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Schranz M, Reumüller A, Kostolna K, Novotny C, Schartmüller D, Abela-Formanek C. Refractive outcome and lens power calculation after intrascleral intraocular lens fixation: a comparison of three-piece and one-piece intrascleral fixation technique. Eye Vis (Lond) 2023; 10:29. [PMID: 37291668 DOI: 10.1186/s40662-023-00341-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 03/30/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE To evaluate the refractive prediction error of common intraocular lens (IOL) power calculation formulae in patients who underwent intrascleral IOL fixation using two different techniques. METHODS This is a prospective, randomized, longitudinal, single-site, single-surgeon study. Patients who underwent intrascleral IOL implantation using the Yamane or the Carlevale technique were followed up for a period of six months postoperatively. Refraction was measured using the best-corrected visual acuity at 4 m (EDTRS chart). Lens decentration, tilt and effective lens position (ELP) were assessed using an anterior segment optical coherence tomography (AS-OCT). The prediction error (PE) and the absolute error (AE) were evaluated for the SRK/T, Hollayday1 and Hoffer Q formula. Subsequently, correlations between the PE and axial length, keratometry, white to white and ELP were assessed. RESULTS In total, 53 eyes of 53 patients were included in the study. Twenty-four eyes of 24 patients were in the Yamane group (YG) and 29 eyes of 29 patients were in the Carlevale group (CG). In the YG, the Holladay 1 and Hoffer Q formulae resulted in a hyperopic PE (0.02 ± 0.56 D, and 0.13 ± 0.64 D, respectively) while in the SRK/T formula the PE was slightly myopic (- 0.16 ± 0.56 D). In the CG, SRK/T and Holladay 1 formulae led to a myopic PE (- 0.1 ± 0.80 D and - 0.04 ± 0.74 D, respectively), Hoffer Q to a hyperopic PE (0.04 ± 0.75 D). There was no difference between the PE of the same formulae across both groups (P > 0.05). In both groups the AE differed significantly from zero in each evaluated formula. The AE error was within ± 0.50 D in 45%-71% and was within ± 1.00 D in 72%-92% of eyes depending on the formula and surgical method used. No significant differences were found between formulae within and across groups (P > 0.05). Intraocular lens tilt was lower in the CG (6.45 ± 2.03°) compared to the YG (7.67 ± 3.70°) (P < 0.001). Lens decentration was higher in the YG (0.57 ± 0.37 mm) than in the CG (0.38 ± 0.21 mm), though the difference was not statistically significant (P = 0.9996). CONCLUSIONS Refractive predictability was similar in both groups. IOL tilt was better in the CG, however this did not influence the refractive predictability. Though not significant, Holladay 1 formula seemed to be more probable than the SRK/T and Hoffer Q formulae. However, significant outliers were observed in all three different formulae and therefore remain a challenging task in secondary fixated IOLs.
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Affiliation(s)
- Markus Schranz
- Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Adrian Reumüller
- Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Klaudia Kostolna
- Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Caroline Novotny
- Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Daniel Schartmüller
- Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Claudette Abela-Formanek
- Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Lin P, Xu J, Miao A, Xu C, Qian D, Lu Y, Zheng T. A Comparative Study on the Accuracy of IOL Calculation Formulas in Nanophthalmos and Relative Anterior Microphthalmos. Am J Ophthalmol 2023; 245:61-69. [PMID: 36084681 DOI: 10.1016/j.ajo.2022.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE We sought to compare the prediction accuracy of 6 intraocular lens (IOL) formulas, namely, the Haigis, Hoffer Q, Holladay I, SRK/T, Barrett Universal II and Hoffer QST formulas, in microphthalmic eyes, including those with nanophthalmos and relative anterior microphthalmos (RAM). DESIGN Retrospective case series. METHODS Twenty-six eyes with nanophthalmos (axial length [AL] 16.84 ± 1.36 mm, range 15.25 mm-19.82 mm) and 12 eyes with RAM (corneal diameter 8.41 ± 0.92 mm, range 7.00 mm-9.50 mm) receiving cataract surgery were included. The IOL Master 500 was used for biometry; thus, lens thickness (LT) was omitted in the IOL power calculation. The mean and median arithmetic and absolute prediction errors (PEs) of the 6 original calculation formulas, the absolute PEs of the 6 formulas after optimization, and the proportion of PEs within ±0.25 diopters (D), ±0.5 D, ±1 D, and ±2 D with each formula were compared. The factors influencing PE were analyzed by multivariate regression. RESULTS In the nanophthalmos group, the overall prediction results were shifted to myopia. The original Haigis formula had the smallest median absolute PE (1.61 D, P < 0.001), and the optimized Haigis formula had the highest proportion of PEs within ±0.25 D, ±0.5 D, and ±1 D. In the RAM group, the overall prediction results were not significantly different from 0 (P > .05). No significant difference was found among the formulas before optimization (P = .146) and after optimization (P = .161), but the optimized Barrett Universal II formula had the highest proportion of PEs within ±1 D and ±2 D. CONCLUSIONS When omitting the LT parameter in the calculation, the Haigis formula was the most accurate in cataract patients with nanophthalmos (AL <20 mm) among the 6 IOL calculation formulas, and the Barrett Universal II formula had the highest accuracy in cataract patients with RAM (corneal diameter ≤9.5 mm).
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Affiliation(s)
- Peimin Lin
- From the Department of Ophthalmology, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Department of Ophthalmology and the Eye Institute,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Key Laboratory of Myopia, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Ministry of Health, Shanghai, China; the Shanghai Key Laboratory of Visual Impairment and Restoration,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Shanghai, China
| | - Jie Xu
- From the Department of Ophthalmology, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Department of Ophthalmology and the Eye Institute,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Key Laboratory of Myopia, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Ministry of Health, Shanghai, China; the Shanghai Key Laboratory of Visual Impairment and Restoration,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Shanghai, China
| | - Ao Miao
- From the Department of Ophthalmology, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Department of Ophthalmology and the Eye Institute,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Key Laboratory of Myopia, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Ministry of Health, Shanghai, China; the Shanghai Key Laboratory of Visual Impairment and Restoration,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Shanghai, China
| | - Canqing Xu
- From the Department of Ophthalmology, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Department of Ophthalmology and the Eye Institute,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Key Laboratory of Myopia, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Ministry of Health, Shanghai, China; the Shanghai Key Laboratory of Visual Impairment and Restoration,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Shanghai, China
| | - Dongjin Qian
- From the Department of Ophthalmology, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Department of Ophthalmology and the Eye Institute,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Key Laboratory of Myopia, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Ministry of Health, Shanghai, China; the Shanghai Key Laboratory of Visual Impairment and Restoration,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Shanghai, China
| | - Yi Lu
- From the Department of Ophthalmology, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Department of Ophthalmology and the Eye Institute,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Key Laboratory of Myopia, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Ministry of Health, Shanghai, China; the Shanghai Key Laboratory of Visual Impairment and Restoration,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Shanghai, China.
| | - Tianyu Zheng
- From the Department of Ophthalmology, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Department of Ophthalmology and the Eye Institute,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Key Laboratory of Myopia, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Ministry of Health, Shanghai, China; the Shanghai Key Laboratory of Visual Impairment and Restoration,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Shanghai, China.
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