbucher A, Hoffmann P, Kohnen T. Biometry and Intraocular Lens Power Calculation in Eyes with Prior Laser Vision Correction (LVC) - A Review. Klin Monbl Augenheilkd 2022; 239:971-981. [PMID: 35973684 DOI: 10.1055/a-1896-0881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND An intraocular lens (IOL) calculation in eyes that have undergone laser vision correction (LVC) poses a significant clinical issue in regards to both patient expectation and accuracy. This review aims to describe the pitfalls of IOL power calculation after LVC and give an overview of the current methods of IOL power calculation after LVC. REVIEW Problems after LVC derive from the measurement of anterior corneal radii, central corneal thickness, asphericity, and the predicted effective lens position. A central issue is that most conventional 3rd generation formulas estimate lens position amongst other parameters on keratometry, which is altered in post-LVC eyes. CONCLUSION An IOL power calculation results in eyes with prior LVC that are notably impaired in eyes without prior surgery. Effective corneal power including anterior corneal curvature, posterior corneal curvature, CCT (central corneal thickness), and asphericity is essential. Total keratometry in combination with the Barrett True-K, EVO (emmetropia verifiying optical formula), or Haigis formula is relatively uncomplicated and seems to provide good results, as does the Barrett True-K formula with anterior K values. The ASCRS ( American Society of Cataract and Refractive Surgery) calculator combines results of various formulae and averages results, which allows a direct comparison between the different methods. Tomography-based raytracing and the Kane and the Castrop formulae need to be evaluated by future studies.
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Affiliation(s)
- Jascha Wendelstein
- IROC, Institut für Refraktive und Ophthalmo-Chirurgie, Zürich, Switzerland.,Abteilung für Augenheilkunde und Optometrie, Johannes Kepler Universität Linz, Linz, Austria.,Institut für Experimentelle Ophthalmologie, Universität des Saarlandes, Homburg/Saar, Germany
| | - Michael Heath
- College of Medicine, University of Oklahoma, Norman, Oklahoma, United States
| | - Kamran M Riaz
- University of Oklahoma, Dean McGee Eye Institute, Oklahoma City, Oklahoma, United States
| | - Theo Seiler
- IROC, Institut für Refraktive und Ophthalmo-Chirurgie, Zürich, Switzerland.,Universitätsklinik für Augenheilkunde, Inselspital, Bern, Switzerland.,Klinik für Augenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - David L Cooke
- Great Lakes Eye Care, Saint Joseoph, United States.,Department of Neurology and Ophthalmology, Michigan State University, East Lansing, Michigan, United States
| | - Achim Langenbucher
- Institut für Experimentelle Ophthalmologie, Universität des Saarlandes, Homburg/Saar, Germany
| | - Peter Hoffmann
- Augen- und Laserklinik Castrop-Rauxel, Castrop-Rauxel, Germany
| | - Thomas Kohnen
- Klinik für Augenheilkunde, Goethe-Universität, Frankfurt, Germany
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20
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Zeng Z, Ye X, Chen Q, Jia C, Zhang G. Intraocular lens power calculation after two different successive corneal refractive surgeries. Am J Ophthalmol Case Rep 2022; 26:101547. [PMID: 35514797 PMCID: PMC9062137 DOI: 10.1016/j.ajoc.2022.101547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 02/06/2022] [Accepted: 04/18/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To report two challenging intraocular lens power calculation cases with patients each underwent different successive corneal refractive surgeries, respectively. Observations Biometry data, including the Back to Front corneal radii ratio (B/F ratio), were collected by Lenstar, IOL Master, and Pentacam AXL for Case 1 (received radial keratotomy (RK) and photorefractive keratectomy (PRK)) and Case 2 (received RK and laser-assisted in situ keratomileusis (LASIK)). The IOL power calculation was determined by several methods, including Shammas, Haigis-L, and Barrett True-K, which are available in the American Society of Cataract and Refractive Surgery online calculator and Pentacam AXL. The Barrett True-K (no history, post-RK) was more accurate in Case 1 (increased B/F ratio), whereas the Shammas, Haigis-L, and Barrett True-K (no history, post-LASIK/PRK) were more accurate in Case 2 (decreased B/F ratio). Conclusion and importance The B/F ratio may be a factor to be considered when selecting the IOL power calculation formula for patients who undergo two different corneal refractive surgeries. The further study focusing on this issue should be performed to clarify the results in the future.
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21
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Fang X, Ben S, Dong Y, Chen X, Xue W, Wang Y. Outcomes of the Haigis-L formula for calculating intraocular lens power in extreme long axis eyes after myopic laser in situ keratomileusis. Eye (Lond) 2022; 36:1178-1184. [PMID: 34117389 PMCID: PMC9151766 DOI: 10.1038/s41433-021-01551-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 03/07/2021] [Accepted: 04/13/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate the accuracy of refractive prediction by the Haigis-L formula compared to four other IOL power calculation formulas in eyes with extremely long axial lengths (AL > 29.0 mm) after LASIK. SETTING Shanghai Eye Disease and Prevention Treatment Center, Shanghai, China. DESIGN Retrospective case series. METHODS Twenty-nine eyes from 19 patients were available for analysis. The primary outcome measure was the arithmetic refractive prediction error (RPE), defined as the difference between the actual postoperative refractive error and the intended formula-derived refractive target. The main outcome measure was the median absolute refraction prediction error (MedAE). The accuracy of the Haigis-L was compared with Barrett True K No History, Shammas-PL, SRK/Tcorrected K, and Holladay 2corrected K methods to calculate IOL power. RESULTS The Haigis-L formula had a significantly larger MedAE than Shammas-PL and SRK/Tcorrected K formulas (P = 0.005 and P = 0.015, respectively), a smaller percentage of eyes within ±1.50 diopter (D) of predicted error in refraction compared with Shammas-PL and SRK/Tcorrected K formulas (P = 0.014 and P = 0.005, respectively). The refractive prediction errors of 6 eyes with corneal keratometry of less than 35 D by Haigis-L all had more than 1.95 D of myopic overestimation, while none of the other four methods resulted in an absolute error over 1.95 D. CONCLUSIONS The Haigis-L formula was relatively accurate in predicting extreme long axis (>29.0 mm) eyes after myopic LASIK surgery but less accurate for eyes with extremely flat corneas (<35 D). SRK/Tcorrected K and Shammas-PL performed better than the other methods for refractive prediction in this type of eyes. SYNOPSIS Haigis-L performed worse than SRK/Tcorrected K and Shammas-PL in predicting IOL power in extremely long axis (>29.0 mm) eyes after myopic LASIK, especially with extremely flat corneas (K < 35 D).
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Affiliation(s)
- Xiaoling Fang
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Shenyu Ben
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Yiping Dong
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Xia Chen
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Wenwen Xue
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Yulan Wang
- Department of Ophthalmology, Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
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Dołowiec-Kwapisz A, Misiuk-Hojło M, Piotrowska H. Cataract Surgery after Radial Keratotomy with Non-Diffractive Extended Depth of Focus Lens Implantation. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:689. [PMID: 35630106 PMCID: PMC9146410 DOI: 10.3390/medicina58050689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/16/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
Abstract
Radial keratotomy was a popular surgical procedure used to treat myopia. Patients who underwent radial keratotomy several years ago, are currently reporting to the ophthalmologist due to worsening of vision associated with age-related cataracts. In this case report we present a case of a 60-year-old woman who underwent radial keratotomy with 16 incisions in the right eye and 12 incisions in the left eye. The patient reported to an ophthalmologist due to a deterioration of vision caused by a cataract. We described, in detail, the difficulties encountered during the diagnostic procedures, differences in the calculation of intraocular lens, and intraoperative difficulties as compared to patients who had not undergone radial keratotomy. We also present the obtained postoperative results.
