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Using the First-Eye Back-Calculated Effective Lens Position to Improve Refractive Outcome of the Second Eye. J Clin Med 2022; 12:jcm12010184. [PMID: 36614985 PMCID: PMC9820906 DOI: 10.3390/jcm12010184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/10/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
The present study is a retrospective, monocentric case series that aims to compare the second-eye IOL power calculation precision using the back-calculated lens position (LP) as a lens position predictor versus using a predetermined correction factor (CF) for thin- and thick-lens IOL calculation formulas. A set of 878 eyes from 439 patients implanted with Finevision IOLs (BVI PhysIOL, Liège, Belgium) with both operated eyes was used as a training set to create Haigis-LP and PEARL-LP formulas, using the back-calculated lens position of the contralateral eye as an effective lens position (ELP) predictor. Haigis-CF, Barrett-CF, and PEARL-CF formulas using an optimized correction factor based on the prediction error of the first eye were also designed. A different set of 1500 eyes from 1500 patients operated in the same center was used to compare the basal and enhanced formula performances. The IOL power calculation for the second eye was significantly enhanced by adapting the formulas using the back-calculated ELP of the first eye or by using a correction factor based on the prediction error of the first eye, the latter giving slightly higher precision. A decrease in the mean absolute error of 0.043D was observed between the basal PEARL and the PEARL-CF formula (p < 0.001). The optimal correction factor was close to 60% of the first-eye prediction error for every formula. A fixed correction factor of 60% of the postoperative refractive error of the first operated eye improves the second-eye refractive outcome better than the methods based on the first eye’s effective lens position back-calculation. A significant interocular biometric dissimilarity precludes the enhancement of the second-eye IOL power calculation according to the first-eye results.
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Kristianslund O, Hassaf SE, Drolsum L. Optical Biometry and Lens Power Calculations in 500 Phakic Patients: Axial Length and Corneal Curvature in the Fellow Eye. Clin Ophthalmol 2022; 16:2775-2780. [PMID: 36039107 PMCID: PMC9419889 DOI: 10.2147/opth.s375743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/14/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Olav Kristianslund
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Correspondence: Olav Kristianslund, Department of Ophthalmology, Oslo University Hospital, Mailbox 4956, Nydalen, Oslo, 0424, Norway, Tel +47 22 11 85 45, Email
| | | | - Liv Drolsum
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Langenbucher A, Szentmáry N, Cayless A, Röggla V, Leydolt C, Wendelstein J, Hoffmann P. Similarity of eyes in a cataractous population—How reliable is the biometry of the fellow eye for lens power calculation? PLoS One 2022; 17:e0269709. [PMID: 35771869 PMCID: PMC9246162 DOI: 10.1371/journal.pone.0269709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background
In some situations it is necessary to use biometry from the fellow eye for lens power calculation prior to cataract surgery. The purpose of this study was to analyse the lateral differences in biometric measurements and their impact on the lens power calculation.
Methods
The analysis was based on a large dataset of 19,472 measurements of 9736 patients prior to cataract surgery with complete biometric data of both left and right eyes extracted from the IOLMaster 700. After randomly indexing the left or right eye as primary (P) and secondary (S), the differences between S and P eye were recorded and analysed (Keratometry (RSEQ), total keratometry (TRSEQ) and back surface power (BRSEQ)), axial length AL, corneal thickness CCT, anterior chamber depth ACD, lens thickness LT). Lens power was calculated with the Castrop formula for all P and S eyes, and the refraction was predicted using both the P and S eye biometry for the lens power calculation.
Results
Lateral differences (S-P, 90% confidence interval) ranged between -0.64 to 0.63 dpt / -0.67 to 0.66 dpt / -0.12 to 0.12 dpt for RSEQ / TRSEQ / BRSEQ. The respective difference in AL / CCT / ACD / LT ranged between -0.46 to 0.43 mm / -0.01 to 0.01 mm / -0.20 to 0.20 mm / -0.13 to 0.14 mm. The resulting difference in lens power and predicted refraction ranged between -2.02 to 2.00 dpt and -1.36 to 1.30 dpt where the biometry of the S eye is used instead of the P eye. The AL and RSEQ were identified as the most critical parameters where the biometry of the fellow eye is used.
Conclusion
Despite a strong similarity of both eyes, intraocular lens power calculation with fellow eye biometry could yield different results for the lens power and finally for the predicted refraction. In 10% of cases, the lens power derived from the S eye deviates by 2 dpt or more, resulting in a refraction deviation of 1.36 dpt or more.
