Refractive outcome and lens power calculation after intrascleral intraocular lens fixation: a comparison of three-piece and one-piece intrascleral fixation technique.

Pub Date : 2023-06-09 DOI:10.1186/s40662-023-00341-6
Markus Schranz, Adrian Reumüller, Klaudia Kostolna, Caroline Novotny, Daniel Schartmüller, Claudette Abela-Formanek
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引用次数: 0

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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巩膜内人工晶状体固定后屈光效果和晶状体度数计算:三片式和一体式巩膜内固定技术的比较。
目的:评价巩膜内人工晶状体(IOL)内固定两种不同术式的屈光预测误差。方法:这是一项前瞻性、随机、纵向、单部位、单外科医生的研究。采用Yamane或Carlevale技术行巩膜内人工晶状体植入术的患者术后随访6个月。使用最佳矫正视力(EDTRS图)在4米处测量屈光度。使用前段光学相干断层扫描(AS-OCT)评估晶状体偏心、倾斜和有效晶状体位置(ELP)。对SRK/T、Hollayday1和Hoffer Q公式的预测误差(PE)和绝对误差(AE)进行了评价。随后,评估PE与轴长、角膜密度、白斑到白斑和ELP之间的相关性。结果:53例患者共53只眼纳入研究。Yamane组24眼(YG), Carlevale组29眼(CG)。YG, Holladay 1和霍夫尔问公式导致远视的PE(0.02±0.56,0.13±0.64 D,分别)在SRK公式/ T PE略近视(- 0.16±0.56 D)。在CG, SRK / T和Holladay 1公式导致了近视的PE(- 0.1±0.80,0.04±0.74 D,分别),Hoffer问一个远视的PE(0.04±0.75 D)。没有区别的PE公式在两组(P > 0.05)。在两组中,每个评估公式的AE均从零显著差异。根据配方和手术方法的不同,45% ~ 71%的眼的AE误差在±0.50 D内,72% ~ 92%的眼的AE误差在±1.00 D内。组内、组间配方间无显著差异(P > 0.05)。CG组的人工晶状体倾斜(6.45±2.03°)低于YG组(7.67±3.70°)(P结论:两组的屈光可预测性相似。人工晶状体倾斜在CG中更好,但这并不影响屈光预测。虽然不显著,Holladay 1公式似乎比SRK/T和Hoffer Q公式更可能。然而,在所有三种不同的公式中观察到显著的异常值,因此在二次固定iol中仍然是一项具有挑战性的任务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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