Mean Absolute Refractive Error Research Articles

Intraocular lens tilt and decentration after primary and delayed implantation in phacovitrectomy for macula-off rhegmatogenous retinal detachment repair.

To evaluate the tilt and decentration of intraocular lenses (IOLs) in eyes that underwent phacovitrectomy for macula-off rhegmatogenous retinal detachment (RRD) repair. In this retrospective cohort study, 63 patients with macula-off RRD who underwent phacovitrectomy were enrolled and divided into a primary implantation group (group A) and a delayed implantation group (group B) according to the time of IOL implantation. Routine ocular examinations, including optometry, were performed, and the IOL tilt and decentration were measured. Postoperative refractive prediction error and IOL tilt and decentration were compared between the two groups, and the relevant factors of IOL positions were analyzed. The mean spherical refractive prediction error (MSE) was - 0.53 ± 0.39 D in group A and - 0.09 ± 0.55 in group B. The mean absolute spherical refractive prediction error (MASE) was 0.61 ± 0.23 D in group A and 0.50 ± 0.22 D in group B. The difference in MSE (t = -3.623, P < 0.05) but not in MASE (t = 1.866, P = 0.067) between the two groups was significant. The mean IOL tilt and mean decentration were 8.54° ±3.65° and 0.55 ± 0.18 mm in group A and 10.62° ±3.29° and 0.66 ± 0.14 mm, respectively, in Group B. Differences in tilt (t = -2.373, P < 0.05) and decentration (t = -2.698, P < 0.05) between the two groups were both significant. In group B, the mean time interval between phacovitrectomy and IOL implantation (TV-I) was 25.2 ± 6.9 weeks, and the absolute values of both IOL tilt and decentration were positively correlated with TV-I. In phacovitrectomy for macula-off RRD repair, primary IOL implantation leads to a postoperative myopic shift, while delayed IOL implantation may cause greater IOL tilt and decentration.

Postoperative Refractive Outcomes of Biometric Formulas in Phacovitrectomy with Gas Tamponade.

To investigate the refractive accuracy of intraocular lens (IOL) power calculation for biometric formulas in phacovitrectomy. This retrospective study included 357 eyes of 357 patients who underwent phacovitrectomy using four commonly available IOL power formulas: Hoffer Q (87 eyes), Holladay 1 (78 eyes), Holladay 2 (91 eyes), and SRK/T (101 eyes). The mean refractive error (ME) and the mean absolute refractive error (MAE) were calculated based on the predicted postoperative refraction error, and they were compared using analysis of variance test. Subjects were divided into high myopic eyes (axial length, ≥26 mm) and nonhigh myopic eyes (axial length, &lt;26 mm). The ME and the MAE after phacovitrectomy did not show a significant difference among the four IOL power formulas (p = 0.546 and p = 0.495, respectively). There was no significant statistical difference in formulas when the eyes were grouped into high myopia and nonhigh myopia (ME: p = 0.526 and p = 0.482, respectively; MAE: p = 0.715 and p = 0.627, respectively). The ME showed myopic shift in all formulas regardless of IOL formula used. The ME showed greater myopic shift in high myopia group than nonhigh myopia group in all formulas. Our study did not find evidence for superiority of any formula in phacovitrectomy. However, in phacovitrectomy, possible myopic shift should be considered for IOL power calculation. Especially, in phacovitrecotmy in patients with high myopia, more myopic shift should be considered when selecting IOL.

Comparison of Post-Operative Outcomes Predicted By Ultrasonic and Optic Biometry after Phacoemulsification

Purpose: To compare postoperative refractive outcomes predicted by ultrasonic and optical biometry after phacoemulsification. Study Design: Descriptive observational. Place and Duration of Study: WAPDA Teaching Hospital and Acuity Eye Center in Lahore Pakistan from January 2022 to May 2022. Methods: The study included 59 eyes with cataracts and required phacoemulsification and implantation of a foldable intraocular lens. They were divided into two groups; (29 in the ultrasonic biometry group and 30 in the optical biometry group). The first group was subjected to ultrasound biometry, whereas the second was subjected to optical biometry. We compared ocular refractions following cataract surgery in two groups. The Mann-Whitney U test was used to compare the mean absolute refractive error (MAE). The operating surgeon was the same in both the groups. Results: All the participants were between 40 and 70 years of age. The preoperative mean target refraction in the ultrasonic group was 0.05 ± 0.13D (range: -0.01 to + 0.17D) and 0.12 ± 0.33D in the optical group (range:-0.01 to +0.49D). Thus, there was a non-significant difference between both groups regarding target refraction(P = 0.58, U = 398.5). The MAE measured for the first group was 0.14 ± 0.46D and for the second group was 0.60 ± 0.53D. The comparison between both the biometry procedures showed that the difference was non-significant between the biometry methods (P = 0.430). Conclusion: The difference between Post-Operative MAE of patients undergoing two different biometry procedures (Optical and Ultrasonic) after cataract surgery was non-significant at P &gt; 0.05.

