scholarly journals Refractive outcomes after vitrectomy combined with phacoemulsification of idiopathic macular holes

2021 ◽  
Vol 14 (2) ◽  
pp. 250-254
Author(s):  
Bo-Shi Liu ◽  
◽  
Rui Niu ◽  
Qiong Chen ◽  
Ze-Tong Nie ◽  
...  
Keyword(s):  
Refractive Error ◽  
Prediction Error ◽  
Power Calculation ◽  
Closure Rate ◽  
Refractive Outcomes ◽  
Age Related ◽  
Macular Holes ◽  
Myopic Shift ◽  
Idiopathic Macular Holes ◽  
The Difference

AIM: To report the refractive outcomes after vitrectomy combined with phacoemulsification and intraocular lens (IOL) implantation (phaco-vitrectomy) in idiopathic macular holes (IMH). METHODS: A total of 56 eyes with IMH (IMH group) that underwent phaco-vitrectomy and 44 eyes with age-related cataract (ARC group) that underwent cataract surgery were retrospectively reviewed. The best corrective visual acuity (BCVA), predicted refractive error (PRE), actual refractive error (ARE), axial length (AL), were measured in both groups before and 6mo after operation. The power calculation of IOL and the predicted refractive error (PRE) were calculated according to the SRK/T formula. The difference of PRE and ARE between the two groups were compared and analyzed. RESULTS: In the IMH group, the diameters of macular holes were 271.73±75.85 μm, the closure rate was 100%. The pre- and post-operative BCVA were 0.80±0.35 and 0.40±0.35 logMAR. The PRE of A-ultrasound and IOL Master in the IMH group was -0.27±0.25 and 0.10±0.66 D. The postoperative mean absolute prediction error (MAE) was observed to be 0.58±0.65 and 0.53±0.37 D in the IOL Master and A-ultrasound (P=0.758). The PRE and ARE of the IMH group were 0.10±0.66 D and -0.19±0.64 D (P=0.102). The PRE and ARE of the ARC group was -0.43±0.95 and -0.31±0.93 D (P=0.383). The difference between PRE and ARE was -0.33±0.81 and 0.09±0.64 D in the IMH and ARC groups (P=0.021). The proportion of myopic shift was 67.9% in the IMH group and 27.3% in the ARC group (P=0.004). CONCLUSION: The myopic shift can be observed in patients with IMH after phaco-vitrectomy.

scholarly journals Lenstar LS 900 versus Pentacam-AXL: analysis of refractive outcomes and predicted refraction

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Henrique Aragão Arruda ◽  
Joana M. Pereira ◽  
Arminda Neves ◽  
Maria João Vieira ◽  
Joana Martins ◽  
...  
Keyword(s):  
Refractive Error ◽  
Prediction Error ◽  
Mean Absolute Error ◽  
Absolute Error ◽  
Spherical Equivalent ◽  
Refractive Outcomes ◽  
Iol Calculation ◽  
Median Absolute Error ◽  
The Difference ◽  
Mean Prediction Error

AbstractAnalysis of refractive outcomes, using biometry data collected with a new biometer (Pentacam-AXL, OCULUS, Germany) and a reference biometer (Lenstar LS 900, HAAG-STREIT AG, Switzerland), in order to assess differences in the predicted and actual refraction using different formulas. Prospective, institutional study, in which intraocular lens (IOL) calculation was performed using the Haigis, SRK/T and Hoffer Q formulas with the two systems in patients undergoing cataract surgery between November 2016 and August 2017. Four to 6 weeks after surgery, the spherical equivalent (SE) was derived from objective refraction. Mean prediction error (PE), mean absolute error (MAE) and the median absolute error (MedAE) were calculated. The percentage of eyes within ± 0.25, ± 0.50, ± 1.00, and ± 2.00 D of MAE was determined. 104 eyes from 76 patients, 35 males (46.1%), underwent uneventful phacoemulsification with IOL implantation. Mean SE after surgery was − 0.29 ± 0.46 D. Mean prediction error (PE) using the SRK/T, Haigis and Hoffer Q formulas with the Lenstar was significantly different (p > 0.0001) from PE calculated with the Pentacam in all three formulas. Percentage of eyes within ± 0.25 D MAE were larger with the Lenstar device, using all three formulas. The difference between the actual refractive error and the predicted refractive error is consistently lower when using Lenstar. The Pentacam-AXL user should be alert to the critical necessity of constant optimization in order to obtain optimal refractive results.

