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Blanco-Vázquez M, Gil-Cazorla R, Barua A, Taneja M, Hanneken L, Shah S. Impact of thermo-mechanical skin treatment on refraction and keratometry in patients with dry eye disease and the implications for cataract surgery. Cont Lens Anterior Eye 2024; 47:102164. [PMID: 38594154 DOI: 10.1016/j.clae.2024.102164] [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: 09/19/2023] [Revised: 01/11/2024] [Accepted: 03/30/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE To determine the changes in keratometry measurements and refraction in patients having the thermo-mechanical periorbital skin treatment, Tixel®, to treat dry eye disease (DED). METHODS A multi-centre, prospective, non-masked study was conducted. DED patients were recruited in 3 international centres and were evaluated in 5 visits separated by an interval of 2 weeks except for the last visit which took place after 18 weeks from visit 1. The same clinical examination was performed at all visits: OSDI questionnaire, tear stability, keratometry, best corrected visual acuity and refraction. Tixel® treatment was applied at the first 3 visits. RESULTS 89 participants (24 males/65 females; mean age: 55.0 ± 14.2 years) were included: 20 presented moderate DED symptoms and 69 severe DED symptoms. Significant differences were found for the spherocylindrical refraction (vector analysis) between visit 1 and visits 2 and 3. Following cumulative analysis, 11.86 % and 16.94 % of participants had more than 0.5 dioptre (D) change in mean keratometry and keratometric astigmatism, respectively, at 3 months post-treatment. A total of 5.40 % had a sphere and cylinder change greater than 0.50D and 16.21 % had the axis changed more than 10 degrees (vector analysis). These changes were particularly significant in patients with severe DED symptoms. CONCLUSIONS Keratometry readings and refraction can change following thermo-mechanical skin treatment for DED, especially in those patients with severe DED symptoms. This should be considered as potential errors in intraocular lens calculations may be induced.
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Affiliation(s)
- Marta Blanco-Vázquez
- Ocular Surface Group, Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, Valladolid, Spain
| | - Raquel Gil-Cazorla
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom; Midland Eye, Solihull, United Kingdom.
| | - Ankur Barua
- Midland Eye, Solihull, United Kingdom; Birmingham and Midland Eye Centre, City Hospital, Birmingham, United Kingdom
| | | | | | - Sunil Shah
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom; Midland Eye, Solihull, United Kingdom; Birmingham and Midland Eye Centre, City Hospital, Birmingham, United Kingdom; Khmer Sight Foundation, Phnom Penh, Cambodia
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Yang F, Yang L, Ning X, Liu J, Wang J. Effect of dry eye on the reliability of keratometry for cataract surgery planning. J Fr Ophtalmol 2024; 47:103999. [PMID: 37919153 DOI: 10.1016/j.jfo.2023.04.016] [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: 02/01/2023] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE This study aimed to evaluate the effects of dry eye on the reproducibility of keratometry (K) measurements in patients presenting for cataract surgery. METHODS A non-randomized controlled clinical study was performed. Eighty-three eyes of eighty-three patients with cataracts who were enrolled in our hospital from March 2020 to July 2020 were studied. The mean non-invasive tear film break-up time (NIBUT), corneal fluorescein staining score, and ocular surface disease (OSD) SPEED II questionnaire were measured and recorded prior to surgery, and the patients were assigned to a "dry eye" group (n=35) or a "non-dry eye" group (n=48). The K of the patients was measured twice by a Tomey OA-2000 (an average of three times each). The difference of the mean K (ΔKm) and astigmatism vector (ΔKvector) between the two measurements was calculated. The ΔKm and ΔKvector between the two groups were compared. The relationship between the measurement parameters of dry eyes and the accuracy of the preoperative K values was analyzed. RESULTS ΔKm was 0.09 D [0.03; 0.19] in the non-dry eye control group and 0.28 D [0.18; 0.50] in the dry eye group, with a statistical difference between the two groups (P=0.005). The ΔKvector of the non-dry eye control group was 0.22 D [0.14; 0.42], and that of the dry eye group was 0.50 D [0.28; 1.06]. There was a significant difference between the two groups (P=0.010). Between the two groups, the percentage of the ΔKm and ΔKvector values greater than 0.5 D were statistically different (P<0.05). There was no significant difference in ΔKm between the groups with NIBUT>5s and NIBUT≤5s (P=0.537). There was no significant difference in ΔKm between groups≥2 and<2 on the OSD SPEED II questionnaire scores (P=0.442). CONCLUSION Dry eye can affect the reliability of keratometry measurements before cataract surgery, thereby affecting the accuracy of intraocular lens power calculations. In cataract surgery planning, it is necessary to detect subjective and objective indicators of dry eye in patients and carry out effective intervention so as to avoid refractive errors caused by inaccurate keratometry measurements.