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Affiliation(s)
- Achim Langenbucher
- Department of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
- * E-mail:
| | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg/Saar, Germany
- Department of Ophthalmology, Semmelweis-University, Budapest, Hungary
| | - Alan Cayless
- School of Physical Sciences, The Open University, Milton Keynes, United Kingdom
| | - Veronika Röggla
- Department of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
- Department of Optometry and Ophthalmology, AKH Vienna University Hospital, Vienna, Austria
| | - Christina Leydolt
- Department of Optometry and Ophthalmology, AKH Vienna University Hospital, Vienna, Austria
| | - Jascha Wendelstein
- Department of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
- Department of Ophthalmology, Johannes Kepler University, Linz, Austria
| | - Peter Hoffmann
- Augen- und Laserklinik Castrop-Rauxel, Castrop-Rauxel, Germany
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Wendelstein JA, Reifeltshammer SA, Hoffmann PC, Fischinger I, Mariacher S, Bolz M, Langenbucher A, Hirnschall N. Project Hyperopic Power Prediction II: The Effects of Second Eye Refinement Methods on Prediction Error in Hyperopic Eyes. Curr Eye Res 2022; 47:1121-1130. [PMID: 35435092 DOI: 10.1080/02713683.2022.2067563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose: The purpose of the study was to evaluate the potential accuracy of different second eye refinement methods in a patient cohort with short axial eye length to assess the performance of intraocular lens (IOL) power calculation schemes in high hyperopes.Methodology: The study design was a single-center, single-surgeon retrospective consecutive case series. The setting of the study was in Augen- und Laserklinik, Castrop-Rauxel, Germany. Patients were assessed after uneventful bilateral cataract surgery implanting either spherical (SA60AT) or aspheric (ZCB00) IOLs. Inclusion criteria were an axial eye length of ≤21.5 mm and/or emmetropizing IOL power of >28.5 dpt. Outcome measures were the mean absolute prediction error (MAE), median absolute prediction error, mean prediction error with standard deviation, median prediction error, and the percentage of eyes with a MAE within 0.25 dpt, 0.5 dpt, 0.75 dpt, or 1.0 dpt. Second eye refinement was performed using the first eye prediction error, either with a correction coefficient of 0.50 (SER1), or an individual coefficient optimized for MAE.Results: A total of 55 patients were assessed. A statistically significant reduction in the absPE after the application of SER1 was observed in 9 of 13 formulae. The SER1 refined Hoffer Q, refined Holladay I, refined Holladay II, refined Kane, refined Okulix, and refined PEARL-DGS provided a smaller absolute prediction error (absPE) than other methods.Conclusion: In this patient cohort with a short axial eye length, the second eye refinement led to a lower MAE in almost all formulae. The use of refinement in Kane, Okulix, PEARL-DGS, and Castrop formulae exhibited the lowest MAE.
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Affiliation(s)
- Jascha A Wendelstein
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020 Linz, Austria.,Johannes Kepler University Linz, Medical Faculty, Altenberger Strasse 69, 4040 Linz, Austria.,Institute of Experimental Ophthalmology, Saarland University, Kirrberger Str. 100/22, 66424 Homburg, Germany
| | - Sophia A Reifeltshammer
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020 Linz, Austria.,Johannes Kepler University Linz, Medical Faculty, Altenberger Strasse 69, 4040 Linz, Austria
| | | | - Isaak Fischinger
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020 Linz, Austria.,Johannes Kepler University Linz, Medical Faculty, Altenberger Strasse 69, 4040 Linz, Austria.,Department of Ophthalmology, Augentagesklinik Spreebogen Berlin, Alt-Moabit 101, 10557 Berlin, Germany
| | - Siegfried Mariacher
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020 Linz, Austria.,Johannes Kepler University Linz, Medical Faculty, Altenberger Strasse 69, 4040 Linz, Austria
| | - Matthias Bolz
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020 Linz, Austria.,Johannes Kepler University Linz, Medical Faculty, Altenberger Strasse 69, 4040 Linz, Austria
| | - Achim Langenbucher
- Institute of Experimental Ophthalmology, Saarland University, Kirrberger Str. 100/22, 66424 Homburg, Germany
| | - Nino Hirnschall
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020 Linz, Austria.,Johannes Kepler University Linz, Medical Faculty, Altenberger Strasse 69, 4040 Linz, Austria
