scholarly journals Improving the prediction of effective lens position for intraocular lens power calculations

2020 ◽  
Vol 17 (2) ◽  
pp. 233-242
Author(s):  
Juanita Noeline Chui ◽  
Keith Ong
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Sagittal Plane ◽  
Anterior Chamber Depth ◽  
Posterior Chamber ◽  
Power Calculation ◽  
Iol Power Calculation ◽  
Lens Position ◽  
Iol Power ◽  
Corneal Apex

Purpose: Achieving the desired post-operative refraction in cataract surgery requires accurate calculations for intraocular lens (IOL) power. Latest-generation formulae use anterior-chamber depth (ACD)—the distance from the corneal apex to the anterior surface of the lens—as one of the parameters to predict the post-operative IOL position within the eye, termed the effective lens position (ELP). Significant discrepancies between predicted and actual ELP result in refractive surprise. This study aims to improve the predictability of ELP. We hypothesise that predictions based on the distance from the corneal apex to the mid-sagittal plane of the cataractous lens would more accurately reflect the position of the principal plane of the non-angulated IOL within the capsular bag. Accordingly, we propose that predictions derived from ACD + ½LT (length thickness) would be superior to those from ACD alone. Design: Retrospective cohort study, comparing ELP predictions derived from ACD to aproposed prediction parameter. Method: This retrospective study includes data from 162 consecutive cataract surgery cases, with posterior-chamber IOL (AlconSN60WF) implantation. Pre- and postoperative biometric measurements were made using the IOLMaster700 (ZEISS, Jena, Germany). The accuracy and reliability of ELP predictions derived from ACD and ACD + ½LT were compared using software-aided analyses. Results: An overall reduction in average ELP prediction error (PEELP) was achieved using the proposed parameter (root-mean-square-error [RMSE] = 0.50 mm), compared to ACD (RMSE = 1.57 mm). The mean percentage PEELP, comparing between eyes of different axial lengths, was 9.88% ± 3.48% and −34.9% ± 4.79% for predictions derived from ACD + ½LT and ACD, respectively. A 44.10% ± 5.22% mean of differences was observed (p < 0.001). Conclusion: ACD + ½LT predicts ELP with greater accuracy and reliability than ACD alone; its use in IOL power calculation formulae may improve refractive outcomes.

scholarly journals Cataract Surgery following Sequential Myopic and Hyperopic LASIK

2018 ◽  
Vol 9 (2) ◽  
pp. 264-268
Author(s):  
Tao Ming Thomas Chia ◽  
Hoon C. Jung
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Calculation Method ◽  
Cataract Extraction ◽  
Power Calculation ◽  
Iol Implantation ◽  
Patient Dissatisfaction ◽  
Iol Power Calculation ◽  
Iol Power

We report a case of patient dissatisfaction after sequential myopic and hyperopic LASIK in the same eye. We discuss the course of management for this patient involving eventual cataract extraction and intraocular lens (IOL) implantation with attention to the IOL power calculation method used.

scholarly journals Improving Intraocular Lens Calculation in Fuchs Endothelial Dystrophy According To Preoperative Degree of Corneal Edema

2021 ◽  
Author(s):  
Beatriz Gargallo-Martinez ◽  
Amanda Ortiz-Gomariz ◽  
Ana Maria Gomez-Ramirez ◽  
Angel Ramon Gutiérrez-Ortega ◽  
Jose Javier Garcia-Medina
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Target Selection ◽  
Corneal Transplantation ◽  
Corneal Edema ◽  
Power Calculation ◽  
Iol Power Calculation ◽  
Iol Power ◽  
Fuchs Endothelial Dystrophy

Abstract Fuchs endothelial dystrophy (FED) is a bilateral, asymmetric, progressive corneal endothelium disorder that causes corneal edema. Resolution of corneal edema is only possible by corneal transplantation. Cataract surgery is a common surgery that replaces the natural lens of the eye by an artificial intraocular lens (IOL). The IOL-power calculation depends mainly on the anterior corneal keratometry and the axial length. In patients with FED, anterior keratometry may be affected by corneal edema and calculations may be less accurate. Therefore, the aim of this study is to establish the theorical postoperative refractive error due to corneal edema resolution after Descemet stripping endothelial keratoplasty combined with cataract surgery and IOL implantation. For this, anterior keratometry was measure preoperatively with edematous cornea and postoperatively after corneal edema resolution. Both keratometries were compared and used to calculate the respective theorical IOL-powers. The difference between target IOLs was used to establish the theorical refractive error due to corneal edema resolution. The results showed that corneal edema resolution induces a change in anterior keratometry, which affects IOL-power calculations and causes a hyperopic shift. The patients with moderate-to-severe preoperative corneal edema had higher theorical refractive error so their target selection should be adjusted for additional − 0.50D.