Correction of Asymmetric Bowtie Corneal Astigmatism with a Toric Intraocular Lens: Outcomes and Accuracy of Measurement Modes.

The outcomes of toric intraocular lens (IOL) implantation in correcting asymmetric bowtie corneal astigmatism remain uncertain. The accurate measurement of corneal astigmatism is essential for surgical planning. In this prospective cohort study, patients with asymmetric or symmetric bowtie corneal astigmatism who underwent toric IOL implantation were recruited. Preoperative corneal astigmatism was measured with an IOLMaster and Pentacam (including the simulated keratometry (SimK), total corneal refractive power (TCRP), and wavefront aberration (WFA) modes). At 3 months after surgery, the refractive outcomes and residual astigmatic refractive errors were compared with patients with symmetric bowtie astigmatism. The prediction errors (the differences between the calculated actual corneal astigmatism and the measured corneal astigmatism) were compared among the different measurement modes in the asymmetric group. There were no differences in residual astigmatism between the asymmetric and symmetric groups. However, the mean absolute residual astigmatic refractive error was greater in the asymmetric group than in the symmetric group (0.72 ± 0.42 D vs. 0.53 ± 0.24 D, p = 0.043). In the asymmetric group, the mean absolute prediction errors for the IOLMaster, SimK, TCRP and WFA modes were 0.53 ± 0.40, 0.56 ± 0.47, 0.68 ± 0.52, and 0.43 ± 0.40 D, respectively. The Pentacam WFA mode was the most accurate mode (p < 0.05). The absolute prediction error of the WFA mode was positively correlated with the total corneal irregular astigmatism higher-order aberrations and coma (r = 0.416 and r = 0.473, respectively; both p < 0.05). Our study suggests toric IOL implantation effectively corrected asymmetric bowtie corneal astigmatism. The Pentacam WFA mode may be the most accurate measurement mode, although its accuracy decreased as asymmetry increased.

Detection of Anterior Hyaloid Membrane Detachment Using Deep-Range Anterior Segment Optical Coherence Tomography.

The visibility of anterior hyaloid membrane (AHM) and Berger’s space in phakic eyes was investigated. In 624 eyes of 624 patients, the retrolental space was scanned with the deep-range anterior segment optical coherence tomography (AS-OCT, CASIA2, Tomey). Subgroup analysis was conducted in 223 eyes undergoing cataract surgery. The logistic regression analysis using the backward-elimination method was performed to evaluate the influence of various factors on the visibility of AHM (dependent variable). Explanatory variables included age, gender, axial length, corneal power, corneal cylinder, and the Co III gradings. Intrarater repeatability for AHM visibility was excellent with the prevalence-adjusted bias-adjusted kappa (κ coefficient) of 0.90. AHM was observed in 43 eyes (6.9%). The patients with visible AHM (68.1 ± 8.8 years) were significantly older than those without visible AHM (52.6 ± 25.6 years) (p < 0.001). The logistic regression analysis in the cataract surgery subgroup revealed that axial length (p = 0.030) and corneal power (p = 0.043) were significantly associated with AHM visibility. The mean absolute refractive error from target was significantly larger in eyes with visible AHM (0.670 ± 0.384 D) than with invisible AHM (0.494 ± 0.412 D) (p = 0.037). The postoperative refractive prediction was less accurate in eyes with visible AHM, but no significant tendency existed in terms of myopic or hyperopic shifts.

Influence of combined phacovitrectomy without tamponade on intraocular lens displacement and postoperative refraction.