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Affiliation(s)
| | - Marta Misiuk-Hojło
- Department of Ophthalmology, Wrocław Medical University, 50-556 Wrocław, Poland;
| | - Halina Piotrowska
- Department of Ophthalmology, Hospital in Zgorzelec, 59-900 Zgorzelec, Poland;
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Sun Y, Hong Y, Rong X, Ji Y. Presbyopia-Correcting Intraocular Lenses Implantation in Eyes After Corneal Refractive Laser Surgery: A Meta-Analysis and Systematic Review. Front Med (Lausanne) 2022; 9:834805. [PMID: 35479941 PMCID: PMC9035540 DOI: 10.3389/fmed.2022.834805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To assess the efficacy, safety, and predictability of presbyopia-correcting intraocular lenses (IOLs) in cataract patients with previous corneal refractive surgery. Methods A systematic literature search was performed to identify studies evaluating the clinical outcomes of presbyopia-correcting IOLs implantation in cataract surgery after laser refractive surgery. Outcomes were efficacy, safety and predictability parameters. Results The authors identified 13 studies, involving a total of 128 patients and 445 eyes. Presbyopia-correcting IOLs were effective at improving distance, intermediate and near visual acuity aftercataract surgery. The proportion of post-laser surgery eyes with uncorrected distance visual acuity (UDVA) ≥ 20/25 was 0.82 [95% confidence interval (CI), 0.74-0.90] and the pooled rates of spectacle independence at near, intermediate, and far distances were 0.98 (95% CI, 0.94-1.00), 0.99 (95% CI, 0.95-1.00) and 0.78 (95% CI, 0.65-0.94) respectively. The percentage of participants who suffered from halos and glare was 0.40 (95% CI, 0.25-0.64) and 0.31 (95% CI, 0.16-0.60), respectively. The predictability had a percentage of 0.66 (95% CI, 0.57-0.75) and 0.90 (95% CI, 0.85-0.96) of eyes within ±0.5 diopters (D) and ±1.0 D from the targeted spherical equivalent. Conclusions Presbyopia-correcting IOLs provide satisfactory results in terms of efficacy, safety and predictability in patients with previous corneal refractive surgery, but have a higher risk of photopic side effects such as halos and glare.
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Affiliation(s)
- Yang Sun
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- National Health Commission (NHC) Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yingying Hong
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- National Health Commission (NHC) Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xianfang Rong
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- National Health Commission (NHC) Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yinghong Ji
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- National Health Commission (NHC) Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- *Correspondence: Yinghong Ji
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Development of a New Method for Calculating Intraocular Lens Power after Myopic Laser In Situ Keratomileusis by Combining the Anterior-Posterior Ratio of the Corneal Radius of the Curvature with the Double-K Method. J Clin Med 2022; 11:jcm11030522. [PMID: 35159971 PMCID: PMC8837081 DOI: 10.3390/jcm11030522] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/12/2021] [Accepted: 01/17/2022] [Indexed: 02/05/2023] Open
Abstract
Background: A new method, the Iida–Shimizu–Shoji (ISS) method, is proposed for calculating intraocular lens (IOL) power that combines the anterior–posterior ratio of the corneal radius of the curvature after laser in situ keratomileusis (LASIK) and to compare the predictability of the method with that of other IOL formulas after LASIK. Methods: The estimated corneal power before LASIK (Kpre) in the double-K method was 43.86 D according to the American Society of Cataract and Refractive Surgery calculator, and the K readings of the IOL master were used as the K values after LASIK (Kpost). The factor for correcting the target refractive value (correcting factor [C-factor]) was calculated from the correlation between the anterior–posterior ratio of the corneal radius of the curvature and the refractive error obtained using this method for 30 eyes of 30 patients. Results: Fifty-nine eyes of 59 patients were included. The mean values of the numerical and absolute prediction errors obtained using the ISS method were −0.02 ± 0.45 diopter (D) and 0.35 ± 0.27 D, respectively. The prediction errors using the ISS method were within ±0.25, ±0.50, and ±1.00 D in 49.2%, 76.3%, and 96.6% of the eyes, respectively. The predictability of the ISS method was comparable to or better than some of the other formulas. Conclusions: The ISS method is useful for calculating the IOL power in eyes treated with cataract surgery after LASIK.
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Wang L, Koch D. Intraocular lens power calculations in eyes with previous corneal refractive surgery: Challenges, approaches, and outcomes. Taiwan J Ophthalmol 2022; 12:22-31. [PMID: 35399961 PMCID: PMC8988985 DOI: 10.4103/tjo.tjo_38_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/10/2021] [Indexed: 11/04/2022] Open
Abstract
In eyes with previous corneal refractive surgery, difficulties in accurately determining corneal refractive power and in predicting the effective lens position create challenges in intraocular lens (IOL) power calculations. There are three categories of methods proposed based on the use of historical data acquired prior to the corneal refractive surgery. The American Society of Cataract and Refractive Surgery postrefractive IOL calculator incorporates many commonly used methods. Accuracy of refractive prediction errors within ± 0.5 D is achieved in 0% to 85% of eyes with previous myopic LASIK/photorefractive keratectomy (PRK), 38.1% to 71.9% of eyes with prior hyperopic LASIK/PRK, and 29% to 87.5% of eyes with previous radial keratotomy. IOLs with negative spherical aberration (SA) may reduce the positive corneal SA induced by myopic correction, and IOLs with zero SA best match corneal SA in eyes with prior hyperopic correction. Toric, extended-depth-of-focus, and multifocal IOLs may provide excellent outcomes in selected cases that meet certain corneal topographic criteria. Further advances are needed to improve the accuracy of IOL power calculation in eyes with previous corneal refractive surgery.
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Anders P, Anders LM, Barbara A, Szentmary N, Langenbucher A, Gatzioufas Z. Intraocular lens power calculation in eyes with previous corneal refractive surgery. Ther Adv Ophthalmol 2022; 14:25158414221118524. [PMID: 36061972 PMCID: PMC9434667 DOI: 10.1177/25158414221118524] [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: 12/28/2021] [Accepted: 07/12/2022] [Indexed: 12/05/2022] Open
Abstract
Intraocular lens (IOL) power calculation after corneal refractive surgery (CRS)
becomes an expanding challenge for ophthalmologists as more and more cataract
surgeries after CRS are required. These patients typically also have high
expectations as to visual performance. Conventional IOL power calculation
schemes frequently provide inaccurate results in these cases. This review aims
to summarize and recommend currently available IOL power calculation methods for
eyes with the most common CRS methods: radial keratotomy (RK), photorefractive
keratectomy (PRK), laser in situ keratomileusis (LASIK), and
small incision lenticule extraction (SMILE). To this end, biometry measuring
methods and IOL formulas will be explained and combinations of both are
proposed. In synopsis, it is evident that the latest generation of vergence
formulas exhibit favorable IOL power prediction accuracy in post-CRS eyes, even
though the predictive precision of methods in eyes without CRS is not attained.