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Yan C, Yao K. Effect of Lens Vault on the Accuracy of Intraocular Lens Calculation Formulas in Shallow Anterior Chamber Eyes. Am J Ophthalmol 2022; 233:57-67. [PMID: 34293335 DOI: 10.1016/j.ajo.2021.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE To explore the impact of preoperative lens vault (LV) on the accuracy of the Barrett Universal Ⅱ, Haigis, Hoffer Q, Hoffer QST, Holladay 1, Kane, and SRK/T formulas in eyes with a shallow anterior chamber. DESIGN Retrospective case series. METHODS Included were 409 eyes with anterior chamber depth (ACD) shallower than 3.0 mm that underwent phacoemulsification. Eyes were divided into a short axial length (AL) group (<22.00 mm) and a normal AL group (22.00 ≤ AL < 24.50 mm). Each group was further divided into a small LV subgroup (LV <0.95 mm) and a large LV subgroup (LV ≥0.95 mm) according to the median of the preoperative LV. Postoperative refraction was measured 3 months after surgery. Mean absolute error (MAE) was calculated and compared for each formula. The correlation between LV and the mean numeric error predicted by each formula was analyzed. RESULTS Overall, the Barrett and Kane formulas generated the smallest MAE in both short AL and normal AL groups (P < .05 for both). In short AL eyes with small LV, the Haigis formula performed better than other traditional formulas (P < .05 for all). In normal AL eyes with a small LV, the Barrett and Kane formulas showed higher accuracy (P < .05 for all), and other formulas were comparable. In either subgroup with a large LV, the Haigis formula created a significant higher MAE (P < .001 for all), followed by Hoffer QST. Positive correlations were found between LV and mean numeric errors predicted by all formulas, except for Barrett and Kane formulas (P < .001 for all), indicating a postoperative hyperopic shift with an increased LV. CONCLUSIONS In shallow anterior chamber eyes with a large LV, the Haigis and Hoffer QST formulas taking preoperative ACD into calculation surprisingly showed a larger prediction error. However, the Barrett and the Kane formulas, which include both ACD and lens thickness as predictive parameters, showed good accuracy in both small and large LV subgroups. Therefore, although formulas referring to preoperative ACD are generally believed to achieve better refractive results in patients with a shallow anterior chamber, LV may be valuable to consider when choosing an IOL power calculation formula.
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Affiliation(s)
- Chenxi Yan
- From the Eye Center (C.Y., K.Y.) of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ke Yao
- From the Eye Center (C.Y., K.Y.) of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
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Shu ZM, Li FQ, Che ST, Shan CL, Zhao JS. Topical Review: Causes of Refractive Error After Silicone-oil Removal Combined with Cataract Surgery. Optom Vis Sci 2021; 97:1099-1104. [PMID: 33252540 DOI: 10.1097/opx.0000000000001609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE This review summarizes the main factors of refractive error after silicone oil removal combined with cataract surgery.The post-operative refractive results of silicone oil removal combined with cataract surgery are closely related to the patient's future vision quality. This report summarizes the factors that influence the difference between the actual post-operative refractive power and the pre-operatively predicted refractive power after silicone oil removal combined with cataract surgery, including axial length, anterior chamber depth, silicone oil, commonly used tools for measuring intraocular lens power, and intraocular lens power calculation formulas, among others. The aim of the report is to assist clinical and scientific research on the elimination of refractive error after silicone oil removal combined with cataract surgery.
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Affiliation(s)
- Zhi-Min Shu
- Department of Ophthalmology, Second Hospital of Jilin University, Changchun, China
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7
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Zhang P, Yang Y, Yan H, Zhang J, Yan W. Correlation of binocular refractive error and calculation of intraocular Lens power for the second eye. BMC Ophthalmol 2020; 20:237. [PMID: 32552707 PMCID: PMC7302342 DOI: 10.1186/s12886-020-01496-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 06/01/2020] [Indexed: 12/26/2022] Open
Abstract
Background Reducing refractive error has always been a tricky problem. The aim of this study was to verify the correlation between binocular refractive error (RE) after sequential cataract surgery and explore an individualized calculation method of intraocular lens (IOL) for the second eye. Methods This was a prospective study. One hundred eighty-eight affected eyes in 94 age-related cataract patients who underwent sequential cataract surgery in the Department of Ophthalmology, Tangdu Hospital, China, were recruited. Complete case data were included for a correlation analysis of binocular RE. Data obtained in patients with RE values greater than 0.50 diopters (D) in the first eye were extracted and the patients divided randomly into two groups: Group A and B. In the adjustment group, group A, we modified the IOL power for the second eyes as 50% of the RE of the first eye. In group B, the control group, there was no modification. The mean absolute refractive error (MARE) values of the second eyes were evaluated one month after surgery. Results The correlation coefficient of the binocular RE after sequential cataract surgery was 0.760 (P < 0.001). After the IOL power of the second eyes was adjusted, the MARE of the second eyes was 0.57 ± 0.41 D, while the MARE of the first eyes was 1.18 ± 0.85 D, and the difference was statistically significant (P < 0.001). Conclusions Binocular REs were positively correlated after sequential cataract surgery. The RE of the second eye can be reduced by adjusting the IOL power based on 50% of the postoperative RE of the first eye.