To compare phacoemulsification versus phacovitrectomy regarding postoperative intraocular lens (IOL) shift and refraction. This prospective bilateral comparison study included 40 eyes of 20 patients. Inclusion criteria were combined phacovitrectomy without gas/air tamponade in one eye and cataract surgery in the contralateral eye with implantation of the same IOL. Postoperative anterior chamber depth (ACD) was compared between both groups 1-5 hr, 1 day and 8 weeks after surgery. Postoperative refraction was compared after 8 weeks using the Holladay I, HofferQ, SRK/T, Haigis and Barrett formulae. There were no intergroup differences in ACD (8 weeks: 0.02 mm absolute difference, SD 0.22, range -0.36 to 0.65, p = 0.401), mean absolute refractive error (8 weeks: Holladay I p = 0.452; HofferQ p = 0.475; SRK/T p = 0.498; Haigis p = 0.869; and Barrett p = 0.352) or percentages within the 0.5 D and 1.0 D range at any time-point. All formulae were optimized for the phacovitrectomy and the cataract groups. There was no correlation of macular thickness change and refractive error (cataract group r2 = -0.13, p = 0.58; phacovitrectomy group r2 = -0.10, p = 0.68). Combined phacovitrectomy without air/ gas tamponade caused neither ACD displacement nor refractive shifts compared to phacoemulsification alone. Surgically induced macular thickness change had no significant influence on postoperative refraction in this study. All five IOL formulae showed comparable postoperative refractive outcomes.

P-19 Transepithelial PTK/limited non topoigraphic PRK combined with corneal crosslinking for keratoconus.

Data were analysed from a retrospective cohort of eyes undergoing PTK epithelial removal or limited PRK combined with corneal crosslinking. Patients undergoing PRK were either contact lens intolerant or were considering alternate surgical therapy including corneal transplantation. Data included uncorrected and best corrected vision, refraction and OCT topographic findings. Treatments were performed using a TECHNOLAS® TENEO™ 2 (Bausch & Lomb) and CXL with Avedro KXL (Glaukos) according to a modified protocol. 24 eyes were treated using combined Excimer laser PTK or limited non-topographic transepithelial PRK depending on intervention protocol with >3 month follow-up. Postoperative best corrected visual acuity improved by a mean of 0.42 LOGMAR units (SD 0.37, range 0.1 to 1.4) (p<0.005). All eyes had improvement of BCVA. Mean absolute spherical refractive error decreased by 0.56 D (SD 1.26, range -2.5 to 2) (p<0.05). Postoperative spherical error increased in a few cases (3/24, 12%) Mean absolute refractive cylinder decreased by 1.46D (SD 2.3 range -4.75 to 7) (p<0.05). Limited increase of astigmatism occurred in 2 (8,3%) cases. There were no postoperative complications noted. PTK/limited non topographic PRK combined with CXL may offer improvement to corrected visual acuity compared to CXL alone.

Intraocular lens power calculation after excimer laser corneal refractive surgery: A retrospective study to compare the predictability and the efficacy of commonly used and modified formulas.

PURPOSE:Our article aims to assess the accuracy of modified and commonly used formulas of intraocular lens (IOL) power calculation after excimer laser corneal refractive surgery.METHODS:This is a retrospective study, with data retrieved for 50 eyes of 32 patients who underwent uncomplicated cataract surgery after excimer laser corneal refractive surgery. The expected spherical equivalent was calculated using the American Society of Cataract and Refractive Surgeons (ASCRS) IOL power calculator for Shammas and Barrett True-K, using three-fourth generation formulas (Haigis-L, Barrett True-K no history, and Holladay 2), and using three-third generation formulas (SRKT, Holladay 1, and Hoffer Q) with single k, as a reference, and adjusting these formulas by calculating the keratometry readings by two methods (Jarade's index and formula). The mean refractive error and mean absolute refractive error (MARE) were calculated at the 1 postoperative month.RESULTS:When all data was available (eight eyes), 13 formulas were compared. Holladay 1 as modified by Jarade's index and formula, and Hoffer Q as modified by Jarade's formula resulted in MARE <0.75D (P < 0.05). In the group of 25 eyes with only ablation available, the formulas with MARE <0.75D were Haigis L, Barrett TK (from ASCRS), Hoffer Q, and the three conventional formulas in Jarade's index (P < 0.001). In the group of 17 eyes with no available prerefractive data, only Haigis-L and Barret TK (no history) had a MARE <0.75 D.CONCLUSION:The use of Hoffer Q or Holladay 1, when prerefractive data are available, gives reliable results with Jarade's index.

Refractive Accuracy of Barrett True-K vs Intraoperative Aberrometry for IOL Power Calculation in Post-Corneal Refractive Surgery Eyes.