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Affiliation(s)
- F Yang
- Affiliated to Shanxi Medical University, Shanxi Eye Hospital, 030002 Taiyuan, China.
| | - L Yang
- Changzhi Aier Eye Hospital, Department of ophthalmology, 046000 Changzhi, China
| | - X Ning
- Affiliated to Shanxi Medical University, Shanxi Eye Hospital, 030002 Taiyuan, China
| | - J Liu
- Affiliated to Shanxi Medical University, Shanxi Eye Hospital, 030002 Taiyuan, China
| | - J Wang
- Affiliated to Shanxi Medical University, Shanxi Eye Hospital, 030002 Taiyuan, China
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Nibandhe AS, Donthineni PR. Understanding and Optimizing Ocular Biometry for Cataract Surgery in Dry Eye Disease: A Review. Semin Ophthalmol 2023; 38:24-30. [PMID: 35989638 DOI: 10.1080/08820538.2022.2112699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE To understand the impact of dry eye disease (DED) on the components of ocular biometry and ways to optimize the visual outcomes of cataract surgery in eyes with DED. METHODOLOGY A thorough literature review of the components pertaining to this review was undertaken using the databases, PubMed (from the year 2000), MEDLINE, CENTRAL (including Cochrane Eyes and Vision Trials Register; Cochrane Library: Issue 12 of 12 December 2019), metaRegister of Controlled Trials (mRCT) (www.controlled-trials. com), ClinicalTrials.gov (www.clinicaltrial.gov) and WHO International Clinical Trials Registry Platform (www.who.int/ictrp/search/en). The keywords used for the search included "cataract surgery" or "phacoemulsification" combined with "dry eye", "dry eye disease","biometry", "keratometry". RESULTS Publications considered for this review included meta-analysis, systematic reviews, case-control and cohort studies, case series, and laboratory-based studies. Published articles reporting tear film alteration in DED, its impact on the quality of vision and optical aberrations, the effect of topical medications on keratometry variations, and reports on optimizing the ocular surface before cataract surgery were included. CONCLUSIONS DED is a common entity seen in patients presenting to routine cataract clinics and is known to impact the accuracy, reliability, and repeatability of ocular biometry and IOL power calculations in them. This review intends to emphasize the preoperative screening for the presence of DED, initiation of appropriate medical management for optimization of the ocular surface before cataract surgery, and recommendations for performing biometry. The algorithmic approach proposed will help the general ophthalmologists in routine practice to provide quality care and acceptable visual outcomes in patients with pre-existing DED.
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Strong Caldwell A, Patnaik JL, Ackerman M, Christopher KL, Lynch AM, Singh JK. Risk of Refractive Prediction Error After Cataract Surgery in Patients with Thyroid Eye Disease. Clin Ophthalmol 2021; 15:4431-4438. [PMID: 34795474 PMCID: PMC8593354 DOI: 10.2147/opth.s337360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/15/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose To investigate the risk of unexpected refractive prediction error after cataract surgery in patients with thyroid eye disease (TED) at the University of Colorado. Patients and Methods A retrospective observational study was performed using records of patients who underwent cataract surgery (2014 to 2018) who were included in a Cataract Surgery Outcomes database. Any patient with documentation of thyroid eye disease (TED) in the medical record was classified as TED. Post-operative refraction error greater than or equal to ±1.0 diopter from the target refraction was the main outcome of this study. Eyes with history of refractive surgery, ocular trauma, retinal detachment, non-Graves’ disease thyroid conditions or Graves’ disease without TED, and eyes without refractive error at follow-up were excluded. Results A total of 5716 eyes from 3692 patients who underwent cataract surgery were analyzed. Sixty-five eyes of thirty-nine patients (1.1%) had TED. Former and/or current cigarette use was associated with having TED (p = 0.0504). Patients with TED had a statistically significant shorter axial length as compared to eyes without TED (p = 0.0257). Three hundred and forty-nine eyes (6.1%), including 9 eyes (13.8%) in patients with TED, had refractive prediction error greater than ±1.0 diopter following surgery (univariate OR = 2.5, 95% CI: 1.1–5.7, p = 0.0274). After multivariate analysis controlling for race, tobacco use, combined surgery, and axial length, TED was associated with an increased risk of our primary outcome, refractive prediction error greater than ±1.0 diopter (OR = 2.4, 95% CI: 1.0–5.7, p = 0.0506). Conclusion Patients with TED are at increased risk for refractive prediction error following cataract surgery. Discussion with patients regarding their risk and possible need for glasses following surgery is important for setting realistic patient expectations.