scholarly journals Comparison of intraocular lens power calculation results before and after glaucoma surgery

2020 ◽  
Vol 13 (4) ◽  
pp. 15-20
Author(s):  
Dmitrii Fedorovich Belov ◽  
Vadim Petrovich Nikolaenko
Keyword(s):  
Intraocular Lens ◽  
Anterior Chamber Depth ◽  
Glaucoma Surgery ◽  
Power Calculation ◽  
Ahmed Glaucoma Valve ◽  
Iol Power Calculation ◽  
Iol Calculation ◽  
Before And After ◽  
Iol Power ◽  
Target Refraction

Aim to compare intraocular lens (IOL) power calculation before and after different types glaucoma procedures. Material and methods.Into the study, 115 patients were included, divided into 3 groups: group 1 patients, in whom sinustrabeculectomy was performed (n= 86); group 2 patients with implanted Ex-PRESS shunt (n= 19), group 3 patients after Ahmed glaucoma valve implantation (n= 10). For each patient before surgery optical biometry (IOL-Master 500) was performed and IOL power calculation using Barrett Universal II Formula (target refraction emmetropia). Baseline data were compared with corresponding examinations results obtained in 6 months after glaucoma procedure, to evaluate its effect on main biometric parameters of the eye and the IOL calculation accuracy. Results.Despite significant changes of optical and anatomic indices, mean values of target refraction before and after glaucoma surgery did not differ significantly: 0.00 0.03 versus 0.03 0.52 D (p= 0.628), 0.00 0.1 versus 0.19 0.61 D (p= 0.173), 0.04 0.08 versus 0.11 0.42 D (p= 0.269) for groups, respectively. However, there was a pronounced trend to the increase of target refraction data scattering. Conclusion.Glaucoma procedures cause changes of biometrical parameters of the eye, which leads to decrease in accuracy of IOL calculation. Consequently, when choosing intraocular lens, it is recommended to use measurement results obtained after glaucoma surgery. Keywords:intraocular lens; IOL power calculation; glaucoma; sinustrabeculectomy; Ex-PRESS shunt; Ahmed glaucoma valve; biometry; phacoemulsification; axial length; anterior chamber depth; keratometry.

scholarly journals Relationship between Medium-Term Changes in Intraocular Lens Position and Refraction after Cataract Surgery with Two Different Models of Monofocal Lenses

2021 ◽  
Vol 10 (17) ◽  
pp. 3856
Author(s):  
Hideki Fukumitsu ◽  
Vicent J. Camps ◽  
Sara Miraflores ◽  
David P. Piñero
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Statistical Significance ◽  
Anterior Chamber Depth ◽  
Strong Correlations ◽  
Lens Position ◽  
Single Piece ◽  
Iol Power ◽  
The Difference ◽  
Group 2

The aim of this prospective descriptive study was to characterize the variations of the clinical effective lens position (ELP) (considering paraxial optics and postoperative data) and the intraocular lens (IOL) position, using “eye” data gathered from a 6-month follow-up of patients who underwent uneventful cataract surgery. Patients were implanted with two different monofocal IOLs: AcrySof IQ SN60WF (Alcon) (Group 1, 247 eyes) and Akreos MI60L (Bausch & Lomb) (Group 2, 104 eyes). No significant differences were found between groups concerning spherical equivalent (SE), axial length, and clinical ELP changes, from 1 to 6 months after surgery (p ≥ 0.516). A more positive change in postoperative anterior chamber depth was found in Group 2, but the difference did not reach statistical significance (p = 0.065). No significant moderate to strong correlations were found between the changes in clinical ELP and preoperative data. The correlation between the changes in SE and clinical ELP over time was strong and statistically significant (groups 1 and 2: r = 0.957 and r = 0.993, p < 0.001). In conclusion, changes in refraction from 1 to 6 months after cataract surgery, with single-piece monofocal IOLs, are not clinically relevant, which correlates with the presence of good positional stability. These changes cannot be predicted preoperatively and considered in IOL power calculations.