scholarly journals An innovative approach for determining the customized refractive index of ectatic corneas in cataractous patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shiva Pirhadi ◽  
Keivan Maghooli ◽  
Khosrow Jadidi
Keyword(s):  
Refractive Index ◽  
Cataract Surgery ◽  
Ray Tracing ◽  
Prediction Error ◽  
Power Calculation ◽  
Corneal Power ◽  
Iol Power Calculation ◽  
Iol Power ◽  
Hyperopic Shift ◽  
The Difference

Abstract The aim of this study is to determine the customized refractive index of ectatic corneas and also propose a method for determining the corneal and IOL power in these eyes. Seven eyes with moderate and severe corneal ectatic disorders, which had been under cataract surgery, were included. At least three months after cataract surgery, axial length, cornea, IOL thickness and the distance between IOL from cornea, and aberrometry were measured. All the measured points of the posterior and anterior parts of the cornea converted to points cloud and surface by using the MATLAB and Solidworks software. The implanted IOLs were designed by Zemax software. The ray tracing analysis was performed on the customized eye models, and the corneal refractive index was determined by minimizing the difference between the measured aberrations from the device and resulted aberrations from the simulation. Then, by the use of preoperative corneal images, corneal power was calculated by considering the anterior and posterior parts of the cornea and refractive index of 1.376 and the customized corneal refractive index in different regions and finally it was entered into the IOL power calculation formulas. The corneal power in the 4 mm region and the Barrett formula resulted the prediction error of six eyes within ± 1 diopter. It seems that using the total corneal power along with the Barrett formula can prevent postoperative hyperopic shift, especially in eyes with advanced ectatic disorders.

scholarly journals Postoperative Refractive Prediction Error Measured by Optical and Acoustic Biometry after Phacovitrectomy for Rhegmatogenous Retinal Detachment without Macular Involvement

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Masashi Sakamoto ◽  
Izumi Yoshida ◽  
Takahiro Sodeno ◽  
Asao Sakai ◽  
Hidetaka Masahara ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Cataract Surgery ◽  
Refractive Error ◽  
Prediction Error ◽  
Rhegmatogenous Retinal Detachment ◽  
Control Group ◽  
Macular Disease ◽  
Optical Biometry ◽  
The Difference ◽  
Retrospective Comparative Study

Introduction. The aim of this study was to investigate the postoperative prediction error measured by optical biometry and acoustic biometry in eyes after phacovitrectomy for rhegmatogenous retinal detachment (RRD) with no macular involvement. Methods. Forty-nine eyes of 49 patients (32 male, 17 female; mean age 62.6 ± 7.5 years) with RRD without macular involvement who underwent phacovitrectomy (RRD group) and 49 eyes of 33 patients (21 male, 12 female; mean age 74.1 ± 7.1 years) without macular disease who underwent cataract surgery (control group) were included in this retrospective comparative study. The difference between the preoperative predictive value and the postoperative refractive value was measured both by optical and acoustic biometry and compared in each group. Results. The postoperative refractive error calculated by acoustic biometry was −0.81 ± 0.75D and that calculated by optic biometry was −0.44 ± 0.77D in the RRD group. The postoperative refractive error calculated by acoustic biometry was −0.21 ± 0.64D and that calculated by optic biometry was 0.27 ± 0.71D in the control group. Significant myopic shifts were observed in the RRD group using both acoustic biometry and optic biometry but not in the control group. Conclusion. Phacovitrectomy for RRD with no macular involvement resulted in a significant myopic shift when compared with cataract surgery alone in patients without macular disease when calculated by both acoustic biometry and optic biometry.

