Исследование положения интраокулярной линзы с помощью оптической когерентной томографии и связанных с ним изменений рефракции после факоэмульсификации

Abstract

Purpose. To reveal a variability of IOL position after phacoemulsification using the optical coherence tomography (OCT) and to determine associated changes in postoperative refraction. Material and methods . The study enrolled 187 patients (220 eyes) who underwent phacoemulsification with the AcrySof® IOL implantation. The preoperative examination included the «IOLMaster» and «Lenstar LS 900» biometry, and the «Pentacam HR» keratotopography. One month postoperatively all of the measurements were repeated. The «Topcon 3D OCT-2000» optical coherent tomography was used to detect an IOL tilt and its displacement. Results. Axial displacements of the IOL optical part revealed by the OCT data allowed to divide the patients into 2 groups. Patients with an IOL «deflection» had eyes with a bigger axial length and a wide corneal segment, a deeper pseudophakic anterior chamber with a larger volume. Also there was a shift of subjective refraction towards the hyperopia relative to values calculated by the Hoffer Q, Holladay I and Haigis formulas in the selected group. Constructed logistic regression equations included the «IOLMaster» and «Lenstar LS 900» biometry parameters, the calculated IOL power and had a high predictive quality. Conclusions. The OCT data allow to reveal axial «deflections» of the IOL in patients. This leads to a weakening of subjective refraction. The probability of displacements can be calculated with a high predictive quality according to the logistic regression model. So, it enables to assess a risk of such dislocations and to make adjustments in the calculation of IOL optical power.