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Cione F, De Bernardo M, Di Stasi M, De Luca M, Albano R, Rosa N. Lens Factor Choice in IOL Power Calculation after Laser Refractive Surgery: The Right Constant for Advanced Lens Measurement Approach (ALMA). J Clin Med 2024; 13:5186. [PMID: 39274399 PMCID: PMC11395884 DOI: 10.3390/jcm13175186] [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: 07/01/2024] [Revised: 08/01/2024] [Accepted: 08/28/2024] [Indexed: 09/16/2024] Open
Abstract
Background/Objectives: To evaluate the advanced lens measurement approach (ALMA) formula accuracy using different lens constants available on the user group for laser interference biometry (ULIB) and IOL Con platforms. Methods: In this retrospective, comparative, case-series study, 150 eyes of 160 patients with previous myopic Photorefractive Keratectomy (PRK) or laser-assisted in situ keratomileusis (LASIK), who underwent uneventful cataract surgery and IOL implantation, were examined. The ALMA formula was evaluated to calculate the refractive prediction error (PE), analysing four different categories of lens constants: both nominal and optimized A-Constant for SRKT, which are available on the ULIB and IOL Con platforms. An additional analysis was carried out in this study, evaluating if a decreased ULIB optimized constant (DUOC) with different fixed factors (-1.2 -1.3 -1.4 -1.5) could improve refractive outcomes. Median absolute error (MedAE) and percentage of eyes within ±0.50 and ±1.00 diopters (D) of prediction error were measured as the main outcomes. Results: Comparing the lens factors available on ULIB and IOL Con platforms, the ALMA formula reported a lower MedAE and higher percentages of eyes with a refractive PE within 1.0 D using ULIB nominal constants (all p < 0.05). Using DUOC (-1.3), and there was a statistically significant improvement of both MedAE and of the percentages of eyes with PE within ±0.50 D with the ALMA method compared to nominal ULIB constants (all p < 0.05). Conclusions: The impact of different lens factors in the IOL power calculation after myopic LRS should be carefully evaluated. The ALMA formula, in the absence of optimized constants by zeroing the mean error, should be used by subtracting 1.3 from the optimized ULIB constants available on the IOL Con website. This finding suggests further studies to test which of these constants could work better with the other post-refractive surgery formulas.
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Affiliation(s)
- Ferdinando Cione
- Ophthalmological Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Salerno, Italy
- AOU San Giovanni di Dio e Ruggi D'Aragona, 84131 Salerno, Italy
| | - Maddalena De Bernardo
- Ophthalmological Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Salerno, Italy
| | - Margherita Di Stasi
- Ophthalmological Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Salerno, Italy
| | - Martina De Luca
- Ophthalmological Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Salerno, Italy
| | - Rosa Albano
- Ophthalmological Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Salerno, Italy
| | - Nicola Rosa
- Ophthalmological Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Salerno, Italy
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Pan X, Wang Y, Li Z, Ye Z. Intraocular Lens Power Calculation in Eyes After Myopic Laser Refractive Surgery and Radial Keratotomy: Bayesian Network Meta-analysis. Am J Ophthalmol 2024; 262:48-61. [PMID: 37865389 DOI: 10.1016/j.ajo.2023.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/17/2023] [Accepted: 09/27/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE To compare the accuracy of formulas for calculating intraocular lens power in eyes after myopic laser refractive surgery or radial keratotomy. DESIGN Bayesian network meta-analysis. METHODS PubMed, Embase, the Cochrane Data Base of Systematic Reviews, and the Cochrane Central Register of Controlled Trials databases were searched for retrospective and prospective clinical studies published from January 1, 2012, to August 24, 2022. The outcome measurement was the percentage of eyes with a predicted error within the target refractive range (±0.50 diopter [D] or ±1.00 D). RESULTS Our meta-analysis includes 24 studies of 1172 eyes after myopic refractive surgery that use 12 formulas for intraocular lens power calculation. (1) A network meta-analysis showed that Barrett true-K no history, the optical coherence tomography (OCT) formula, and the Masket formula had a significantly higher percent of eyes within ±0.50 D of the goal than the Haigis-L formula, whereas the Wang-Koch-Maloney formula showed the poor predictability. Using an error criterion of within ±1.00 D, the same 3 formulas performed slightly better than the Haigis-L formula. Based on performance using both prediction error criteria, the Barrett true-K no history formula, OCT formula, and Masket formula showed the highest probability of ranking as the top 3 among the 12 methods. (2) A direct meta-analysis with a subset of 4 studies and 5 formulas indicated that formulas did not differ in percent success for either the ±0.5 D or ±1.0 D error range in eyes that had undergone radial keratotomy. CONCLUSIONS The OCT, Masket, and Barrett true-K no history formulas are more accurate for eyes with previous myopic laser refractive surgery, whereas no significant difference was found among the formulas for eyes that had undergone radial keratotomy.
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Affiliation(s)
- Xiaoying Pan
- From the School of Medicine, Nankai University, Tianjin (X.P.); Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China
| | - Yuyao Wang
- Department of Ophthalmology, Medical School of Chinese People's Liberation Army, Beijing (Y.W.); Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China
| | - Zhaohui Li
- Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China
| | - Zi Ye
- Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China.
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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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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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Xiong T, Mu J, Chen H, Fan W. Intraocular lens power calculation after radical keratotomy and photorefractive keratectomy: A case report. Medicine (Baltimore) 2022; 101:e29465. [PMID: 35801733 PMCID: PMC9259111 DOI: 10.1097/md.0000000000029465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE To report a rare case of calculating the IOL power in a cataract patient who underwent both radial keratotomy (RK) and photorefractive keratectomy (PRK). PATIENT CONCERNS A 48-year-old woman underwent bilateral RK at age 22 and bilateral PRK at age 46. She developed bilateral corneal haze and corneal endothelial inflammation and received steroids therapy for long time after PRK. Then she was referred to our hospital due to decreased vision in the both eyes. DIAGNOSES The patient was diagnosed with binocular complicated cataract, corneal haze, high myopia and post corneal refractive surgery (RK and PRK). INTERVENTIONS The patient underwent bilateral phacoemulsification. The IOL power was calculated using SRK/T formula for RK and Haigis-L formula for PRK, respectively. We finally selected the Haigis-L formula and the intraocular lens (SN60WF) was implanted within the capsular bag. OUTCOMES After the surgery, both eyes showed myopia drift, and the right eye continuously fluctuated in refractive results. However, by nearly 1 year later, refractive results in both eyes had stabilized, and no other complications had occurred. LESSONS IOL power in patients who undergo both RK and PRK can be reliably calculated using the Shammas-PL, Average of multiple formulas, or Barret True-K No History formulas. Haigis-L formula is not suitable. Such patients require at least three months after surgery to attain refractive stability in both eyes.
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Affiliation(s)
- Tianxu Xiong
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Jiancheng Mu
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Hao Chen
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Wei Fan
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- *Correspondence: Wei Fan, Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan Province 610041, China (e-mail: )
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