Ray tracing computation, intraoperative aberrometry, and machine learning–based
formulas hold potential to further improve refractive outcomes in post-CRS
eyes.
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Affiliation(s)
- Philipp Anders
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - Lisa-Marie Anders
- Institute of Molecular and Clinical Ophthalmology Basel, 4031 Basel, Switzerland
- Department of Ophthalmology, University of Basel, Basel, Switzerland
| | | | - Nora Szentmary
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Homburg, Germany
| | | | - Zisis Gatzioufas
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, University of Basel, Basel, Switzerland
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Prediction accuracy of No History IOL formulas for a diffractive extended depth-of-focus IOL after myopic corneal refractive surgery. J Cataract Refract Surg 2021; 48:462-468. [PMID: 34978784 DOI: 10.1097/j.jcrs.0000000000000873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
Purpose To compare the accuracy of intraocular lens (IOL) calculation methods for extended depth-of-focus (EDOF) IOLs in eyes with a history of myopic LASIK/PRK surgery lacking historical data. Setting Changsha Aier Eye Hospital, Changsha, and Wuhan Aier Eye Hospital, Wuhan, China. Design Retrospective case series. Methods Patients with ALs >= 25.0 mm and a history of myopic LASIK/PRK surgery who underwent cataract surgery with implantation of EDOF IOLs were enrolled. A comparison was performed of the accuracy of 10 IOL methods lacking historical data, including Barrett True-K No History (Barrett TKNH), Haigis-L, Shammas, Potvin-Hill, "Average", 'minimum" and "maximum" IOL power on the ASCRS online post-refractive IOL calculator; Triple-S formula; and SToP formulas based on Holladay1 and SRK/T. IOL power was calculated with the abovementioned methods in 2 groups according to AL (Group1: 25.0 mm <= AL < 28.0 mm and Group2: AL >= 28.0 mm). Results Sixty-four eyes were included. Excellent outcomes were achieved with the "Minimum", Barrett TKNH, SToP (SRK/T) and Triple-S in the whole sample and subgroups, which led to similar median absolute error, mean absolute error, and the percentage of eyes with a prediction error within +/- 0.5 D. In the whole sample, the Haigis-L and "Maximum" had a significantly higher absolute error than "Minimum", SToP (SRK/T) and Barrett TKNH. The "Maximum" also had a significantly lower percentage of eyes within +/- 0.5 D than the Barrett TKNH, and SToP (SRK/T) (15.6% vs 50% and 51.5%, all P<0.05 with Bonferroni correction). Conclusions No-history IOL formulas in predicting the EDOF IOL power in post-myopic refractive eyes remain challenging. The Barrett TKNH, Triple-S, "Minimum" and SToP (SRK/T) achieved the best accuracy when AL >= 25.0 mm, while the Barrett TKNH and SToP (SRK/T) were recommended when AL >= 28.0mm.
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de Rojas Silva MV, Tobío Ruibal A, Suanzes Hernández J. Corneal power measurements by ray tracing in eyes after small incision lenticule extraction for myopia with a combined Scheimpflug Camera-Placido disk topographer. Int Ophthalmol 2021; 42:921-931. [PMID: 34799784 DOI: 10.1007/s10792-021-02073-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the accuracy of the measurements of corneal power obtained by ray tracing with a combined Scheimpflug camera-Placido disk corneal topographer (Sirius) in eyes after small incision lenticule extraction for myopia (SMILE). METHODS Retrospective cases study includes 50 eyes of 50 patients who underwent myopic SMILE. Mean value of simulated keratometry (Kpost), mean pupil power (MPP) (ray tracing, diameter of the entrance pupil range 3-6 mm), anterior and posterior corneal radius, and corneal thickness were obtained with Sirius topographer preoperatively and three months postoperatively, as well as cycloplegic refraction. True net power, equivalent keratometry readings, and Haigis equivalent power formula were calculated, and these measurements, MPP and Kpost, were compared with the corneal power calculated with the clinical history method (CHM). RESULTS Corneal power measurements obtained with all methods were significantly different from CHM (P < 0.001), except the value of MPP obtained at 5.5 mm (P = 0.927). A good direct correlation was found between CHM and all measurements. The distribution of differences as compared with the CHM showed that the lowest difference corresponded to the value of MMP at 5.5 mm (- 0.002 ± 0.6). The Bland-Altman plots for the MPP at 5.5 mm showed 95% limits of agreement between - 1.1787 D and 1.1741 D. CONCLUSIONS MPP obtained by ray tracing within a diameter of entrance pupil of 5.5 mm could predict corrected corneal power derived from the CHM in eyes following SMILE surgery.
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Affiliation(s)
- Mª Victoria de Rojas Silva
- Victoria de Rojas Instituto Oftalmológico, Policlínica Assistens, A Coruña, Spain. .,Department of Ophthalmology, Complexo Hospitalario Universitario, A Coruña, Spain.
| | - Adrián Tobío Ruibal
- Victoria de Rojas Instituto Oftalmológico, Policlínica Assistens, A Coruña, Spain
| | - Jorge Suanzes Hernández
- Research Support Unit, Complexo Hospitalario Universitario, A Coruña, Spain.,Institute of Biomedical Research (INIBIC), A Coruña, Spain
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Wang L, Koch DD. Intraocular Lens Power Calculations in Eyes with Previous Corneal Refractive Surgery. Ophthalmology 2021; 128:e121-e131. [DOI: 10.1016/j.ophtha.2020.06.054] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/10/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022] Open
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Simpson MJ. Corneal power values for use with keratoprostheses and intraocular lenses. Ophthalmic Physiol Opt 2021; 41:1285-1291. [PMID: 34533843 DOI: 10.1111/opo.12886] [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: 02/16/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To specify a keratoprosthesis (KPro) power value for use with an intraocular lens (IOL). METHODS Raytracing software was used to determine the imaging properties of both the natural cornea and conceptual KPro designs, and IOL power calculation methods were reviewed. Traditional calculations use 'thick lens' models for the overall eye, while also using 'thin lens' approximations for the cornea and IOL. The power of the natural cornea acts approximately at the apex, although this is unlikely to be the case for a KPro. The IOL location is determined using an empirical adjustment that is calculated from clinical results for natural eyes. RESULTS The use of a KPro has a similar optical effect to corneal refractive surgery, where the cornea no longer matches the original eye. A modification of the 'double-K' calculation method can be used by specifying the KPro effective power at the original corneal apex, but still estimating the postoperative IOL location using the original corneal power. The KPro power is measured by assembling the KPro with fluid and a window to simulate the way it is used, recording the best focus power at room temperature with a 3 mm diameter aperture, rescaling to the in situ power at 35°C using refractive index changes, and then rescaling again to the power expected relative to the original corneal apex. When expressed as a K value, a keratometer refractive index of 1.332 is proposed. If necessary, clinical results may be used later to make empirical adjustments to the calculation method. CONCLUSIONS A KPro power can be specified relative to the expected location of the original corneal apex using a keratometer index of 1.332. A double-K calculation can then be used to determine the correct KPro and IOL power values for a pseudophakic eye.