Autologous internal limiting membrane transplant for recurrent idiopathic macular holes

2020 ◽  
pp. 112067212090639 ◽  
Author(s):  
Tommaso Rossi ◽  
Carlandrea Trillo ◽  
Guido Ripandelli
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Outer Segment ◽  
Internal Limiting Membrane ◽  
Control Group ◽  
Closure Rate ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Macular Holes ◽  
Idiopathic Macular Holes

Purpose: To report a series of recurrent idiopathic macular holes treated by means of a free autologous internal limiting membrane flap and compare visual and anatomic results to a control group undergoing further internal limiting membrane peeling and novel gas tamponade. Methods: Retrospective surgical series of 15 consecutive patients receiving autologous internal limiting membrane flap compared to 14 patients operated on for internal limiting membrane peeling enlargement. Autologous internal limiting membrane flap was created after brilliant blue G staining, internal limiting membrane lifting, perfluorocarbon bubble injection and creation of a wide internal limiting membrane free flap translocated underneath perfluorocarbon liquid, to the macular hole bed. Both groups were tamponated with 20% SF6 and positioned face down for 4 h a day for 3 days. Results: Macular hole closed in 14/15 (93.3%) patients of the autologous internal limiting membrane group and 9/14 (64.2%) controls (p < 0.05). Visual acuity increased from 0.05 ± 0.03 to 0.23 ± 0.13 Snellen in the autologous internal limiting membrane group and from 0.05 ± 0.03 to 0.14 ± 0.10 Snellen of controls (p < 0.05 for both). Vision of the autologous internal limiting membrane group improved more than controls at 1 month (p = 0.043) and 3 months (p = 0.045). Inner segment/outer segment interruption at 3 months was smaller in the autologous internal limiting membrane group than controls, reducing from 1230 ± 288 µm at baseline to 611 ± 245 and 547 ± 204 µm at 3 months versus 1196 ± 362, 745 ± 222 and 705 ± 223 µm, respectively (p < 0.05). Conclusion: Autologous internal limiting membrane flap can effectively close recurrent idiopathic macular holes with a higher closure rate, smaller residual inner segment/outer segment line interruption and higher visual acuity at 3 months than previous standard of care.

scholarly journals Pre- and Post-operative Differences Between Genders in Idiopathic Macular Holes

2020 ◽  
Author(s):  
Jing Wang ◽  
Yanping Yu ◽  
Xida Liang ◽  
Zengyi Wang ◽  
Biying Qi ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Age Of Onset ◽  
Closure Rate ◽  
Recovery Duration ◽  
Macular Holes ◽  
Younger Age ◽  
Stage 4 ◽  
Before And After ◽  
Idiopathic Macular Holes ◽  
23 Gauge

Abstract Background: To compare idiopathic macular holes (IMHs) between male and female before and after surgery.Methods: Patients with IMHs of stage 3 and stage 4 who underwent 23-gauge vitrectomy were retrospectively enrolled. Pre-operative clinical features like age of onset, and best-corrected visual acuity (BCVA) were reviewed. Optical coherence tomography parameters including minimum linear diameter (MLD), central macular thickness and some other indexes were measured and calculated. Main surgical outcomes included the primary closure rate, the highest BCVA during follow-up, and the recovery duration. All the metrics mentioned above were compared between genders with appropriate statistical methods. Results: A total of 298 eyes from 280 patients (male: 51; female: 229) were enrolled. Compared with men, women demonstrated a significantly higher ratio of stage3/stage4 (P=0.045), larger horizontal MLD (P=0.009), but similar surgical outcomes except for a relatively longer recovery duration (P=0.024). For stage 3 IMHs, women exhibited significantly younger age of onset (P=0.023), larger MLD (P=0.003), and smaller height of the hole (P=0.029). However, for stage 4 IMHs, all the pre- and post-operative metrics showed no differences between genders.Conclusions: Female IMHs seem to demonstrate an earlier age of onset and larger size of hole, especially in IMHs of stage 3. However, these differences, which may owe to normal gender-related variations, have limited influence on the surgical outcomes.