PurposeTo compare the refractive predictability of intraoperative aberrometry (IA, ORA, Alcon) and Barrett True-K/Universal II formulas for intraocular lens (IOL) power calculations in post-corneal refractive surgery and normal eyes.MethodsRetrospective study of normal and post-corneal refractive surgery eyes that underwent cataract surgery with IA at tertiary academic center. Preoperatively, IOL power calculations were performed using Barrett Universal II (normal eyes) or Barrett True-K (post-corneal refractive surgery eyes) formulas. Intraoperatively, aphakic IA measurements were used for IOL power calculations. Mean absolute refractive prediction error (MAE) and the percentage of eyes with prediction error within ±0.50, ±0.75 and ±1.00 D were calculated. Refractive predictability was also evaluated in short, normal, and long eyes.ResultsTwo hundred and seventy-three eyes were included in the analysis. No statistically significant differences were observed between the MAE of preoperative formulas and IA for post-hyperopic laser vision correction (LVC), post-myopic LVC, post-radial keratotomy (RK) and normal eyes. For prediction error within ±0.5 D in post-corneal refractive surgery eyes, range of agreement between Barrett True-K and IA ranged from 28% (7/25) of the time in post-RK eyes to 49% (40/81) of the time in post-hyperopic LVC; the corresponding value for Barrett Universal II/IA was 62% (64/103) in normal eyes. When there was disagreement, IA outperformed Barrett True-K in post-hyperopic LVC eyes and Barrett formula outperformed IA in post-myopic LVC, post-RK, and normal eyes.ConclusionIA appears to be comparable to Barrett formulas for IOL power calculations in post-corneal refractive surgery and normal eyes. In post-hyperopic LVC, IA yields better results compared to Barrett True-K formula; in real-life scenarios, IA reveals statistical advantage over the Barrett True-K no history formula for eyes post-hyperopic LVC.

Clinical Accuracy of 6 Intraocular Lens Power Calculation Formulas in Elongated Eyes, According to Anterior Chamber Depth

To investigate the influence of anterior chamber depth (ACD) on the accuracy of the Kane, EVO 2.0, Barrett Universal II (BU II), Olsen, SRK/T, and Haigis formulas in patients with elongated eyes. Retrospective case series study. A total of 106 patients (106 eyes) diagnosed with high myopia (axial length ≥26 mm) were enrolled and divided into 3 subgroups according to preoperative ACD. Mean refractive error (ME), mean absolute refractive error (MAE), median absolute refractive error (MedAE), and proportions of eyes within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D were calculated. In all patients, the MedAE was lowest for the Kane formula (0.28 D), followed by the BU II (0.34 D). In the shallow ACD subgroup, EVO 2.0 formula produced the lowest MedAE (0.22D), and the highest proportion of eyes within ±0.25 D (58%); the BU II (0.23 D, 50%) and Kane (0.25 D, 50%) formulas produced similar proportions. In the deep ACD group, the MedAEs of the Haigis and SRK/T formulas (0.68 D and 0.50 D, respectively) were significantly higher than those of the EVO 2.0 (0.37 D), Kane (0.30 D), BU II (0.43 D), and Olsen (0.34 D) formulas (P < 0.05). Overall, the Kane and EVO 2.0 formulas had the highest accuracy. EVO 2.0 and BU II formulas are recommended for patients with shallow ACD; the Kane formula is recommended for patients with deep ACD (especially patients with extremely elongated eyes). The SRK/T and Haigis formulas should be avoided as much as possible.

Refractive outcome of combined phacoemulsification and glaucoma surgery in patients of primary "open-angle glaucoma"

Introduction Glaucoma and cataracts are the leading causes of blindness worldwide. Treatment of either condition can influence the course of the other. Trabeculectomy induces changes to anterior chamber depth, axial length (AL), and corneal curvature, which could influence the accuracy of intraocular lens power calculations in combined surgery. Aim Assessment accuracy of intraocular lens calculation and refractive outcome after combined surgery versus cataract surgery (phacoemulsification) alone for coexisting cataract and glaucoma. Patients and methods Our study is a prospective nonrandomized comparative study of 43 consecutive patients (60 eyes) with cataract with coexisting glaucoma who had undergone phacotrabeculectomy (group 1) or phacoemulsification only (group 2). The biometry prediction error was determined for each case by the difference between the actual postoperative refraction and the preoperative predicted refraction in a spherical equivalent followed by comparative analysis of mean absolute refractive error, best-corrected visual acuity, and intraocular pressure (IOP) before and after surgery at 1, 3 months postoperatively. Results In both groups, best-corrected visual acuity was improved and IOP was decreased significantly. Mean absolute refractive error at 1, 3 months postoperatively was not significantly different between two groups (P>0.05) with more cylindrical changes and myopic shifts in group 1 due to high bleb, conjunctival or scleral suture, and changes in anterior chamber depth. Conclusion Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, it is more effective in lowering IOP.

