Accuracy of intraocular lens calculation formulas for flanged intrascleral intraocular lens fixation with double-needle technique

McMillin, Jake C.; Wang, Li; Wang, Margaret Y; Al-Mohtaseb, Zaina; Khandelwal, Sumitra; Weikert, Mitchell P.; Hamill, M. Bowes

doi:10.1097/j.jcrs.0000000000000540

Cited by 25 publications

(19 citation statements)

References 8 publications

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“…In this study, SE showed a hyperopic shift of 0.44 ± 1.00 D after ISF. In a previous study by McMillin et al [ 28 ], SE after ISF showed a 0.57 D hyperopic shift compared with the predicted SE using the SRK-T formula, which is consistent with the results of this study.…”

Section: Discussionsupporting

confidence: 93%

Comparison of Clinical Outcomes among Conventional Scleral Fixation, Retropupillary Iris-claw Intraocular Lens Implantation, and Intrascleral Fixation

Kim¹,

Han²,

Chung³

et al. 2022

Korean J Ophthalmol

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Purpose: To compare the efficacy and safety of conventional scleral fixation, retropupillary iris-claw intraocular lens (IOL) implantation, and intrascleral fixation Methods: This retrospective observational study included 58 patients (58 eyes) who underwent conventional scleral fixation (C-SF, 23 eyes), retropupillary iris-claw IOL implantation (RP-IOL, 23 eyes), and intrascleral fixation (ISF, 12 eyes) by a single surgeon at Samsung Medical Center from October 2017 to July 2020 and were followed up for at least 6 months. This study analyzed various clinical outcomes before and 1 day, 1 week, 1 month, 3 months, and 6 months after surgery.Results: Six months after surgery, best-corrected visual acuity (BCVA) in logarithm of minimum angle of resolution was 0.08 ± 0.10, 0.08 ± 0.16, and 0.03 ± 0.04 in C-SF group, RP-IOL group, and ISF group, respectively, and there was a significant improvement in each group compared to preoperative BCVA. All groups showed a significant increase in astigmatism postoperatively, but no between-group differences were observed. The prediction error was -0.15 ± 0.77, 0.56 ± 0.62, and 0.44 ± 1.00 diopters in the three groups, respectively, indicating RP-IOL group and ISF group for hyperopic shift.The three groups did not differ in terms of absolute prediction error. Six months after surgery, the corneal endothelial cell counts were 2073 ± 691, 2014 ± 692, and 1712 ± 891 cells/mm 2 , respectively, which were lower than before surgery. IOL dislocation occurred in five eyes only in RP-IOL group, two of which underwent two reoperations, and re-enclavation was performed smoothly without complications in all cases.Conclusions: Although the frequency of IOL dislocation in RP-IOL group was higher than that in the other groups, it can be re-enclavated relatively easily. As a method of secondary IOL fixation, both RP-IOL implantation and intrascleral fixation were as effective as conventional scleral fixation.

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Section: Discussionsupporting

confidence: 93%

Comparison of Clinical Outcomes among Conventional Scleral Fixation, Retropupillary Iris-claw Intraocular Lens Implantation, and Intrascleral Fixation

Kim¹,

Han²,

Chung³

et al. 2022

Korean J Ophthalmol

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“…Te principle of the three formulas might account for the results because these formulas were introduced to predict IOL power within the capsular bag; however, the fxation sites in the present technique were 2.0 mm posterior to the limbus, anterior to the intracapsular implantation position, leading to myopic errors. Te reported MAE following intrascleral or transscleral fxation using the thirdgeneration formulas was 0.61 to 0.86 D, which agreed with our results [30,31]; whereas the values of MAE in our series were larger than those of routine cataract surgery, suggesting the compromised performance of formulas when the IOL was placed outside the capsular bag [32]. Previous studies reported that 30% to 45% of eyes with a PE within ±0.5 D in patients receiving fanged or transscleral-sutured fxation, in accordance with our study (43.48%) [30,33].…”

