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

Sakamoto, Masashi; Yoshida, Izumi; Sodeno, Takahiro; Sakai, Asao; Masahara, Hidetaka; Maeno, Takatoshi

doi:10.1155/2019/5964127

Cited by 14 publications

(9 citation statements)

References 24 publications

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“…It has been reported that a combined approach may lead to a slight myopic shift when the optical biometry is reliable. A comparable slight postoperative myopic shift has been reported in cases that underwent phacovitrectomy based on fellow-eye biometry 9 , 10 . That point was taken in consideration in the choice of the refraction power of the IOL of our patients, incorporating our own previous experience regarding refractive outcomes after phacovitrectomy.…”

Section: Discussionsupporting

confidence: 69%

Simultaneous Management of Retinal Detachment and Aphakia with Pars Plana Vitrectomy, Silicone Oil Tamponade and Retropupillary Iris-Claw Intraocular Lens Implantation in Patients with Marfan Syndrome

Hsin

Stappler

Potić

et al. 2022

Klin Monbl Augenheilkd

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Background Marfan Syndrome is an autosomal dominant disease with multiple ocular abnormalities including ectopia lentis and a high incidence of rhegmatogenous retinal detachment (RRD). The management of RRD may be challenging in cases of aphakic patients with Marfan. Purpose To report on the management of four cases of simultaneous RRD and aphakia with vitrectomy, silicone oil tamponade, and retropupillary iris-claw intraocular lens (IOL) implantation in patients with Marfan that have been operated at the Jules-Gonin Eye Hospital between 2019 and 2020. History and Signs Ages at presentation were 20, 30, 32, and 31 years, respectively. All patients had a history of extraction of a dislocated lens. None of the patients had a previous posterior vitrectomy. Two patients had records of previous measurements for IOL calculation by optical biometry (IOL Master, Carl Zeiss Meditec AG, Jena, Germany) about 1 year prior to the RRD development. In two cases, measurements for IOL calculation by optical biometry were based on the contralateral eye. Therapy and Outcome All patients underwent 23 G vitrectomy, peripheral iridotomy, and retropupillary iris-claw IOL. No intraoperative complications were encountered. All patients had silicone oil tamponade, one of which required heavy silicone oil. Silicone oil was removed 3 months following primary surgery. Minimum follow-up was 1 year. The single surgery anatomic success rate was 100%. All patients had visual acuity of at least 0.8 at the last follow-up (1.25, 1.0, 0.8, and 0.8 respectively). The targeted refractive results were accurately achieved in all four cases postoperatively. One patient presented ocular hypertension 2 weeks after surgery due to presumed steroid response and was managed conservatively. None of the patients had silicone oil migration into the anterior chamber. Conclusion Retropupillary iris-claw IOL implantation in cases of RRD and aphakia creates a barrier to tamponades from the posterior segment, effectively preventing them from entering the anterior segment of the eye. Therefore, the management of aphakia and retinal detachment with simultaneous vitrectomy and a retropupillary iris-claw IOL may be a successful strategy in reducing postoperative complications in patients with Marfan syndrome.

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Section: Discussionsupporting

confidence: 69%

Simultaneous Management of Retinal Detachment and Aphakia with Pars Plana Vitrectomy, Silicone Oil Tamponade and Retropupillary Iris-Claw Intraocular Lens Implantation in Patients with Marfan Syndrome

Hsin

Stappler

Potić

et al. 2022

Klin Monbl Augenheilkd

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“…Sakamoto et al compared 49 patients undergoing phacovitrectomy for macula-on retinal detachment to 49 patients undergoing cataract surgery alone. They noted a myopic shift in these eyes which required the use of intraocular gas [8]. Although these smaller studies suggested a relationship between intraocular gas and induced myopia after combined cataract surgery and vitrectomy, our results demonstrate that gas tamponade is not a significant factor in refractive error outcomes.…”

Section: Discussion/conclusioncontrasting

confidence: 62%

Refractive Outcomes of Combined Cataract Surgery and Vitrectomy Compared to Cataract Surgery Alone

