Relationship between Medium-Term Changes in Intraocular Lens Position and Refraction after Cataract Surgery with Two Different Models of Monofocal Lenses

Hideki Fukumitsu,Vicent J Camps,Sara Miraflores,David P Piñero

doi:10.3390/jcm10173856

Hideki Fukumitsu, Vicent J Camps + Show 2 more

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https://doi.org/10.3390/jcm10173856

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Abstract

The aim of this prospective descriptive study was to characterize the variations of the clinical effective lens position (ELP) (considering paraxial optics and postoperative data) and the intraocular lens (IOL) position, using “eye” data gathered from a 6-month follow-up of patients who underwent uneventful cataract surgery. Patients were implanted with two different monofocal IOLs: AcrySof IQ SN60WF (Alcon) (Group 1, 247 eyes) and Akreos MI60L (Bausch & Lomb) (Group 2, 104 eyes). No significant differences were found between groups concerning spherical equivalent (SE), axial length, and clinical ELP changes, from 1 to 6 months after surgery (p ≥ 0.516). A more positive change in postoperative anterior chamber depth was found in Group 2, but the difference did not reach statistical significance (p = 0.065). No significant moderate to strong correlations were found between the changes in clinical ELP and preoperative data. The correlation between the changes in SE and clinical ELP over time was strong and statistically significant (groups 1 and 2: r = 0.957 and r = 0.993, p < 0.001). In conclusion, changes in refraction from 1 to 6 months after cataract surgery, with single-piece monofocal IOLs, are not clinically relevant, which correlates with the presence of good positional stability. These changes cannot be predicted preoperatively and considered in IOL power calculations.

Highlights

The world population is aging, and as a result, age-related cataracts have become a major cause of blindness worldwide [1]
The purpose of the current study was to characterize the variations of effective lens position (ELP) and intraocular lens (IOL) positions measured with a biometry device, validated for this purpose [21] during a 6-month follow-up of the eyes of patients who underwent uneventful cataract surgery, and who were implanted with two different types of monofocal IOLs
We investigated the relationship with residual refraction and if it could be accurately predicted from preoperative data

Summary

Introduction

The world population is aging, and as a result, age-related cataracts have become a major cause of blindness worldwide [1]. Patient dissatisfaction after cataract surgery, due to the presence of residual refractive error, could be attributed to specific factors, including inadequate calculation and selection of the intraocular lens (IOL) power, inaccurate estimation of the effective lens position (ELP), and anatomical changes that occur with surgery, affecting the predictability of the IOL power formulae [4]. Several authors have reported a significant increase of the anterior chamber depth (ACD) after surgery, as well as widening of the iridocorneal angle [5,6,7]. These anatomical modifications could produce errors in ELP prediction, accounting for 22% to 38% of the total refractive prediction error [8]. The use of intraoperative ACD measurements for the estimation of ELP has shown promising results, better predicting the postoperative position of open loop IOLs and plate-haptic IOLs than preoperative ACD measurements [11,12,13]

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