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Affiliation(s)
- Anne Strong Caldwell
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jennifer L Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Melisa Ackerman
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Karen L Christopher
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Anne M Lynch
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jasleen K Singh
- Department of Ophthalmology, Children's Hospital of Colorado, Aurora, CO, USA
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Fernández J, Rodríguez-Vallejo M, Poyales F, Burguera N, Garzón N. New method to assess the accuracy of intraocular lens power calculation formulas according to ocular biometric parameters. J Cataract Refract Surg 2020; 46:849-856. [DOI: 10.1097/j.jcrs.0000000000000165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Advanced Technology IOL Cataract Surgery Optimized for Pre-existing Corneal Disease. CURRENT OPHTHALMOLOGY REPORTS 2018. [DOI: 10.1007/s40135-018-0188-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Visual acuity and quality of life in dry eye disease: Proceedings of the OCEAN group meeting. Ocul Surf 2017; 15:169-178. [DOI: 10.1016/j.jtos.2016.11.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 10/14/2016] [Accepted: 11/28/2016] [Indexed: 11/19/2022]
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Epitropoulos AT, Matossian C, Berdy GJ, Malhotra RP, Potvin R. Effect of tear osmolarity on repeatability of keratometry for cataract surgery planning. J Cataract Refract Surg 2016; 41:1672-7. [PMID: 26432124 DOI: 10.1016/j.jcrs.2015.01.016] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/31/2014] [Accepted: 01/02/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the effects of tear osmolarity on the repeatability of keratometry (K) measurements in patients presenting for cataract surgery. SETTING Three clinical practices. DESIGN Observational prospective nonrandomized study. METHODS Subjects were prospectively recruited based on tear osmolarity (Tearlab Osmolarity System); that is, osmolarity more than 316 mOsm/L in at least 1 eye (hyperosmolar) and osmolarity less than 308 mOsm/L in both eyes (normal). The baseline K value was measured, and a second measurement was taken on the same instrument (IOLMaster) within 3 weeks of the first. Variability in average K, calculated corneal astigmatism using vector analysis, and intraocular lens (IOL) sphere power calculations were compared between groups. RESULTS The hyperosmolar group (50 subjects) had a statistically significantly higher variability in the average K reading (P = .05) than the normal group (25 subjects) and a statistically significantly higher percentage of eyes with a 1.0 diopter (D) or greater difference in the measured corneal astigmatism (P = .02). A statistically significantly higher percentage of eyes in the hyperosmolar group had an IOL power difference of more than 0.5 D (P = .02). No statistically significant differences were present when the subjects were grouped by self-reported dry eye. CONCLUSIONS Significantly more variability in average K and anterior corneal astigmatism was observed in the hyperosmolar group, with significant resultant differences in IOL power calculations. Variability was not significantly different when subjects were grouped by self-reported dry eye. Measurement of tear osmolarity at the time of cataract surgery planning can effectively identify patients with a higher likelihood of high unexpected refractive error resulting from inaccurate keratometry. FINANCIAL DISCLOSURE Drs. Epitropoulos, Matossian, Berdy, and Malhotra received compensation from Tearlab for participating in the study. No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Alice T Epitropoulos
- From the Eye Center of Columbus (Epitropoulos), Columbus, Ohio, Matossian Eye Associates (Matossian), Pennington, New Jersey, Ophthalmology Associates (Berdy, Malhotra), Saint Louis, Missouri, and Science in Vision (Potvin), Akron, New York, USA
| | - Cynthia Matossian
- From the Eye Center of Columbus (Epitropoulos), Columbus, Ohio, Matossian Eye Associates (Matossian), Pennington, New Jersey, Ophthalmology Associates (Berdy, Malhotra), Saint Louis, Missouri, and Science in Vision (Potvin), Akron, New York, USA
| | - Gregg J Berdy
- From the Eye Center of Columbus (Epitropoulos), Columbus, Ohio, Matossian Eye Associates (Matossian), Pennington, New Jersey, Ophthalmology Associates (Berdy, Malhotra), Saint Louis, Missouri, and Science in Vision (Potvin), Akron, New York, USA
| | - Ranjan P Malhotra
- From the Eye Center of Columbus (Epitropoulos), Columbus, Ohio, Matossian Eye Associates (Matossian), Pennington, New Jersey, Ophthalmology Associates (Berdy, Malhotra), Saint Louis, Missouri, and Science in Vision (Potvin), Akron, New York, USA
| | - Richard Potvin
- From the Eye Center of Columbus (Epitropoulos), Columbus, Ohio, Matossian Eye Associates (Matossian), Pennington, New Jersey, Ophthalmology Associates (Berdy, Malhotra), Saint Louis, Missouri, and Science in Vision (Potvin), Akron, New York, USA.
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Moshirfar M, McCaughey MV, Santiago-Caban L. Corrective Techniques and Future Directions for Treatment of Residual Refractive Error Following Cataract Surgery. EXPERT REVIEW OF OPHTHALMOLOGY 2014; 9:529-537. [PMID: 25663845 DOI: 10.1586/17469899.2014.966817] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Postoperative residual refractive error following cataract surgery is not an uncommon occurrence for a large proportion of modern-day patients. Residual refractive errors can be broadly classified into 3 main categories: myopic, hyperopic, and astigmatic. The degree to which a residual refractive error adversely affects a patient is dependent on the magnitude of the error, as well as the specific type of intraocular lens the patient possesses. There are a variety of strategies for resolving residual refractive errors that must be individualized for each specific patient scenario. In this review, the authors discuss contemporary methods for rectification of residual refractive error, along with their respective indications/contraindications, and efficacies.
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Affiliation(s)
- Majid Moshirfar
- Department of Ophthalmology, Co-Director Cornea and Refractive Surgery Division, Francis I. Proctor Foundation, University of California San Francisco, 10 Koret Way, K101, San Francisco, CA 94143, USA
| | | | - Luis Santiago-Caban
- Ophthalmology Department, University of Puerto Rico School of Medicine, San Juan, PR 00936
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