Comparison of refractive outcomes using Scheimpflug Holladay equivalent keratometry or IOLMaster 700 keratometry for IOL power calculation.

This study aims to compare postoperative refractive error results using Pentacam (Oculus Optikgeräte GmbH) Holladay equivalent keratometry readings (EKR) or IOLMaster 700 (Carl Zeiss Meditec AG) keratometry (K) values in IOL power calculation. This retrospective study included 54 eyes of 31 patients who underwent cataract surgery. Preoperative biometric measurements of all patients were obtained using IOLMaster 700 followed by Pentacam measurements. IOLMaster 700K measurements on horizontal (K1) and vertical (K2) axes and EKR measurements on 2mm (EKR2mm), 3mm (EKR3mm) and 4.5mm (EKR4.5mm) corneal zones were recorded. EKR4.5mm value and IOLMaster 700K values were used in Holladay-II, SRK/T, Haigis, and Hoffer-Q formulas to calculate predictive refractive error (PRE). Absolute refractive error (ARE) was calculated as the absolute difference between actual postoperative refractive error (APRE) and PRE values. Mean age was 72.2 ± 8.3 (51-87) years and mean IOL power was 21.5 ± 2.9 D (18-23 D). There was no significant difference between PRE values when IOLMaster 700K measurements and EKR4.5mmK measurements were used in Holladay-II, SRK/T, Haigis, and Hoffer-Q formulas (p = 0.571, p = 0.833, p = 0.165, p = 0.347, respectively). There was no significant difference between APRE and ARE values (p = 0.124). According to mean ARE results, the closest estimate was achieved when the IOLMaster 700K values were used in the Holladay-II formula (p = 0.271). IOLMaster 700K measurement and Pentacam EKR4.5mm measurements can be used interchangeably. IOLMaster 700K values yielded the most predictive measurement of the refractive result using the Holladay-II formula.

Effect of the capsular tension ring on refractive outcome after phacoemulsification.

Purpose: To evaluate how capsular tension rings (CTR) affect refractive outcomes following cataract extraction by phacoemulsification complicated by zonular instability.Study design: Retrospective.Methods: In a retrospective case-control study, the 29 eyes of 29 patients with CTRs were compared with the 29 eyes of patients without zonular instability following routine phacoemulsification, with mean arithmetic refractive prediction error (ArRPE) and mean absolute refractive prediction error (AbRPE) as primary outcome measures.Results: A comparison of eyes with and without CTRs according to the SRK/ T formula revealed no statistically significant difference in ArRPE (0.52 vs. 0.45 D, p = 0.570) or AbRPE (0.52 vs. 0.55 D, p = 0.799). Postoperative hypermetropic shift occurred in most cases in both groups, although the mean difference between eyes with CTR (22/ 29) and without CTR (25/ 29) was not statistically significant (p = 0.315).Conclusion: Implanting CTRs did not consistently affect refractive outcomes versus routine phacoemulsification. Results suggest that intraocular lens power can be calculated as usual when CTRs are used.Abbreviations: CTR = capsular tension ring, ArRPE = arithmetic refractive prediction errors, AbRPE = absolute refractive prediction errors, IOL = intraocular lens, WTW = white-to-white, ACD = anterior chamber depths, AL = axial lengths, RPE = refractive prediction error

Combined versus Sequential Phacoemulsification and Pars Plana Vitrectomy: A Meta-Analysis