scholarly journals Age-related changes of the vitreous body

2019 ◽  
Vol 100 (1) ◽  
pp. 170-174
Author(s):  
S D Stebnev ◽  
V S Stebnev ◽  
I V Malov ◽  
V M Malov ◽  
E B Eroshevskaya
Keyword(s):  
Posterior Vitreous Detachment ◽  
Vitreous Body ◽  
Vitreous Detachment ◽  
Age Related ◽  
Macular Holes ◽  
Retinal Disorders ◽  
Viscoelastic Structure ◽  
Idiopathic Macular Holes ◽  
Strength And Plasticity ◽  
Age Related Changes

Innovative advances in recent years in the study of pathological changes of the posterior segment of the eye including the use of optical coherence tomography which is considered the gold standard for diagnosing vitreoretinal interface pathology, not only significantly expanded the idea of the most prevalent lesions of the structure of posterior eye segment but also discovered absolutely new aspects of their pathology. The review emphasizes the spreading understanding of vitreous body, its age-related changes in the pathology of the posterior eye segment. Two main interrelated processes occurring in the vitreous body - synchysis and syneresis, gradually increasing with age, are considered. Synchysis process begins at the early age and by the age of 70 reaches 50% of the volume of the vitreous body in 70% of the population. Parallelly, syneresis provides strength and plasticity of the entire vitreous volume due to collagen involved in formation of fibrillar frame. An important role in maintaining a stable and viscoelastic structure of the vitreous body, belonging to hyaluronic acid, is discussed, the level of which remains relatively stable at any age due to its constant synthesis. The accumulated data on the structure of age-related and pathological biodegradation of the vitreous body demonstrates inevitable progression of this process leading to age-related posterior vitreous detachment, which is a detachment of the posterior cortical layers of the vitreous body from subjacent retina. Posterior detachment under the influence of age-related changes in the vitreous body has certain stages - from incomplete juxtafoveolar detachment to complete posterior vitreous detachment with clinical retinal changes corresponding to each stage (idiopathic macular holes, lamellar macular tears, macular fibrosis, vitreomacular traction syndrome, myopic foveoschisis). Complete posterior vitreous detachment usually does not cause anatomical retinal disorders and any clinical forms of its diseases, thus, it can be considered as a natural favorable outcome.

scholarly journals Intraocular lens power calculation formulas accuracy in combined phacovitrectomy: an 8-formulas comparison study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Diogo Hipólito-Fernandes ◽  
Maria Elisa Luís ◽  
Diogo Maleita ◽  
Pedro Gil ◽  
Vitor Maduro ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Prediction Error ◽  
Retrospective Chart Review ◽  
Absolute Error ◽  
Power Calculation ◽  
Myopic Shift ◽  
Iol Power ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Our study aimed to assess and compare the accuracy of 8 intraocular lens (IOL) power calculation formulas (Barrett Universal II, EVO 2.0, Haigis, Hoffer Q, Holladay 1, Kane and PEARL-DGS) in patients submitted to combined phacovitrectomy for vitreomacular (VM) interface disorders. Methods Retrospective chart review study including axial-length matched patients submitted to phacoemulsification alone (Group 1) and combined phacovitrectomy (Group 2). Using optimized constants in both groups, refraction prediction error of each formula was calculated for each eye. The optimised constants from Group 1 were also applied to patients of Group 2 – Group 3. Outcome measures included the mean prediction error (ME) and its standard deviation (SD), mean (MAE) and median (MedAE) absolute errors, in diopters (D), and the percentage of eyes within ± 0.25D, ± 0.50D and ± 1.00D. Results A total of 220 eyes were included (Group 1: 100; Group 2: 120). In Group 1, the difference in formulas absolute error was significative (p = 0.005). The Kane Formula had the lowest MAE (0.306) and MedAE (0.264). In Group 2, Kane had the overall best performance, followed by PEARL-DGS, EVO 2.0 and Barrett Universal II. The ME of all formulas in both Groups 1 and 2 were 0.000 (p = 0.934; p = 0.971, respectively). In Group 3, a statistically significant myopic shift was observed for each formula (p < 0.001). Conclusion Surgeons must be careful regarding IOL power selection in phacovitrectomy considering the systematic myopic shift evidenced—constant optimization may help eliminating such error. Moreover, newly introduced formulas and calculation methods may help us achieving increasingly better refractive outcomes both in cataract surgery alone and phacovitrectomy.