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Wei L, Meng J, Qi J, Lu Y, Zhu X. Comparisons of intraocular lens power calculation methods for eyes with previous myopic laser refractive surgery: Bayesian network meta-analysis. J Cataract Refract Surg 2021; 47:1011-1018. [PMID: 34290197 DOI: 10.1097/j.jcrs.0000000000000562] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 12/14/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the accuracy of the methods for calculation of intraocular lens (IOL) power in eyes with previous myopic laser refractive surgery. SETTING EENT Hospital of Fudan University, Shanghai, China. DESIGN Network meta-analysis. METHODS A literature search of MEDLINE and Cochrane Library from January 2000 to July 2019 was conducted for studies that evaluated methods of calculating IOL power in eyes with previous myopic laser refractive surgery. Outcomes measurements were the percentages of prediction error within ±0.50 diopters (D) and ±1.00 D of the target refraction (% ±0.50 D and % ±1.00 D). Traditional and network meta-analysis were conducted. RESULTS Nineteen prospective or retrospective clinical studies, including 1217 eyes and 13 calculation methods, were identified. A traditional meta-analysis showed that compared with the widely used Haigis-L method, the Barrett True-K formula, optical coherence tomography (OCT), and Masket methods showed significantly higher % ±0.50 D, whereas no difference was found in the % ±1.00 D. A network meta-analysis revealed that compared with the Haigis-L method, the OCT, Barrett True-K formula, and optiwave refractive analysis (ORA) methods performed better on the % ±0.50 D, whereas the Barrett True-K formula and ORA methods performed better on the % ±1.00 D. Based on the performances of both outcomes, the Barrett True-K formula, OCT, and ORA methods showed highest probability to rank the top 3 among the 13 methods. CONCLUSIONS The Barrett True-K formula, OCT, and ORA methods seemed to offer greater accuracy than others in calculating the IOL power for postrefractive surgery eyes.
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Affiliation(s)
- Ling Wei
- From the Department of Ophthalmology and Eye Institute, Eye and ENT Hospital of Fudan University; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Science; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Comparison of intraocular lens power formulas according to axial length after myopic corneal laser refractive surgery. J Cataract Refract Surg 2021; 47:297-303. [PMID: 32991505 DOI: 10.1097/j.jcrs.0000000000000445] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/01/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the predictive accuracy of 4 no-history intraocular lens (IOL) power formulas in eyes with prior myopic excimer laser surgery, classified in 4 groups according to their axial length (AL), and investigate the relationship between AL and predictive accuracy. SETTING Seoul St. Mary's Hospital, Republic of Korea. DESIGN Retrospective case series. METHODS IOL power was calculated with the Barrett True-K, Haigis-L, Shammas-PL, and Triple-S formulas in 4 groups classified according to AL. Primary outcomes were the median absolute error (MedAE) and percentage of eyes with a prediction error (PE) within ±0.50 diopter (D). RESULTS This study included 107 eyes of 107 patients. The Barrett True-K had the lowest MedAE when AL was <26.0 mm (0.30 D) and between 26.0 and 28.0 mm (0.54 D); in these subgroups, it had the highest percentages with a PE within ±0.50 D (71.4% and 46.2%). For AL between 28.0 and 30.0 mm, the Triple-S method showed the lowest MedAE (0.43 D) and highest percentage with a PE within ±0.50 D (58.3%). For AL ≥30.0 mm, the Shammas-PL formula produced the lowest MedAE (0.41 D) and highest percentage with a PE within ±0.50 D (58.3%). The Barrett True-K was the only formula with a correlation between AL and PE (r = -0.219/P = .023). CONCLUSIONS The predictive accuracy of no-history IOL formulas depends on the AL. The Barrett True-K had the highest accuracy when AL was < 28.0 mm and the Triple-S when it ranged from 28.0 mm to 30.0 mm, whereas the Shammas-PL was more accurate when AL was ≥30.0 mm.
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Leite de Pinho Tavares R, de Almeida Ferreira G, Ghanem VC, Ghanem RC. IOL Power Calculation After Radial Keratotomy Using the Haigis and Barrett True-K Formulas. J Refract Surg 2021; 36:832-837. [PMID: 33295996 DOI: 10.3928/1081597x-20200930-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 09/10/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the accuracy of intraocular lens (IOL) power calculation in patients with previous radial keratotomy using the Haigis and Barrett True-K formulas. METHODS In a retrospective cases series of patients with previous radial keratotomy and minimum follow-up of 1.2 months, preoperative data from an IOLMaster 500 or 700 (Carl Zeiss Meditec AG), the IOL power implanted, and the postoperative refraction were used to calculate the refractive prediction error. The primary outcomes were the mean absolute and arithmetic refractive prediction errors and the percentage of eyes with a refractive prediction error within ±0.50 and ±1.00 diopters (D). RESULTS One hundred eight eyes were evaluated with a mean follow-up of 6.9 ± 4.9 months. The Haigis formula yielded a mean arithmetic refractive prediction error of -0.29 ± 1.00 D, which was significantly different than that of the Barrett True-K formula, which was -0.03 ± 0.96 D (P < .001). The mean absolute refractive prediction error was 0.80 ± 0.67 for the Haigis formula and 0.74 ± 0.60 for the Barrett True-K formula (P > .05). The percentages of eyes with a refractive prediction error within ±0.50 and ±1.00 D were 43.5% and 65.7% for the Haigis formula and 42.6% and 75.9% for the Barrett True-K formula, respectively (all P > .05). The subgroup analysis revealed that for flat corneas (K1 < 38.00 D), the Barrett True-K formula resulted in more hyperopic results than the Haigis formula. CONCLUSIONS The Barrett True-K formula exhibited better arithmetic predictability than the Haigis formula; however, it showed a tendency for hyperopic results in very flat corneas. [J Refract Surg. 2020;36(12):832-837.].
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Predictability of intraocular lens power calculation after small-incision lenticule extraction for myopia. J Cataract Refract Surg 2021; 47:304-310. [PMID: 32932366 DOI: 10.1097/j.jcrs.0000000000000405] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 08/03/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate and compare the predictability of intraocular lens (IOL) power calculation after small-incision lenticule extraction (SMILE) for myopia and myopic astigmatism. SETTING Department of Ophthalmology, Philipps University of Marburg, Marburg, Germany. DESIGN Retrospective comparative case series. METHODS Preoperative evaluation included optical biometry using IOLMaster 500 and corneal tomography using Pentacam HR. The corneal tomography measurements were repeated at 3 months postoperatively. The change of spherical equivalent due to SMILE was calculated by the manifest refraction at corneal plane (SMILE-Dif). A theoretical model, involving the virtual implantation of the same IOL before and after SMILE, was used, and the IOL power calculations were performed using ray tracing (OKULIX, version 9.06) and third- (Hoffer Q, Holladay 1, and SRK/T) and fourth-generation (Haigis-L and Haigis) formulas. The difference between the IOL-induced refractive error at corneal plane before and after SMILE (IOL-Dif) was compared with SMILE-Dif. The prediction error (PE) was calculated as the difference between SMILE-Dif-IOL-Dif. RESULTS The study included 204 eyes that underwent SMILE. The PE with ray tracing was -0.06 ± 0.40 diopter (D); Haigis-L, -0.39 ± 0.62 D; Haigis, 0.70 ± 0.48 D; Hoffer Q, 0.84 ± 0.47 D; Holladay 1, 1.21 ± 0.51 D; and SRK/T, 1.46 ± 0.54 D. The PE with ray tracing was significantly smaller compared with that of all formulas (P ≤ .001). The PE variance with ray tracing was σ2 = 0.159, being significantly more homogenous compared with that of all formulas (P ≤ .011, F ≥ 6.549). Ray tracing resulted in an absolute PE of 0.5 D or lesser in 81.9% of the cases, followed by Haigis-L (53.4%), Haigis (35.3%), Hoffer Q (25.5%), Holladay 1 (6.4%), and SRK/T (2.9%) formulas. CONCLUSIONS Ray tracing was the most accurate approach for IOL power calculation after myopic SMILE.
