ABSTRACT
PURPOSE: This study evaluates the accuracy of modern intraocular lens (IOL) calculation formulas using axial length (AL) data obtained by ultrasound biometry (UBM) compared to the third-generation SRK/T calculator. MATERIAL AND METHODS: The study included 230 patients (267 eyes) with severe lens opacities that prevented optical biometry, who underwent phacoemulsification (PE) with IOL implantation. IOL power calculation according to the SRK/T formula was based on AL and anterior chamber depth obtained by UBM (Tomey Biometer Al-100) and keratometry on the Topcon KR 8800 autorefractometer. To adapt AL for new generation calculators - Barrett Universal II (BUII), Hill RBF ver. 3.0 (RBF), Kane and Ladas Super Formula (LSF) - the retinal thickness (0.20 mm) was added to the axial length determined by UBM, and then the optical power of the artificial lens was calculated. The mean error and its modulus value were used as criteria for the accuracy of IOL calculation. RESULTS: A significant difference (p=0.008) in the mean IOL calculation error was found between the formulas. Pairwise analysis revealed differences between SRK/T (-0.32±0.58 D) and other formulas - BUII (-0.16±0.52 D; p=0.014), RBF (-0.17±0.51 D; p=0.024), Kane (-0.17±0.52 D; p=0.029), but not with the LSF calculator (-0.19±0.53 D; p=0.071). No significant differences between the formulas were found in terms of mean error modulus (p=0.238). New generation calculators showed a more frequent success in hitting target refraction (within ±1.00 D in more than 95% of cases) than the SRK/T formula (86%). CONCLUSION: The proposed method of adding 0.20 mm to the AL determined by UBM allows using this parameter in modern IOL calculation formulas and improving the refractive results of PE, especially in eyes with non-standard anterior segment structure.
Subject(s)
Biometry , Lenses, Intraocular , Phacoemulsification , Refraction, Ocular , Humans , Biometry/methods , Male , Female , Aged , Middle Aged , Reproducibility of Results , Refraction, Ocular/physiology , Phacoemulsification/methods , Axial Length, Eye/diagnostic imaging , Lens Implantation, Intraocular/methods , Cataract/physiopathology , Cataract/diagnosis , Optics and Photonics/methods , Microscopy, Acoustic/methodsABSTRACT
PURPOSE: This study analyzed cases with postoperative displacement of intraocular lens (IOL) relative to the haptic plane using ultrasound biomicroscopy (UBM). MATERIAL AND METHODS: The study analyzed biometry data of 231 patients (277 eyes) aged 72.39±7.77 years, among them 43.25% were males. IOL position and refraction were analyzed at 1, 3 and 6 months after standard phacoemulsification. RESULTS AND DISCUSSION: UBM was performed to analyze the position of the IOL. Stabilization of lens position was observed by the 3rd month of observation. Among the cases with displacement of the optical part relative to the haptic plane, the forward shift was determined in 24.85%, backward - in 16.67% of cases. Eyes with opposite IOL displacements differed significantly in lens diameter, ciliary sulcus diameter and the power of implanted IOL. IOL shift towards the retina produced significant hyperopic refractive error. A discriminant function was compiled using preoperative biometry data comprising the model for predicting backward IOL displacement with high probability. However, we failed to obtain a qualitative model for forward IOL displacements. CONCLUSION: Calculation error in modern formulas could occur because of IOL displacement, including the shift of the optical part relative to the haptic plane in postoperative period. Analysis of biometry data allows calculating IOL displacement towards the retina with a high probability, which could help avoid hyperopic refraction error postoperatively.
Subject(s)
Hyperopia , Lenses, Intraocular , Phacoemulsification , Refractive Errors , Male , Humans , Female , Lens Implantation, Intraocular/methods , Microscopy, Acoustic , Haptic Technology , Refraction, Ocular , Phacoemulsification/adverse effects , Biometry/methods , Retrospective StudiesABSTRACT
PURPOSE: To test a prediction algorithm for deflection of the optical part of IOL after uncomplicated phacoemulsification. MATERIAL AND METHODS: The study included 226 patients (287 eyes) who underwent phacoemulsification with implantation of intracapsular AcrySof IOL. Preoperative examination included IOLMaster, Lenstar LS 900 biometry and Pentacam HR keratotopography. All measurement were repeated one month postoperatively. To determine the tilt and deflection of the IOL's optical part, anterior segment optical coherence tomography (OCT) was performed on Topcon 3DOCT-2000. RESULTS: OCT data analysis helps identify the slope and deflection of the IOL's optical part relative to the pupil plane. In the previous study we built logistic regression models for predicting the deflection of the IOL's optical part with high predictive quality based on the calculated IOL power and preoperative biometry measurements. When checked with new patient data, the areas under the ROC curves have changed slightly. Large area under the ROC curves with small deviation rates, as well as retention of the level of true positive responses with little increase in false negative responses verify the high quality of the models. CONCLUSION: Logistic regression models based on the optical power of the implanted IOL, as well as on a combination of preoperative biometry data from IOLMaster and Lenstar LS 900, make it possible to predict the probability of deflection of the optical part of IOL with high reliability and promptly correct the IOL power.