It is unclear whether differences exist in efficacy and safety between combined versus sequentially performed phacoemulsification and pars plana vitrectomy (phaco-PPV). This meta-analysis aimed to compare the efficacy and incidence of complications between these surgical methods. Ovid MEDLINE, EMBASE, and Cochrane CENTRAL were searched for articles reporting the efficacy and safety of combined versus sequential phaco-PPV for any indication. The primary outcomes were postoperative best-corrected visual acuity (BCVA) and mean absolute refractive error from target (RET). Secondary outcomes included efficacy outcomes and postoperative complications. Meta-analysis was conducted using a random effects model in all cases. Risk of bias assessment was performed using the Cochrane risk of bias assessment tool for randomized trials and ROBINS-I tool for observational studies. Of the 5410 articles identified, 1 randomized controlled trial and 14 comparative studies were included, with 1407 and 951 eyes in the combined and sequential surgery groups, respectively. Mean age was 62.71 ± 6.16 years and 44% (range, 32.1%-70%) of eyes were from men. The mean baseline BCVA was 0.88±0.59 logarithm of the minimum angle of resolution units (Snellen equivalent, 20/152). The meta-analysis showed no significance between groups in postoperative mean BCVA (P= 0.76) and mean absolute RET (P= 0.46). The risks of synechiae formation (risk ratio [RR], 2.74; 95% confidence interval [CI], 1.83-4.11; P < 0.001), fibrin formation (RR, 2.81; 95% CI, 1.84-4.30; P < 0.001), and intraoperative or postoperative retinal detachment (RR, 2.65; 95% CI, 1.08-6.47; P= 0.03) were significantly higher after combined surgery. However, the risks of posterior capsular tear (RR, 0.43; 95% CI, 0.25-0.73; P= 0.002) and macular hole nonclosure or reopening (RR, 0.18; 95% CI, 0.03-0.93; P= 0.04) were significantly lower in the combined group. No significant differences were found in visual and refractive outcomes between combined and sequential phaco-PPV, whereas differences existed in certain safety outcomes. These conclusions remain preliminary, as most evidence is derived from low- to moderate-quality retrospective studies. Given the variability in outcome reporting and associated heterogeneity, future randomized controlled trials are needed.

IOL Power Calculation After Radial Keratotomy Using the Haigis and Barrett True-K Formulas.

To compare the accuracy of intraocular lens (IOL) power calculation in patients with previous radial keratotomy using the Haigis and Barrett True-K formulas. In a retrospective cases series of patients with previous radial keratotomy and minimum follow-up of 1.2 months, preoperative data from an IOLMaster 500 or 700 (Carl Zeiss Meditec AG), the IOL power implanted, and the postoperative refraction were used to calculate the refractive prediction error. The primary outcomes were the mean absolute and arithmetic refractive prediction errors and the percentage of eyes with a refractive prediction error within ±0.50 and ±1.00 diopters (D). One hundred eight eyes were evaluated with a mean follow-up of 6.9 ± 4.9 months. The Haigis formula yielded a mean arithmetic refractive prediction error of -0.29 ± 1.00 D, which was significantly different than that of the Barrett True-K formula, which was -0.03 ± 0.96 D (P < .001). The mean absolute refractive prediction error was 0.80 ± 0.67 for the Haigis formula and 0.74 ± 0.60 for the Barrett True-K formula (P > .05). The percentages of eyes with a refractive prediction error within ±0.50 and ±1.00 D were 43.5% and 65.7% for the Haigis formula and 42.6% and 75.9% for the Barrett True-K formula, respectively (all P > .05). The subgroup analysis revealed that for flat corneas (K1 < 38.00 D), the Barrett True-K formula resulted in more hyperopic results than the Haigis formula. The Barrett True-K formula exhibited better arithmetic predictability than the Haigis formula; however, it showed a tendency for hyperopic results in very flat corneas. [J Refract Surg. 2020;36(12):832-837.].

Comparison of Clinical Outcomes Between Intracapsular Implantation and Intrascleral Fixation Using the Same Model of Intraocular Lens.