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Affiliation(s)
- Pengcheng Zhang
- Xi'an Fourth Hospital, Shaanxi Eye Hospital, Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University, Xi'an, 710004, Shaanxi Province, China.,Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Yuhuan Yang
- Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Hong Yan
- Xi'an Fourth Hospital, Shaanxi Eye Hospital, Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University, Xi'an, 710004, Shaanxi Province, China. .,Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China.
| | - Jie Zhang
- Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Weijia Yan
- Department of Ophthalmology, University of Heidelberg, 69120, Heidelberg, Germany
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8
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Sieck EG, Capitena Young CE, Epstein RS, SooHoo JR, Pantcheva MB, Patnaik JL, Lynch AM, Kahook MY, Seibold LK. Refractive outcomes among glaucoma patients undergoing phacoemulsification cataract extraction with and without Kahook Dual Blade goniotomy. EYE AND VISION (LONDON, ENGLAND) 2019; 6:28. [PMID: 31548974 PMCID: PMC6751845 DOI: 10.1186/s40662-019-0153-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/29/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Glaucoma patients undergoing phacoemulsification alone have a higher rate of refractive surprise compared to patients without glaucoma. This risk is further increased with combined filtering procedures. Indeed, there are few and conflicting reports on the effect of combined phacoemulsification and micro-invasive glaucoma surgery (MIGS). Here, we look at refractive outcomes of glaucoma patients undergoing phacoemulsification with and without Kahook Dual Blade (KDB) goniotomy. METHODS Retrospective chart review of 385 glaucomatous eyes of 281 patients, which underwent either phacoemulsification alone (n = 309) or phacoemulsification with KDB goniotomy (n = 76, phaco-KDB) at the University of Colorado. The main outcome was refractive surprise defined as the difference in target and postoperative refraction spherical equivalent greater than ±0.5 Diopter (D). RESULTS Refractive surprise greater than ±0.5 D occurred in 26.3% of eyes in the phaco-KDB group and 36.2% in the phacoemulsification group (p = 0.11). Refractive surprise greater than ±1.0 D occurred in 6.6% for the phaco-KDB group and 9.7% for the phacoemulsification group (p = 0.08). There was no significant difference in risk of refractive surprise when pre-operative IOP, axial length, keratometry or performance of KDB goniotomy were assessed in univariate analyses. CONCLUSION There was no difference between refractive outcomes of glaucomatous patients undergoing phacoemulsification with or without KDB goniotomy.
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Affiliation(s)
- Erin G. Sieck
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Cara E. Capitena Young
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Rebecca S. Epstein
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Jeffrey R. SooHoo
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Mina B. Pantcheva
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Jennifer L. Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Anne M. Lynch
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Malik Y. Kahook
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Leonard K. Seibold
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
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Predictive value of intracrystalline interphase point measured by optical low-coherence reflectometry for the estimation of the anatomical position of an intraocular lens after cataract surgery. J Cataract Refract Surg 2019; 45:1294-1304. [DOI: 10.1016/j.jcrs.2019.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/02/2019] [Accepted: 04/16/2019] [Indexed: 11/21/2022]
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Ning X, Yang Y, Yan H, Zhang J. Anterior chamber depth - a predictor of refractive outcomes after age-related cataract surgery. BMC Ophthalmol 2019; 19:134. [PMID: 31238910 PMCID: PMC6591866 DOI: 10.1186/s12886-019-1144-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 06/13/2019] [Indexed: 12/30/2022] Open
Abstract