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Intraocular lens power calculation using adjusted corneal power in eyes with prior myopic laser vision correction. Graefes Arch Clin Exp Ophthalmol 2021; 259:3729-3737. [PMID: 34287694 DOI: 10.1007/s00417-021-05309-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/20/2021] [Accepted: 07/01/2021] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To evaluate the prediction accuracy of the intraocular lens (IOL) power calculation using adjusted corneal power according to the posterior/anterior corneal curvature radii ratio in the Haigis formula (Haigis-E) in patients with a history of prior myopic laser vision correction. METHODS Seventy eyes from 70 cataract patients who underwent cataract surgery and had a history of myopic laser vision correction were enrolled. The adjusted corneal power obtained with conventional keratometry (K) was calculated using the posterior/anterior corneal curvature radii ratio measured by a single Scheimpflug camera. In eyes longer than 25.0 mm, half of the Wang-Koch (WK) adjustment was applied. The median absolute error (MedAE) and the percentage of eyes that achieved a postoperative refractive prediction error within ± 0.50 diopters (D) based on the Haigis-E method was compared with those in the Shammas, Haigis-L, and Barrett True-K no-history methods. RESULTS The MedAE predicted using the Haigis-E (0.33 D) was significantly smaller than that obtained using the Shammas (0.44 D), Haigis-L (0.43 D), and Barrett True-K (0.44 D) methods (P < 0.001, P = 0.001, and P = 0.014, respectively). The percentage of eyes within ± 0.50 D of refractive prediction error using the Haigis-E (78.6%) was significantly greater than that produced using the Shammas (57.1%), Haigis-L (58.6%), and Barrett True-K (61.4%) methods (P = 0.025). CONCLUSION IOL power calculation using the adjusted corneal power according to the posterior/anterior corneal curvature radii ratio and modified WK adjustment in the Haigis formula could improve the refraction prediction accuracy after cataract surgery in eyes with prior myopic laser vision correction.
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Color light-emitting diode reflection topography: Validation of Equivalent K Reading for IOL power calculation in eyes with previous corneal myopic refractive surgery. J Cataract Refract Surg 2021; 48:32-36. [PMID: 34074995 DOI: 10.1097/j.jcrs.0000000000000709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/26/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the accuracy of the Equivalent K reading (EKR) from Color Light-Emitting Diode Corneal Topographer (Cassini, iOptics) to that of other no-history formulas for intraocular lens (IOL) power calculation in eyes with previous myopic excimer laser surgery. SETTING Centro de Oftalmología Barraquer, Barcelona, Spain. DESIGN Retrospective case series. PATIENTS AND METHODS In 37 eyes, the refractive outcomes of the Cassini EKR entered into the Haigis formula were compared to those of the Barrett-True K, Haigis-L, Shammas-PL formulas and the Triple-S method combined with the Haigis formula. Optimized lens constants for virgin eyes were used. The mean prediction error (PE), median absolute error (MedAE) and the percentage of eyes with a PE within ±0.25 D, ±0.50 D, ±0.75 D and ±1.00 D were calculated. RESULTS The Haigis-L, Shammas-PL and Barrett True-K no-history methods produced a myopic mean PE that was significantly different from zero (p<0.01, p<0.01 and p=0.01, respectively), whereas the mean PEs of Cassini EKR and the Triple-S combined with the Haigis formula were not different from zero. Repeated measures ANOVA disclosed a significant difference among all methods (p<0.0001). The MedAE of the Cassini EKR, Barrett True-K, Haigis-L, Shammas-PL and Triple-S were, respectively, 0.34D, 0.34D, 0.49 D, 0.48 D and 0.31D (p=0.0026). CONCLUSIONS The performance of the combination of standard Haigis formula with Cassini EKR was comparable to other no-history formulas in eyes with previous myopic excimer laser surgery.
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Zhang J, Shao J, Zheng L, Shen Y, Zhao X. Comparative clinical accuracy analysis of the newly developed ZZ IOL and four existing IOL formulas for post-corneal refractive surgery eyes. BMC Ophthalmol 2021; 21:231. [PMID: 34034681 PMCID: PMC8146991 DOI: 10.1186/s12886-021-01991-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intraocular lens (IOL) calculation using traditional formulas for post-corneal refractive surgery eyes can yield inaccurate results. This study aimed to compare the clinical accuracy of the newly developed Zhang & Zheng (ZZ) formula with previously reported IOL formulas. STUDY DESIGN Retrospective study. METHODS Post-corneal refractive surgery eyes were assessed for IOL power using the ZZ, Haigis-L, Shammas, Barrett True-K (no history), and ray tracing (C.S.O Sirius) IOL formulas, and their accuracy was compared. No pre-refractive surgery information was used in the calculations. RESULTS This study included 38 eyes in 26 patients. ZZ IOL yielded a lower arithmetic IOL prediction error (PE) compared with ray tracing (P = 0.04), whereas the other formulas had values like that of ZZ IOL (P > 0.05). The arithmetic IOL PE for the ZZ IOL formula was not significantly different from zero (P = 0.96). ZZ IOL yielded a lower absolute IOL PE compared with Shammas (P < 0.01), Haigis-L (P = 0.02), Barrett true K (P = 0.03), and ray tracing (P < 0.01). The variance of the mean arithmetic IOL PE for ZZ IOL was significantly smaller than those of Shammas (P < 0.01), Haigis-L (P = 0.03), Barrett True K (P = 0.02), and ray tracing (P < 0.01). The percentages of eyes within ± 0.5 D of the target refraction with the ZZ IOL, Shammas, Haigis-L, Barrett True-K, and ray-tracing formulas were 86.8 %, 45.5 %, 66.7 %, 73.7 %, and 50.0 %, respectively (P < 0.05 for Shammas and ray tracing vs. ZZ IOL). CONCLUSIONS The ZZ IOL formula might offer superior outcomes for IOL power calculation for post-corneal refractive surgery eyes without prior refractive data.