Kokame¹,

Tanji²,

Yanagihara³

et al. 2022

Ophthalmologica

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Purpose: To evaluate the refractive outcomes of combined cataract surgery and vitrectomy to cataract surgery alone. Methods: This retrospective chart review study included two groups – 1) combined surgery in 103 eyes (101 patients) who underwent cataract surgery with posterior chamber intraocular lens (PCIOL) placement by a single cataract surgeon and vitrectomy by a single vitreoretinal surgeon at the same surgical setting 2) cataract surgery alone by the same surgeon in 107 eyes (84 patients). Refractive outcomes and complications between the combined and cataract surgery alone group were compared. The predicted refractive error was compared to postoperative refractive outcomes in both groups, surgically induced astigmatism (SIA), intraoperative or postoperative complications of either cataract surgery or vitrectomy, and cystoid macular edema. Results: There was no statistically significant difference between predicted and actual postoperative refractive outcomes between the combined and cataract surgery alone groups (within ±0.5 diopters (D), P = 0.099; within ±1.0 D, P = 0.721). There was no difference in SIA refractive outcomes between the two groups (P = 0.509). The use of intraoperative gas for retina tamponade did not significantly affect postoperative refractive outcomes. Both cataract surgery and vitrectomy were successfully performed without unexpected complications from either procedure affecting the other. Discussion/Conclusion: Combined cataract surgery and vitrectomy allows excellent refractive outcomes equal to cataract surgery alone, allowing each procedure to be performed independently by separate anterior and posterior segment surgeons. Combined procedures can be performed in eyes with a variety of retinal indications and can include fluid-gas exchange with minimal risk of PCIOL malposition or change in targeted refraction.

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“…Phacovitrectomy is a safe and effective procedure to treat RRD. Kang et al and Sakamoto et al confirmed that there is a tolerable biometric error after the treatment of RRD with phacovitrectomy in macula-sparing cases, with comparable results obtained with acoustic and optic biometry [ 21 , 22 ]. Although the anatomical and functional results were comparable with those obtained with single PPV and delayed cataract surgery, the refractive outcomes were less favourable and shifted towards myopia, especially in macula-off cases [ 23 ].…”

Section: Discussionmentioning

confidence: 94%

Differences in Axial Length and IOL Power Based on Alternative A-Scan or Fellow-Eye Biometry in Macula-Off Rhegmatogenous Retinal Detachment Eyes

2021

Ophthalmol Ther

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Introduction: This study was performed to observe the potential refractive prediction error based on alternative A-scan ultrasound and fellow-eye biometry for phacovitrectomy in macula-off rhegmatogenous retinal detachment (RRD) eyes. Methods: Phakic macula-off RRD eyes without axial length (AL) measurements obtained using IOLMaster were included. Vitrectomy without lens extraction was performed for RRD repair.Preoperative AL was measured using alternative A-scan ultrasound (AL-US). Postoperative AL was obtained in eyes with silicone oil tamponade (AL-SO) and preoperative fellow-eye biometry (AL-FE) using IOLMaster. Other eyes that faced the same preoperative situation but underwent phacovitrectomy based on felloweye biometry were recruited as controls.Results: AL-US, AL-FE, and AL-SO were 25.39 ± 2.14 mm, 25.85 ± 2.16 mm and 26.08 ± 2.53 mm, respectively. The Bland-Altman agreement among AL-US, AL-FE and AL-SO was good (95.5%, 21/22 of cases were in the LoA). The mean IOL power calculated using AL-US (Power-US), AL-FE (Power-FE) and AL-SO (Power-SO) was 16.81 ± 7.19 D, 14.74 ± 6.95 D and 13.54 ± 8.32 D, respectively. The difference between AL-US and AL-SO was significant (P \ 0.05), while that between AL-FE and AL-SO was not (P [ 0.05). The difference between Power-US and Power-SO was significant (P \ 0.05), while that between Power-FE and Power-SO was not (P [ 0.05). Nine eyes underwent phacovitrectomy based on fellow-eye biometry and had a final postoperative myopic shift of 0.64 ± 0.78 D. Conclusions: Alternative A-scan ultrasound led to a significant difference in AL and a prediction error in IOL power, while fellow-eye biometry provided similar results to silicone oil-filled eyes after RRD repair.

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

Cited by 14 publications

References 24 publications

Simultaneous Management of Retinal Detachment and Aphakia with Pars Plana Vitrectomy, Silicone Oil Tamponade and Retropupillary Iris-Claw Intraocular Lens Implantation in Patients with Marfan Syndrome

Simultaneous Management of Retinal Detachment and Aphakia with Pars Plana Vitrectomy, Silicone Oil Tamponade and Retropupillary Iris-Claw Intraocular Lens Implantation in Patients with Marfan Syndrome

Refractive Outcomes of Combined Cataract Surgery and Vitrectomy Compared to Cataract Surgery Alone

Differences in Axial Length and IOL Power Based on Alternative A-Scan or Fellow-Eye Biometry in Macula-Off Rhegmatogenous Retinal Detachment Eyes

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