PurposeTo compare the clinical outcomes of intrascleral intraocular lens (IOL) fixation surgery with those of intracapsular IOL implantation in conventional cataract surgery.Patients and MethodsTwenty-one eyes of 21 consecutive patients who underwent intrascleral IOL fixation (SF group) and 21 eyes of 21 patients who underwent IOL intracapsular implantation during cataract surgery (IN group) were retrospectively enrolled. For both groups, the same model of IOL was used in all cases. For all cases in the SF group, Yamane’s double-needle technique was performed.ResultsThe mean corrected visual acuity (logMAR) after surgery was significantly better in the IN than in the SF group (−0.063 ± 0.12 vs 0.05 ± 0.14; p = 0.0083). The mean anterior chamber depth after surgery was significantly smaller in the IN than in the SF group (4.65 ± 0.23 mm vs 4.98 ± 0.61 mm; p = 0.0231). The amounts of tilt and decentration were also significantly smaller in the IN group (5.21°± 1.47° and 0.22 ± 0.13 mm, respectively, vs 8.8° ± 3.9° and 0.52 ± 0.35 mm, respectively; p = 0.0003 and p = 0.0007). The mean absolute refractive prediction error was significantly smaller in the IN than in the SF group (0.22 ± 0.17 D vs 0.86 ± 0.59 D; p = 0.0002).ConclusionThe intrascleral IOL fixation surgery proved to be highly effective. However, its clinical outcomes were slightly inferior to those of IOL intracapsular implantation, and further improvement of this surgical technique may be needed.

Correlation of binocular refractive error and calculation of intraocular Lens power for the second eye

BackgroundReducing 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.MethodsThis 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.ResultsThe 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).ConclusionsBinocular 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.

The use of new cohesive ophthalmic viscoelastic in cataract surgery

The article presents the results of an original study which was dedicated to the investigation of the new cohesive viscoelastic Cogevisc (sodium hyaluronate 1.6%) in ophthalmic surgery.&#x0D; Aim. Analysis of the efficacy and safety of a new cohesive viscoelastic (Cogevisc, Solopharm) in phacoemulsification.&#x0D; Patients and Methods. The clinical study was based on an assessment of the clinical and functional state of 80 patients (80 eyes), which were divided into 2 groups depending on viscoelastic used during the phacoemulsification procedure (Softshell technology): in group I (40 patients, 40 eyes) Viscoat was used to protect tissues, and Amvisc Plus was added to create volume; in group II (40 patients, 40 eyes) Viscoat was used to protect tissues, and Kogevisc was used to create volume. In the postoperative period, all patients received standard anti-inflammatory treatment. There was no significant difference in mean age, gender, preoperative intraocular pressure (IOP) and preoperative central corneal thickness (CCT) between the two groups. Before surgery and in the postoperative period (in one day, 7 days, and 1 month), IOP, CCT, and endothelial cell density (ECD) were measured. The duration of the procedure and the amount of the consumed fluid were estimated.&#x0D; Results. There was no significant difference in IOP, CCT, ECD 1 day and 1 week postoperatively between the two groups. Mean absolute refractive error was also not significantly different between the two groups. There was no significant difference in procedure duration between groups I and II (1523.81 75.66 seconds, 1500.33 92.56 seconds, respectively, p 0.001). No complications were observed during the intraocular lens implantation in both groups.&#x0D; Conclusion. The investigated viscoelastic Cogevisc allows creating and effectively maintaining the necessary depth of the anterior chamber and the maximum diameter of the pupil, which simplifies different stages of phacoemulsification and minimizes the risk of intraoperative complications. Promising for further research is its use in combination with an adhesive viscoelastic of the same production. Reduced cost of Cogevisc is the advantage of this viscoelastic.

Visual and refractive outcomes and complications in femtosecond laser-assisted versus conventional phacoemulsification cataract surgery: findings from a randomised, controlled clinical trial

Background/aimTo compare visual and refractive outcomes, changes in intraocular pressure (IOP), and complications of femtosecond laser-assisted cataract surgery (FLACS) to conventional phacoemulsification surgery (CPS) in paired eyes from the same...

Wang Koch-adjusted axial length in SRK/T formula for ocular biometry in high myopia: a prospective study

Background: The aim of this study was to prospectively assess refractive results of cataract surgery in highly myopic eyes using the SRKT formula and Wang Koch-adjusted axial length. Material and methods: Prospectively, we recruited consecutive candidates for cataract surgery having an axial length equal to 27 mm and longer. We performed biometry by using Wang and Koch-adjusted axial length applied to the SRKT formula. The main outcome measures were: mean of refractive error, mean of absolute refractive error, and percentage of eyes that achieved a refractive error of ± 0.5D and ± 1D. Results: Fifteen eyes of nine patients were involved in the study. The mean refractive error was -0.01D ± 0.4D, and the mean absolute refractive error was + 0.35D ± 0.20D. Refractive errors of ± 0.5D and ± 1D were achieved, respectively, in 86.6% and in 100% of eyes. Conclusions: Wang Koch’s axial length adjustment applied to the SRKT formula is a reliable alternative in high myopic cataract patients.