Intraocular Lens Power Calculation – Still Searching for the Holy Grail

2015 ◽  
Vol 09 (01) ◽  
pp. 13
Author(s):  
Nino Hirnschall ◽  
Oliver Findl ◽  
◽  
Keyword(s):  
Intraocular Lens ◽  
Power Calculation ◽  
Refractive Outcome ◽  
Intraocular Lens Power Calculation ◽  
Iol Power Calculation ◽  
Lens Position ◽  
Intraocular Lens Power ◽  
Iol Power ◽  
Lens Power ◽  
Lens Power Calculation

Since the introduction of optical biometry and modern intraocular lens (IOL) power calculation formulae, the refractive outcome after cataract surgery improved significantly. This is necessary, as patient demand for spectacle independence is increasing. However, especially when it comes to short and long eyes, all formulae have their difficulties in predicting the effective lens position – and, therefore, the post-operative refractive outcome. This review summarises the development of IOL power calculation formulae, explains their basics and presents some alternative calculation methods.

scholarly journals Gradient Boosting Decision Tree Algorithm for the Prediction of Postoperative Intraocular Lens Position in Cataract Surgery

2020 ◽  
Author(s):  
Tingyang Li ◽  
Kevin Yang ◽  
Joshua Stein ◽  
Nambi Nallasamy
Keyword(s):  
Decision Tree ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Anterior Chamber Depth ◽  
Absolute Error ◽  
Gradient Boosting ◽  
Tree Model ◽  
Lens Position ◽  
Iol Power ◽  
Testing Set

Purpose: To develop a method for predicting postoperative anterior chamber depth (ACD) in cataract surgery patients based on preoperative biometry, demographics, and intraocular lens (IOL) power. Methods: Patients who underwent cataract surgery and had both preoperative and postoperative biometry measurements were included. Patient demographics and IOL power were collected from the Sight Outcomes Research Collaborative (SOURCE) database. A gradient boosting decision tree model was developed to predict the postoperative ACD. The mean absolute error (MAE) and median absolute error (MedAE) were used as evaluation metrics. The performance of the proposed method was compared to five existing formulas. Results: 847 patients were assigned randomly in a 4:1 ratio to a training/validation set (678 patients) and a testing set (169 patients). Using preoperative biometry and patient sex as predictors, the presented method achieved an MAE of 0.106 (SD: 0.098) on the testing set, and a MedAE of 0.082. MAE was significantly lower than that of the five existing methods (p < 0.01). When keratometry was excluded, our method attained an MAE of 0.123 (SD: 0.109), and a MedAE of 0.093. When IOL power was used as an additional predictor, our method achieved an MAE of 0.105 (SD: 0.091) and a MedAE of 0.080. Conclusions: The presented machine learning method achieved accuracy surpassing that of previously reported methods in the prediction of postoperative ACD. Translational Relevance: Increasing accuracy of postoperative ACD prediction with the presented algorithm has the potential to improve refractive outcomes in cataract surgery.

scholarly journals Prediction accuracy of conventional and total keratometry for intraocular lens power calculation in femtosecond laser-assisted cataract surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Soyoung Ryu ◽  
Ikhyun Jun ◽  
Tae-im Kim ◽  
Kyoung Yul Seo ◽  
Eung Kweon Kim
Keyword(s):  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Intraclass Correlation ◽  
Absolute Error ◽  
Power Calculation ◽  
Prediction Errors ◽  
Intraocular Lens Power Calculation ◽  
Iol Power Calculation ◽  
Severance Hospital

AbstractThis study evaluated the accuracy of total keratometry (TK) and standard keratometry (K) for intraocular lens (IOL) power calculation in eyes treated with femtosecond laser-assisted cataract surgery. The retrospective study included a retrospective analysis of data from 62 patients (91 eyes) who underwent uneventful femtosecond laser-assisted cataract surgery with Artis PL E (Cristalens Industrie, Lannion, France) IOL implantation by a single surgeon between May 2020 and December 2020 in Severance Hospital, Seoul, South Korea. The new IOLMaster 700 biometry device (Carl Zeiss Meditec, Jena, Germany) was used to calculate TK and K. The mean absolute error (MAE), median absolute error (MedAE), and the percentages of eyes within prediction errors of ± 0.25 D, ± 0.50 D, and ± 1.00 D were calculated for all IOL formulas (SRK/T, Hoffer-Q, Haigis, Holladay 1, Holladay 2, and Barrett Universal II). There was strong agreement between K and TK (intraclass correlation coefficient = 0.99), with a mean difference of 0.04 D. For all formulas, MAE tended to be lower for TK than for K, and relatively lower MAE and MedAE values were observed for SRK/T and Holladay 1. Furthermore, for all formulas, a greater proportion of eyes fell within ± 0.25 D of the predicted postoperative spherical equivalent range in the TK group than in the K group. However, differences in MAEs, MedAEs, and percentages of eyes within the above prediction errors were not statistically significant. In conclusion, TK and K exhibit comparable performance for refractive prediction in eyes undergoing femtosecond laser-assisted cataract surgery.