Background Anterior chamber depth (ACD) is becoming a hot topic and plays an important role in correcting the refractive errors (REs) after cataract surgery. The aim of this study was to assess the ACD changes and their relationship with the REs after phacoemulsification and intraocular lens (IOL) implantation in patients with age-related cataracts. Methods One hundred forty-five eyes of 125 age-related cataract patients from the Department of Ophthalmology, Tangdu Hospital, China, were recruited. IOL Master was used for axial length (AL) and the IOL power calculation measurements, and the Pentacam HR device was used for the ACD and lens thickness (LT) measurements. Every patient underwent uncomplicated phacoemulsification by a single surgeon using a single technique. Postoperative refraction results were obtained at 1 month. The appropriate formula used for the IOL power calculation was chosen depending on the AL, specifically the Hoffer Q (AL < 22.0 mm), SRK/T (22.0 mm ≤ AL ≤ 30.0 mm), and Haigis (AL > 30.0 mm) formulas. Results The postoperative ACD was deepened and tended to stabilize gradually after 2 weeks. A concurrent hyperopic shift (0.57 ± 0.47 D) was observed when the change in the ACD was less than 1.65 mm, whereas a myopic shift (− 0.18 ± 0.62 D) occurred contrarily, and the difference between the two groups was statistically significant (P < 0.0001). The change in ACD was significantly larger in the shallow anterior chamber (1.92 ± 0.40 mm) than in the deep chamber (1.33 ± 0.42 mm) (P < 0.0001). Similarly, the change in ACD was larger in the short AL (2.12 ± 0.37 mm) than in the long AL (1.32 ± 0.49 mm). The postoperative ACD and refractive changes were correlated with the preoperative ACD and AL (P < 0.0001), respectively. Two regression formulas were proposed: postoperative ACD = 3.524 + 0.294 × preoperative ACD and postoperative ACD = 3.361 + 0.228× (preoperative ACD + 1/2 LT). Conclusions The results of this study showed that the ACD deepened and was associated with a concurrent RE after cataract surgery. Postoperative changes in the ACD were related to the preoperative ACD and AL, which determined the refraction status and visual quality. The regression formula of the postoperative ACD could provide a theoretical basis for predicting refractive errors in the clinic.
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Affiliation(s)
- Xiaona Ning
- Department of Ophthalmology, Xi'an No. 4 Hospital, Shaanxi Eye Hospital, Affiliated Guangren Hospital School of Medicine, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China.,Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Yuhuan Yang
- Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Hong Yan
- Department of Ophthalmology, Xi'an No. 4 Hospital, Shaanxi Eye Hospital, Affiliated Guangren Hospital School of Medicine, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China. .,Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China.
| | - Jie Zhang
- Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
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Kim YC, Sung MS, Heo H, Park SW. Anterior segment configuration as a predictive factor for refractive outcome after cataract surgery in patients with glaucoma. BMC Ophthalmol 2016; 16:179. [PMID: 27756264 PMCID: PMC5070221 DOI: 10.1186/s12886-016-0359-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 10/11/2016] [Indexed: 12/30/2022] Open
Abstract
Background To compare refractive outcomes after cataract surgery between patients with closed-angle and open-angle glaucoma and evaluate the influence of preoperative factors on refractive outcomes in patients with glaucoma. Methods Patients diagnosed with glaucoma and who underwent uncomplicated cataract surgery were enrolled in this retrospective observational study. We collected data including age, history of prior laser peripheral iridotomy and trabeculectomy, type of glaucoma, manifest refraction, intraocular pressure, axial length, and various anterior segment parameters using anterior-segment optical coherence tomography. Factors associated with unsatisfactory refractive outcome at postoperative 6 month were evaluated. Results A total of 143 eyes (143 subjects) were included. Of these, 49 and 94 had closed-angle and open-angle glaucoma, respectively. At postoperative-6 month evaluation, the mean absolute error (MAE) predicted by the SRK-II and SRK-T formulae was 0.67 ± 0.61 and 0.81 ± 0.66 diopters (D), respectively. The overall predictability of achieving within ± 1.0 D of target was 76.92 % and 72.73 %, respectively. At a cutoff value of 1.0 D for MAE, there was no statistical significant difference in refractive outcome between the closed-angle and open-angle glaucoma groups. Logistic regression modeling showed that large lens vault (LV) was a significant predictor of unsatisfactory refractive outcome after cataract surgery in patients with glaucoma. Conclusions When considering cataract surgery in patients with glaucoma, surgeons should recognize that the refractive outcomes may be unsatisfactory in eyes with large LV.
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Affiliation(s)
- Young Cheong Kim
- Department of Medical Science Graduate School, Chonnam National University, Gwangju, Republic of Korea
| | - Mi Sun Sung
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Hwan Heo
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Sang Woo Park
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea. .,Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, Republic of Korea.
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