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Affiliation(s)
- Jun Zhang
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Jie Shao
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Li Zheng
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Ye Shen
- Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
| | - Xia Zhao
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
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Affiliation(s)
- Pammal T Ashwin
- Birmingham and Midland Eye Centre, Birmingham, United Kingdom
| | - Sunil Shah
- Birmingham and Midland Eye Centre, Birmingham, United Kingdom
- Aston University, School of Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom E‐mail:
| | - James S Wolffsohn
- Aston University, School of Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom E‐mail:
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Marcos S, Martinez-Enriquez E, Vinas M, de Castro A, Dorronsoro C, Bang SP, Yoon G, Artal P. Simulating Outcomes of Cataract Surgery: Important Advances in Ophthalmology. Annu Rev Biomed Eng 2021; 23:277-306. [PMID: 33848431 DOI: 10.1146/annurev-bioeng-082420-035827] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
As the human eye ages, the crystalline lens stiffens (presbyopia) and opacifies (cataract), requiring its replacement with an artificial lens [intraocular lens (IOL)]. Cataract surgery is the most frequently performed surgical procedure in the world. The increase in IOL designs has not been paralleled in practice by a sophistication in IOL selection methods, which rely on limited anatomical measurements of the eye and the surgeon's interpretation of the patient's needs and expectations. We propose that the future of IOL selection will be guided by 3D quantitative imaging of the crystalline lens to map lens opacities, anticipate IOL position, and develop fully customized eye models for ray-tracing-based IOL selection. Conversely, visual simulators (in which IOL designs are programmed in active elements) allow patients to experience prospective vision before surgery and to make more informed decisions about which IOL to choose. Quantitative imaging and optical and visual simulations of postsurgery outcomes will allow optimal treatments to be selected for a patient undergoing modern cataract surgery.
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Affiliation(s)
- Susana Marcos
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Eduardo Martinez-Enriquez
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Maria Vinas
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Alberto de Castro
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Carlos Dorronsoro
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain; .,2EyesVision, Madrid 28760, Spain
| | - Seung Pil Bang
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, Department of Biomedical Engineering, University of Rochester, Rochester, New York 14632, USA
| | - Geunyoung Yoon
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, Department of Biomedical Engineering, University of Rochester, Rochester, New York 14632, USA
| | - Pablo Artal
- Laboratorio de Óptica, Universidad de Murcia, Murcia 30100, Spain
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Jacob S. February consultation #4. J Cataract Refract Surg 2021; 47:275. [PMID: 33901142 DOI: 10.1097/01.j.jcrs.0000733912.14902.f7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pantanelli SM, Lin CC, Al-Mohtaseb Z, Rose-Nussbaumer JR, Santhiago MR, Steigleman WA, Schallhorn JM. Intraocular Lens Power Calculation in Eyes with Previous Excimer Laser Surgery for Myopia: A Report by the American Academy of Ophthalmology. Ophthalmology 2021; 128:781-792. [PMID: 33500124 DOI: 10.1016/j.ophtha.2020.10.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To review the literature to evaluate the outcomes of intraocular lens (IOL) power calculation in eyes with a history of myopic LASIK or photorefractive keratectomy (PRK). METHODS Literature searches were conducted in the PubMed database in January 2020. Separate searches relevant to cataract surgery outcomes and corneal refractive surgery returned 1169 and 162 relevant citations, respectively, and the full text of 24 was reviewed. Eleven studies met the inclusion criteria for this assessment; all were assigned a level III rating of evidence by the panel methodologist. RESULTS When automated keratometry was used with a theoretical formula designed for eyes without previous laser vision correction, the mean prediction error (MPE) was universally positive (hyperopic), the mean absolute errors (MAEs) and median absolute errors (MedAEs) were relatively high (0.72-1.9 diopters [D] and 0.65-1.73 D, respectively), and a low (8%-40%) proportion of eyes were within 0.5 D of target spherical equivalent (SE). Formulas developed specifically for this population requiring both prerefractive surgery keratometry and manifest refraction (i.e., clinical history, corneal bypass, and Feiz-Mannis) produced a proportion of eyes within 0.5 D of target SE between 26% and 44%. Formulas requiring only preoperative keratometry or no history at all had lower MAEs (0.42-0.94 D) and MedAEs (0.30-0.81 D) and higher (30%-68%) proportions within 0.5 D of target SE. Strategies that averaged several methods yielded the lowest reported MedAEs (0.31-0.35 D) and highest (66%-68%) proportions within 0.5 D of target SE. Even after using the best-known methods, refractive outcomes were less accurate in eyes that had previous excimer laser surgery for myopia compared with those that did not have it. CONCLUSIONS Calculation methods requiring both prerefractive surgery keratometry and manifest refraction are no longer considered the gold standard. Refractive outcomes of cataract surgery in eyes that had previous excimer laser surgery are less accurate than in eyes that did not. Patients should be advised of this refractive limitation when considering cataract surgery in the setting of previous corneal refractive surgery. Conclusions are limited by the small sample sizes and retrospective nature of nearly all existing literature in this domain.
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Affiliation(s)
| | - Charles C Lin
- Byers Eye Institute, Stanford University, Palo Alto, California
| | | | - Jennifer R Rose-Nussbaumer
- Division of Research Kaiser Permanente Northern California and Francis I Proctor Foundation University of California, San Francisco, California
| | | | | | - Julie M Schallhorn
- Francis I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco, California
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Koga Y, Kojima K, Yoshii K, Kusada N, Kagitani Y, Aoki T, Horiuchi N, Kitazawa K, Sotozono C. Prediction Error of Intraocular Lens Power Calculation in Very Elderly Patients over 90 Years Old. Curr Eye Res 2020; 46:1148-1153. [PMID: 33356625 DOI: 10.1080/02713683.2020.1858486] [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: 10/22/2022]
Abstract
BACKGROUND To investigate the influence of age on prediction error (PE) after cataract surgery in very elderly (VE) patients aged more than 90 years. METHODS We retrospectively analyzed 66 eyes of patients aged ≥90 years (VE group) who underwent phacoemulsification and intraocular lens (IOL) implantation. As the control group (CG), we investigated 121 eyes of patients aged 70-89 years who underwent the same surgery. PE was calculated 1 month post-surgery as the actual postoperative spherical equivalent minus the target diopter, which was calculated using the Sanders-Retzlaff-Kraff/T formula. The absolute and arithmetic PE were compared between the two groups. The factors affecting absolute PE outside ±0.5 diopter (D) and ±1.0 D were determined through logistic regression analysis with the variables age, sex, axial length (AL), average corneal power, preoperative best-corrected visual acuity, target diopter, and coexisting pseudoexfoliation syndrome. RESULTS The absolute PE was significantly larger in the VE group than that in the CG (0.60 ± 0.52 D and 0.34 ± 0.25 D, respectively; P < .001). There was no significant difference in terms of arithmetic PE between the two groups (-0.06 ± 0.79 D and -0.07 ± 0.42 D, respectively; P = .653). In the logistic regression analysis, age was significantly associated with absolute PE outside ±0.50 D (Odds ratio [OR]: 1.05). Age and AL were significantly associated with absolute PE outside ±1.0 D (OR: 1.24 and 0.20, respectively). CONCLUSIONS Absolute PE tended to increase in the cataract surgery of VE patients.