scholarly journals Post Cataract Surgery Refractive Error in Myopic Patients Using SRK/T Versus Holladay 1 Formula for IOL Power Calculation

2019 ◽  
Vol 34 (2) ◽  
Author(s):  
Sidra Anwar, Atif Mansoor Ahmad, Irum Abbas, Zyeima Arif
Keyword(s):  
Intraocular Lens ◽  
Refractive Error ◽  
Axial Length ◽  
Power Calculation ◽  
Mean Error ◽  
Iol Power Calculation ◽  
Group A ◽  
Iol Power ◽  
The Mean ◽  
Group B

Purpose: To compare post-operative mean refractive error with SandersRetzlaff-Kraff/theoretical (SRK-T) and Holladay 1 formulae for intraocular lens (IOL) power calculation in cataract patients with longer axial lengths. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Ophthalmology, Shaikh Zayed Hospital Lahore from 01 January 2017 01 January, 2018. Material and Methods: A total of 80 patients were selected from Ophthalmology Outdoor of Shaikh Zayed Hospital Lahore. The patients were randomly divided into two groups of 40 each by lottery method. IOL power calculation was done in group A using SRK-T formula and in group B using Holladay1 formula after keratomery and A-scan. All patients underwent phacoemulsification with foldable lens implantation. Post-operative refractive error was measured after one month and mean error was calculated and compared between the two groups. Results: Eighty cases were included in the study with a mean age of 55.8 ± 6.2 years. The mean axial length was 25.63 ± 0.78mm, and the mean keratometric power was 43.68 ± 1.1 D. The mean post-operative refractive error in group A (SRK/T) was +0.36D ± 0.33D and in group B (Holladay 1) it was +0.68 ± 0.43. The Mean Error in group A was +0.37D ± 0.31D as compared to +0.69D ± 0.44D in group B. Conclusion: SRK/T formula is superior to Holladay 1 formula for cases having longer axial lengths. Key words: Phacoemulsification, intraocular lens power, longer axial length, biometry.

Comparison of the accuracy of 11 intraocular lens power calculation formulas

2020 ◽  
pp. 112067212096203
Author(s):  
David Carmona-González ◽  
Alfredo Castillo-Gómez ◽  
Carlos Palomino-Bautista ◽  
Marta Romero-Domínguez ◽  
María Ángeles Gutiérrez-Moreno
Keyword(s):  
Intraocular Lens ◽  
Case Series ◽  
University Hospital ◽  
Power Calculation ◽  
Refractive Outcome ◽  
Retrospective Case ◽  
Intraocular Lens Power Calculation ◽  
Iol Power Calculation ◽  
Refractive Outcomes ◽  
Iol Power

Purpose To compare the accuracy of 11 intraocular lens (IOL) power calculation formulas (SRK-T, Hoffer Q, Holladay I, Haigis, Holladay II, Olsen, Barrett Universal II, Hill-RBF, Ladas Super formula, EVO and Kane). Setting Private university hospital (QuironSalud, Madrid, Spain). Design Retrospective case series Methods Data were compiled from 481 eyes of 481 patients who had undergone uneventful cataract surgery with IOL insertion. Preoperative biometric measurements were made using an IOL Master® 700. Respective ULIB IOL constants ( http://ocusoft.de/ulib/c1.htm ) for each of 4 IOL models implanted were used to calculate the predictive refractive outcome for each formula. This was compared with the actual refractive outcome determined 3 months postoperatively. The primary outcome was mean absolute prediction error (MAE). The study sample was divided according to axial length (AL) into three groups of eyes: short (⩽22.00 mm), normal (22.00–25.00 mm) and long (⩾25.00 mm). Results The Barrett Universal II and Haigis formulas yielded the lowest MAEs over the entire AL range ( p < .01, except EVO) as well as in the long ( p < .01, all formulas) and normal ( p < .01, except Haigis, Holladay II, Olsen and LSF) eyes. In the short eyes, the lower MAEs were provided by Haigis and EVO ( p < .01 except Hoffer Q, SRK/T and Holladay I). Conclusions Barrett Universal II was the most accurate for IOL power calculation in the normal and long eyes. For short eyes, the formulas Haigis and EVO seem best at predicting refractive outcomes.

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