scholarly journals Combined Idiopathic Macular Hole Vitrectomy with Phacoemulsification without Face-Down Positioning

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Fumihiko Yagi ◽  
Seiji Takagi ◽  
Goji Tomita
Keyword(s):  
Visual Acuity ◽  
Case Series ◽  
Functional Results ◽  
Idiopathic Macular Hole ◽  
Closure Rate ◽  
Postoperative Visual Acuity ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
The Mean ◽  
Final Closure

Purpose. To evaluate the outcome of combined vitrectomy with phacoemulsification without postoperative face-down positioning for idiopathic macular holes (MHs).Design. Retrospective, observational case series.Participants. Forty-two eyes of 42 patients with MH.Methods. We studied 42 eyes of 42 cases followed up for 6 months postoperatively. MH closure rate and preoperative and postoperative visual acuity (VA) were evaluated.Main Outcome Measures. MH closure rate and VA were evaluated after combined vitrectomy with phacoemulsification without postoperative face-down positioning.Results. Of the 42 holes, 40 (95.2%) were initially closed, and the final closure rate was 100%. Compared with preoperative VA, the mean VA was significantly improved at 1 month and the improvement was maintained for at least 6 months postoperatively.Conclusions. Combined vitrectomy with phacoemulsification without postoperative face-down positioning produced favorable anatomic and functional results for MH repair. Improvement in VA can be expected for up to at least 6 months postoperatively.

scholarly journals Refractive outcomes following cataract surgery in patients who have had myopic laser vision correction

2019 ◽  
Vol 4 (1) ◽  
pp. e000242 ◽  
Author(s):  
Chung Shen Chean ◽  
Boon Kang Aw Yong ◽  
Samuel Comely ◽  
Deena Maleedy ◽  
Stephen Kaye ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Refractive Error ◽  
Control Group ◽  
Prediction Errors ◽  
Spherical Equivalent ◽  
Refractive Outcomes ◽  
Vision Correction ◽  
Laser Vision ◽  
The Mean ◽  
The Difference

ObjectivePrediction errors are increased among patients presenting for cataract surgery post laser vision correction (LVC) as biometric relationships are altered. We investigated the prediction errors of five formulae among these patients.Methods and analysisThe intended refractive error was calculated as a sphero-cylinder and as a spherical equivalent for analysis. For determining the difference between the intended and postoperative refractive error, data were transformed into components of Long's formalism, before changing into sphero-cylinder notation. These differences in refractive errors were compared between the five formulae and to that of a control group using a Kruskal-Wallis test. An F-test was used to compare the variances of the difference distributions.Results22 eyes post LVC and 19 control eyes were included for analysis. Comparing both groups, there were significant differences in the postoperative refractive error (p=0.038). The differences between the intended and postoperative refractive error were greater in post LVC eyes than control eyes (p=0.012), irrespective of the calculation method for the intended refractive error (p<0.01). The mean difference between the intended and postoperative refractive error was relatively small, but its variance was significantly greater among post LVC eyes than control eyes (p<0.01). Among post LVC eyes, there were no significant differences between the mean intended target refraction and between the intended and postoperative refractive error using five biometry formulae (p=0.76).ConclusionBiometry calculations were less precise for patients who had LVC than patients without LVC. No particular biometry formula appears to be superior among patients post LVC.

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