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Affiliation(s)
- Yusuke Koga
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kentaro Kojima
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kengo Yoshii
- Department of Mathematics and Statistics in Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Natsuki Kusada
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yu Kagitani
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takanori Aoki
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Noriko Horiuchi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koji Kitazawa
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Corneal Topography for Intraocular Lens Selection in Refractive Cataract Surgery. Ophthalmology 2020; 128:e142-e152. [PMID: 33221325 DOI: 10.1016/j.ophtha.2020.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 10/26/2020] [Accepted: 11/13/2020] [Indexed: 11/22/2022] Open
Abstract
The purpose of this review is to evaluate the usefulness of corneal topography to select premium intraocular lenses (IOLs), including aspherical IOLs, toric IOLs, and multifocal IOLs, in refractive cataract surgery. Corneal topography can detect corneal regular astigmatism, corneal irregular astigmatism (higher-order aberrations [HOAs]) including spherical aberration, and corneal shape abnormalities after corneal refractive surgery. Surgeons can explain to the patients with significant corneal HOAs about its effect on postoperative visual function before surgery. Multifocal IOLs should not be selected for such eyes. For eyes with abnormal corneal shape, appropriate IOL power calculation formulae can be applied. In the case of toric IOLs, regular astigmatism and corneal HOAs should be checked. Before implanting an aspheric IOL, it is ideal to confirm spherical aberration of the cornea is not below the normal range. Because corneal HOAs, abnormal corneal shape after corneal refractive surgery, corneal regular astigmatism, and corneal spherical aberration increase postoperative refractive errors and poor vision quality with premium IOLs, corneal topography before cataract surgery is helpful in screening patients who are not appropriate candidates for premium IOLs.
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Brenner LF, Gjerdrum B, Aakre BM, Lundmark PO, Nistad K. Presbyopic refractive lens exchange with trifocal intraocular lens implantation after corneal laser vision correction: Refractive results and biometry analysis. J Cataract Refract Surg 2020; 45:1404-1415. [PMID: 31564315 DOI: 10.1016/j.jcrs.2019.05.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 05/19/2019] [Accepted: 05/27/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the refractive and biometry results of presbyopic refractive lens exchange (RLE) with trifocal intraocular lens (IOL) implantation in eyes with previous myopic or hyperopic corneal laser vision correction (LVC). SETTINGS Memira AS, Norway, Sweden, and Denmark. DESIGN Retrospective case series. METHODS The refractive results included the manifest refraction spherical equivalent, uncorrected near (UNVA) and distance (UDVA) visual acuities, corrected distance visual acuity, safety, efficacy, and precision. The biometry analysis included the refractive prediction error (RPE), median absolute error (MedAE), and percentage of eyes within a certain RPE range for the formulas from the American Society of Cataract and Refractive Surgery (ASCRS) online calculator. RESULTS The study comprised 241 eyes. Six months postoperatively, 60.0% of eyes were within ±0.25 diopter (D), 80.9% within ±0.50 D, and 97.9% within ±1.00 D of emmetropia. There were no statistical differences in the mean monocular UDVA (0.87 ± 0.20 [SD]), safety index (0.98 ± 0.09), or efficacy index (0.81 ± 0.18) between the myopic ablation group and hyperopic ablation group. Binocularly, 85% of patients had simultaneous UDVA and UNVA of 0.9 or better and Jaeger 3, respectively. The ASCRS online calculator formulas gave different performances for previous myopic and hyperopic ablation profiles. Using optimized constants and nomogram for correcting the mean RPE improved the MedAE. CONCLUSIONS Presbyopic RLE was safe and effective in selected cases with a history of LVC. The use of optimized IOL constants and nomograms can improve the refractive precision of lens-based refractive surgery.
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Patel P, Ashena Z, Vasavada V, Vasavada SA, Vasavada V, Sudhalkar A, Nanavaty MA. Comparison of intraocular lens calculation methods after myopic laser-assisted in situ keratomileusis and radial keratotomy without prior refractive data. Br J Ophthalmol 2020; 106:47-53. [PMID: 33093154 DOI: 10.1136/bjophthalmol-2020-317681] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/22/2020] [Accepted: 10/03/2020] [Indexed: 11/03/2022]
Abstract
AIM To compare intraocular lens (IOL) calculation methods not requiring refraction data prior to myopic laser-assisted in situ keratomileusis (LASIK) and radial keratotomy (RK). METHODS In post-LASIK eyes, the methods not requiring prior refraction data were Hagis-L; Shammas; Barrett True-K no-history; Wang-Koch-Maloney; 'average', 'minimum' and 'maximum' IOL power on the American Society of Cataract and Refractive Surgeons (ASCRS) IOL calculator. Double-K method and Barrett True-K no-history, 'average', 'minimum' and 'maximum' IOL power on ASCRS IOL calculator were evaluated in post-RK eyes. The predicted IOL power was calculated with each method using the manifest postoperative refraction. Arithmetic and absolute IOL prediction errors (PE) (implanted-predicted IOL powers), variances in arithmetic IOL PE and percentage of eyes within ±0.50 and ±1.00 D of refractive PE were calculated. RESULTS Arithmetic or absolute IOL PE were not significantly different between the methods in post-LASIK and post-RK eyes. In post-LASIK eyes, 'average' showed the highest and 'minimum' showed the least variance, whereas 'average' and 'minimum' had highest percentage of eyes within ±0.5 D and 'minimum' had the highest percentage of eyes within ±1.0 D. In the post-RK eyes, 'minimum' had highest variance, and 'average' had the least variance and highest percentage of eyes within ±0.5 D and ±1.0 D. CONCLUSION In post-LASIK and post-RK eyes, there are no significant differences in IOL PE between the methods not requiring prior refraction data. 'Minimum' showed least variance in PEs and more chances of eyes to be within ±1.0 D postoperatively in post-LASIK eyes. 'Average' had least variance and more chance of eyes within ±1.0 D in post-RK eyes.
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Affiliation(s)
- Priyanka Patel
- Iladevi Cataract and IOL Research Center, Ahmedabad, India
| | - Zahra Ashena
- Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Viraj Vasavada
- Iladevi Cataract and IOL Research Center, Ahmedabad, India
| | | | | | | | - Mayank A Nanavaty
- Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK .,Brighton and Sussex Medical School, Brighton, BN1 9PX, United Kingdom
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Yeo TK, Heng WJ, Pek D, Wong J, Fam HB. Accuracy of intraocular lens formulas using total keratometry in eyes with previous myopic laser refractive surgery. Eye (Lond) 2020; 35:1705-1711. [PMID: 32868880 PMCID: PMC8169843 DOI: 10.1038/s41433-020-01159-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives This comparative study aimed to determine if total keratometry (TK) from IOLMaster 700 could be applied to conventional formulas to perform IOL power calculation in eyes with previous myopic laser refractive surgery, and to evaluate their accuracy with known post-laser refractive surgery formulas. Methods Sixty-four eyes of 49 patients with previous myopic laser refractive surgery were evaluated 1 month after cataract surgery. A comparison of the prediction error was made between no clinical history post-laser refractive surgery formulas (Barrett True-K, Haigis-L, Shammas-PL) and conventional formulas (EVO, Haigis, Hoffer Q, Holladay I, and SRK/T) using TK values obtained with the optical biometer IOLMaster 700 (Carl Zeiss Meditec), as well as Barrett True-K with TK. Results The mean prediction error was statistically different from zero for Barrett True-K, Barrett True-K with TK, Haigis-L, Shammas-PL, and Holladay I with TK. The mean absolute error (MAE) was 0.424, 0.671, 0.638, 0.439, 0.408, 0.424, 0.479, 0.647, and 0.524, and median absolute error (MedAE) was 0.388, 0.586, 0.605, 0.298, 0.294, 0.324, 0.333, 0.438, and 0.377 for Barrett True-K, Haigis-L, Shammas-PL, Barrett True-K TK, EVO with TK, Haigis with TK, Hoffer Q with TK, Holladay I with TK, and SRK/T with TK, respectively. EVO TK followed by Barrett True-K TK and Haigis TK achieved the highest percentages of patients with absolute prediction error within 0.50 and 1.00 D (68.75%, 92.19%, and 64.06%, 92.19%, respectively) Conclusions Formulas combined with TK achieve similar or better results compared to existing no-history post-myopic laser refractive surgery formulas.
