Long-term changes in intraocular lens position and corneal curvature after cataract surgery and their effect on refraction

Klijn, Stijn; Sicam, Victor Arni D. P.; Reus, Nicolaas J.

doi:10.1016/j.jcrs.2015.08.015

Cited by 14 publications

(19 citation statements)

References 18 publications

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“…A 0.03-mm shift in an intraocular lens translates into a 0.05-D refraction change. 16 The present study showed that photopic conditions induced a 0.04-mm increase in ACD-ICL and that accommodation induced a 0.05-mm decrease in ACD-ICL. This translates into 0.03- and 0.04-D refraction changes, respectively.…”

Section: Discussionsupporting

confidence: 58%

Vault Changes Caused by Light-Induced Pupil Constriction and Accommodation in Eyes With an Implantable Collamer Lens

Kato

Shimizu

Igarashi

2018

Cornea

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Purpose:An appropriate vault after implantation of a posterior chamber phakic intraocular lens with a central hole (ICL KS-AP) is important for successful long-term outcomes. In the present study, we used anterior segment optical coherence tomography (AS-OCT) to examine dynamic pupil and vault changes under photopic and scotopic conditions and during accommodation in eyes with ICL KS-AP.Methods:This retrospective study included patients at an outpatient ophthalmology clinic who underwent ICL KS-AP implantation >1 month before enrollment. All patients underwent dynamic AS-OCT imaging under photopic and scotopic conditions. Patients aged <40 years also underwent imaging in the accommodative and nonaccommodative states. Primary outcome measures were the pupil size and vault at the maximum and minimum pupil sizes.Results:This study included 91 eyes of 47 patients (35.5 ± 8.6 years, 21 men). Accommodation was examined in 51 eyes of 26 patients (28.9 ± 5.0 years, 10 men) younger than 40 years. The pupil size was significantly smaller under photopic conditions (3.64 ± 0.77 mm) than under scotopic conditions (4.91 ± 0.75 mm, P < 0.001) and during accommodation (3.88 ± 0.64 vs. 4.10 ± 0.61 mm, P < 0.001). Vault was also significantly lower under photopic conditions (476.1 ± 219.6 μm) than under scotopic conditions (521.1 ± 220.4 μm, P < 0.001) and during accommodation (454.8 ± 224.9 vs. 481.6 ± 219.1 μm, P < 0.001).Conclusions:Vault can be significantly lowered by light-induced pupil constriction and accommodation in eyes with ICL KS-AP.

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Section: Discussionsupporting

confidence: 58%

Vault Changes Caused by Light-Induced Pupil Constriction and Accommodation in Eyes With an Implantable Collamer Lens

Kato

Shimizu

Igarashi

2018

Cornea

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“…Postoperative measurements were obtained 2 to 4 months after surgery. Long-term (1 day to 1 year) changes in refractive outcomes in single-piece IOLs (as the IOL of the present study) due to IOL position shifts have been reported to be of negligible clinical relevance 38 , 39 . Further analysis will be needed to potentially incorporate IOL postoperative shifts in other types of IOLs (e.g., multipiece IOLs).…”

Section: Discussionmentioning

confidence: 56%

Estimation of intraocular lens position from full crystalline lens geometry: towards a new generation of intraocular lens power calculation formulas

Martinez-Enriquez

Pérez-Merino

Durán-Poveda

et al. 2018

Sci Rep

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In a cataract surgery, the opacified crystalline lens is replaced by an artificial intraocular lens (IOL). To optimize the visual quality after surgery, the intraocular lens to be implanted must be selected preoperatively for every individual patient. Different generations of formulas have been proposed for selecting the intraocular lens dioptric power as a function of its estimated postoperative position. However, very few formulas include crystalline lens information, in most cases only one-dimensional. The present study proposes a new formula to preoperatively estimate the postoperative IOL position (ELP) based on information of the 3-dimensional full shape of the crystalline lens, obtained from quantitative eye anterior segment optical coherence tomography imaging. Real patients were measured before and after cataract surgery (IOL implantation). The IOL position and the postoperative refraction estimation errors were calculated by subtracting the preoperative estimations from the actual values measured after surgery. The proposed ELP formula produced lower estimation errors for both parameters -ELP and refraction- than the predictions obtained with standard state-of-the-art methods, and opens new avenues to the development of new generation IOL power calculation formulas that improve refractive and visual outcomes.

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“…It has been estimated that a 0.033 mm ± 0.060 (SD) anterior-posterior shift in lens position correlates to a 0.05 diopter change in lens power. 5 This patient's postoperative refractive error measured −1.0 D, while the estimated lens position changed only 0.01 mm in the anterior direction. Therefore, it is likely that change in lens position does not completely explain the patient's myopic shift.…”

Section: Discussionmentioning

confidence: 76%

Myopic shift in a pseudophakic eye with an accommodating IOL following vitrectomy with gas tamponade

Aker

Dowling

Halperin

2018

American Journal of Ophthalmology Case Reports

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PurposeTo report the case of a patient with Crystalens, an accommodating posterior-chamber intraocular lens (IOL), who experienced a myopic shift following subsequent vitrectomy with gas tamponade. We propose a hypothesis as to why this myopic shift occurred and analyze its validity based on current literature.ObservationsA patient had cataract surgery with implantation of a Crystalens AT-50AO +21D. Preoperative A-scan measured anterior chamber depth (ACD) to be 3.69 mm. The refraction was emmetropic following cataract surgery. Nine months later, the patient required pars plana vitrectomy with gas tamponade for a rhegmatogenous retinal detachment, followed by vitrectomy, membrane peel, and air/fluid exchange for epiretinal membrane. The retinal repair was anatomically successful, however, the patient experienced a −1.0 D myopic shift. ACD measurement following vitrectomy was 5.08 mm.Conclusions and importanceMyopic shift following vitrectomy with gas tamponade in pseudophakic eyes is widely reported. This patient's myopic shift was assumed due to anterior movement of the Crystalens caused by a gas bubble placed during retinal detachment repair as this is the prevailing theory in the literature [1]. However, a comparison of the patient's ACD measurements does not support the above hypothesis. Further study is needed to determine the mechanism of myopic shift seen in pseudophakic patients following vitrectomy, specifically those with gas.

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Long-term changes in intraocular lens position and corneal curvature after cataract surgery and their effect on refraction

Abstract: No author has a financial or proprietary interest in any material or method mentioned.

Cited by 14 publications

References 18 publications

Vault Changes Caused by Light-Induced Pupil Constriction and Accommodation in Eyes With an Implantable Collamer Lens

Vault Changes Caused by Light-Induced Pupil Constriction and Accommodation in Eyes With an Implantable Collamer Lens

Estimation of intraocular lens position from full crystalline lens geometry: towards a new generation of intraocular lens power calculation formulas

Myopic shift in a pseudophakic eye with an accommodating IOL following vitrectomy with gas tamponade

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