Axial length adjustment in eyes with silicone oil endotamponade reduces overestimation by a swept-source optical coherence tomography-based biometer

IF 4.9 2区医学 Q1 OPHTHALMOLOGY

Clinical and Experimental Ophthalmology Pub Date : 2024-07-21 DOI:10.1111/ceo.14418

Klemens Paul Kaiser MD, Tyll Jandewerth MD, Julian Bucur MD, Thomas Kohnen MD, PhD, Christoph Lwowski MD

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Abstract

Background

To assess changes in ocular biometry of the phakic eye after pars-plana-vitrectomy (PPV) and silicone oil (SO) endotamponade in eyes with a retinal detachment.

Methods

This retrospective, consecutive case series included 72 eyes of 72 patients who underwent PPV with 5000-centistokes SO endotamponade between July 2018 and June 2023. Pseudophakic eyes and eyes with a combined phacovitrectomy were excluded. Primary endpoints were keratometry values, anterior chamber depth (ACD), lens thickness (LT), horizontal corneal diameter (HCD), and axial length (AL) measured by swept-source optical coherence tomography-based biometry (IOLMaster 700) preoperatively and six weeks postoperatively. A recently described formula was used to adjust the AL (aAL) in eyes with SO endotamponade and a theoretical intraocular lens (IOL) calculation was performed.

Results

The mean age was 62.1 ± 8.3 years (range: 37–85). After PPV with SO fill, there was an increase in K_mean (0.19 ± 0.51D), while ACD (0.05 ± 0.13 mm), LT (0.03 ± 0.14 mm), and HCD (0.02 ± 0.24 mm) decreased. Preoperatively, the mean AL was 25.22 ± 1.78 mm, while postoperatively the AL was overestimated by 0.12 ± 0.42 mm on average (p = 0.04). By adjusting the AL, the mean difference could be reduced to −0.002 ± 0.41 mm. The aAL resulted in a difference in the refractive outcome in eyes with an AL > 25 mm of 0.34 ± 0.10D in the IOL calculation.

Conclusions

While changes in biometry after PPV with SO endotamponade in the anterior segment are clinically less relevant, a considerable overestimation of AL with IOLMaster 700 was found. We recommend the use of a recently introduced formula for adjusting AL in eyes with SO, allowing overestimation to be minimised considerably.

Abstract Image

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硅油内腔填塞眼的轴向长度调整可减少基于扫源光学相干断层扫描的生物测量仪的过高估计。

背景：目的：评估视网膜脱离患者在接受视网膜旁切除术（PPV）和硅油（SO）眼内填塞术后，法眼眼部生物测量的变化：该回顾性连续病例系列包括2018年7月至2023年6月期间接受PPV和5000厘斯托克斯SO内填塞术的72名患者的72只眼睛。假性角膜病变眼和合并虹膜切除术的眼被排除在外。主要终点是角膜测量值、前房深度（ACD）、晶状体厚度（LT）、角膜水平直径（HCD）和轴向长度（AL），测量方法是基于扫源光学相干断层扫描的生物测量法（IOLMaster 700），测量时间为术前和术后六周。使用最近描述的公式调整了有 SO 内陷的眼睛的 AL（aAL），并进行了理论眼内晶状体（IOL）计算：平均年龄为 62.1 ± 8.3 岁（37-85 岁）。SO填充PPV后，Kmean增加（0.19 ± 0.51D），ACD（0.05 ± 0.13 mm）、LT（0.03 ± 0.14 mm）和HCD（0.02 ± 0.24 mm）下降。术前，平均 AL 为 25.22 ± 1.78 毫米，而术后 AL 平均被高估了 0.12 ± 0.42 毫米（p = 0.04）。通过调整 AL，平均差异可降至 -0.002 ± 0.41 毫米。在计算人工晶体时，AL>25毫米的眼睛的屈光结果与AL>25毫米的眼睛的屈光结果相差0.34±0.10D：虽然前段SO内膜填塞PPV后生物测量的变化与临床关系不大，但使用IOLMaster 700发现AL被高估了很多。我们建议使用最近推出的公式来调整有 SO 的眼睛的 AL 值，这样可以大大降低高估的程度。

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来源期刊

Clinical and Experimental Ophthalmology 医学-眼科学

CiteScore

7.60

自引率

12.50%

发文量

150

审稿时长

4-8 weeks

期刊介绍： Clinical & Experimental Ophthalmology is the official journal of The Royal Australian and New Zealand College of Ophthalmologists. The journal publishes peer-reviewed original research and reviews dealing with all aspects of clinical practice and research which are international in scope and application. CEO recognises the importance of collaborative research and welcomes papers that have a direct influence on ophthalmic practice but are not unique to ophthalmology.