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Affiliation(s)
- Tun Kuan Yeo
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.
| | - Wee Jin Heng
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Don Pek
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - John Wong
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Han Bor Fam
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
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Rosa N, Cione F, Pepe A, Musto S, De Bernardo M. An Advanced Lens Measurement Approach (ALMA) in post refractive surgery IOL power calculation with unknown preoperative parameters. PLoS One 2020; 15:e0237990. [PMID: 32841281 PMCID: PMC7447029 DOI: 10.1371/journal.pone.0237990] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 08/06/2020] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To test a new method to calculate the Intraocular Lens (IOL) power, that combines R Factor and ALxK methods, that we called Advance Lens Measurement Approach (ALMA). DESIGN Retrospective, Comparative, Observational study. SETTING Department of Medicine and Surgery, University of Salerno, Italy. METHODS Ninety one eyes of 91 patients previously treated with Photorefractive Keratectomy (PRK) or Laser-Assisted in Situ Keratomileusis (LASIK) that underwent phacoemulsification and IOL implantation in the capsular bag were analyzed. For 68 eyes it was possible to zero out the Mean Errors (ME) for each formula and for selected IOL models, in order to eliminate the bias of the lens factor (A-Costant). Main outcome, measured in this study, was the median absolute error (MedAE) of the refraction prediction. RESULTS In the sample with ME zeroed (68 eyes) both R Factor and ALxK methods resulted in MedAE of 0.67 D. For R Factor 33 eyes (48.53%) reported a refractive error <0.5D, and 53 eyes (77.94%) reported a refractive error <1D, For ALxK method, 32 eyes (47.06%) reported a refractive error <0.5 D, and 53 eyes (77.94%) reported a refractive error <1 D. ALMA method, reported a MedAE of 0.55 D, and an higher number of patients with a refractive error <0.5 D (35 eyes, 51.47%), and with a refractive error <1 D (54 eyes, 79.41%). CONCLUSIONS Based on the results obtained from this study, ALMA method can improve R Factor and ALxK methods. This improvement is confirmed both by zeroing the mean error and without zeroing it.
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Affiliation(s)
- Nicola Rosa
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
| | - Ferdinando Cione
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
| | - Angela Pepe
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
| | - Salvatore Musto
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
| | - Maddalena De Bernardo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
- * E-mail:
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Wen D, Yu J, Zeng Z, McAlinden C, Hu L, Feng K, Wang Y, Song B, Chen S, Ning R, Jin Y, Wang Q, Yu AY, Huang J. Network Meta-analysis of No-History Methods to Calculate Intraocular Lens Power in Eyes With Previous Myopic Laser Refractive Surgery. J Refract Surg 2020; 36:481-490. [PMID: 32644171 DOI: 10.3928/1081597x-20200519-04] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/19/2020] [Indexed: 01/10/2024]
Abstract
PURPOSE To systematically compare and rank the predictability of no-history intraocular lens (IOL) power calculation methods after myopic laser refractive surgery. METHODS PubMed, Embase, the Cochrane Library, and the U.S. trial registry (www.ClinicalTrial.gov) were used to systematically search trials published up to August 2019. Included were case series studies reporting the following outcomes in patients with cataract undergoing phacoemulsification after laser refractive surgery: percentage of eyes with a refractive prediction error (PE) within ±0.50 and ±1.00 diopters (D), mean absolute error (MAE), and median absolute error (MedAE). A network meta-analysis was conducted using the STATA software version 13.1 (STATACorp LLC). RESULTS Nineteen studies involving 1,098 eyes and 19 formulas were identified. A network meta-analysis for the percentage of eyes with a PE within ±0.50 D found that ray-tracing (Okulix), intraoperative aberrometry (Optiwave Refractive Analysis [ORA]), BESSt, and Seitz/Speicher/Savini (Triple-S) (D-K SRK/T), and Fourier-Domain OCT-Based formulas were more predictive than the Wang/Koch/Maloney, Shammas-PL, modified Rosa, Ferrara, and Equivalent K reading at 4.5 mm using the Double-K Holladay 1 formulas. With regard to ranking, the top four formulas as per the surface under the cumulative ranking curve (SUCRA) values for the percentage of eyes with a PE within ±0.50 D were the Okulix, ORA, BESSt, and Triple-S (D-K SRK/T). With regard to MAE, the ORA showed lower errors when compared to the Shammas-PL formula. In this regard, the top four formulas based on the SUCRA values were the Triple-S, BESSt, ORA, and Fourier-Domain OCT-Based formulas. The SToP (SRK/T), ORA, Fourier-Domain OCT-Based, and BESSt formulas had the lowest MedAE. CONCLUSIONS Considering all three outcome measures of highest percentages of eyes with a PE within ±0.50 and ±1.00 D, lowest MAE, and lowest MedAE, the top three no-history formulas for IOL power calculation in eyes with previous myopic corneal laser refractive surgery were: ORA, BESSt, and Triple-S (D-K SRK/T). [J Refract Surg. 2020;36(7):481-490.].
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Results of the Barrett True-K formula for IOL power calculation based on Scheimpflug camera measurements in eyes with previous myopic excimer laser surgery. J Cataract Refract Surg 2020; 46:1016-1019. [DOI: 10.1097/j.jcrs.0000000000000205] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Accuracy of intraocular lens power calculation formulae after laser refractive surgery in myopic eyes: a meta-analysis. EYE AND VISION 2020; 7:37. [PMID: 32656291 PMCID: PMC7339492 DOI: 10.1186/s40662-020-00188-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 04/06/2020] [Indexed: 12/13/2022]
Abstract
Background To compare the accuracy of intraocular lens power calculation formulae after laser refractive surgery in myopic eyes. Methods We searched the databases on PubMed, EMBASE, Web of Science and the Cochrane library to select relevant studies published between Jan 1st, 2009 and Aug 11th, 2019. Primary outcomes were the percentages of refractive prediction error within ±0.5 D and ±1.0 D. Results The final meta-analysis included 16 studies using seven common methods (ASCRS average, Barrett True-K no history, Double-K SRK/T, Haigis-L, OCT formula, Shammas-PL, and Wang-Koch-Maloney). ASCRS average yielded significantly higher percentage of refractive prediction error within ±0.5 D than Haigis-L, Shammas-PL and Wang-Koch-Maloney (P = 0.009, 0.01, 0.008, respectively). Barrett True-K no history also yielded significantly higher percentage of refractive prediction error within ±0.5 D than Shammas-PL and Wang-Koch-Maloney (P = 0.01, P < 0.0001, respectively), and a similar result was found when comparing OCT formula with Haigis-L and Shammas-PL (P = 0.03, P = 0.01, respectively). Conclusion The ASCRS average or Barrett True-K no history should be used to calculate the intraocular lens power in eyes after myopic laser refractive surgery. The OCT formula if available, can also be a good alternative choice.
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