Section: Discussionsupporting

confidence: 92%

“…Te reported MAE following intrascleral or transscleral fxation using the thirdgeneration formulas was 0.61 to 0.86 D, which agreed with our results [30,31]; whereas the values of MAE in our series were larger than those of routine cataract surgery, suggesting the compromised performance of formulas when the IOL was placed outside the capsular bag [32]. Previous studies reported that 30% to 45% of eyes with a PE within ±0.5 D in patients receiving fanged or transscleral-sutured fxation, in accordance with our study (43.48%) [30,33]. Furthermore, for cases following fanged or transscleral-sutured fxation, the percentage of a PE within ±1.0 D was approximately 60% to 75% [30,33].…”

Section: Discussionsupporting

confidence: 92%

Flapless and Conjunctiva‐Sparing Technique for Transscleral Fixation of Intraocular Lens to Correct Refractive Errors in Eyes without Adequate Capsular Support

Lou

Chen

Huang

et al. 2023

Journal of Ophthalmology

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Purpose. To evaluate refractive outcomes, intraocular lens (IOL) power calculation, and IOL position following a novel conjunctiva-sparing transscleral fixation technique. Methods. Forty-one eyes of 40 patients managed with a flapless transscleral-sutured technique were included. Preoperative and postoperative refractive errors (spherical equivalents, SE) were compared. IOL position was assessed on the Scheimpflug images. IOL power was calculated by SRK/T, Holladay 1, and Hoffer Q formulas. Results. The mean age was 57.39 ± 14.83 years (range: 26 to 79 years), and the mean follow-up was 7.46 ± 6.42 months (range: 1 to 24 months). Surgical indications were aphakia (n = 14), subluxated lenses (n = 3), and IOL dislocation (n = 24). The SE was 4.50 ± 6.38 diopter (D) (range: −3.75 to 13.75 D) preoperatively and −1.68 ± 1.57 D (range: −5.50 to 1.13 D) postoperatively ( P < 0.001 ). The mean tilt angle and decentration were 2.90° ± 1.93° (range: 0.39° to 9.10°) and 0.23 ± 0.19 mm (range: 0.02 to 0.94 mm) vertically, and 1.75° ± 1.41° (range: 0.24° to 7.65°) and 0.18 ± 0.19 mm (range: 0.02 to 1.06 mm) horizontally, which were clinically insignificant. All three IOL formulas produced myopic errors (range: −0.29 to −0.50 D). The SRK/T had the lowest median absolute error (0.55 D), followed by the Holladay 1 (0.70 D) and the Hoffer Q (0.74 D). The three formulas had the same percentage of prediction errors (PEs) within ±0.5 D (43.48%), while the Hoffer Q had the highest percentage of PEs within ±1.0 D (82.61%). Conclusion. The present technique can serve as an alternative approach for transscleral IOL fixation and refractive correction in eyes with compromised capsular support, ensuring the stability of IOLs and reasonable IOL power calculation accuracy.

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“…27 Similarly, MAE were found to be more than 0.70 D with a flanged intrascleral IOL fixation, suggesting that, in cases where IOLs that were not implanted in the capsular bag, the accuracy of these formulas could be compromised. 30 Classic scleral IOL fixation and newer flanged intrascleral IOL fixation techniques are widely used in eyes with insufficient capsular support, and large sample multicenter studies and new IOL formulas are therefore required in these cases.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of intraocular lens power formulas for eyes with scleral-sutured intraocular lenses in congenital ectopia lentis

Lian

Cao

et al. 2022

J Cataract Refract Surg

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Accuracy of intraocular lens calculation formulas for flanged intrascleral intraocular lens fixation with double-needle technique

Abstract: Refractive prediction errors for eyes undergoing the Yamane double-needle technique were not statistically significantly different between IOL calculation formulas. Error ranged from hyperopic to predicted values for all formulas tested.

Cited by 25 publications

References 8 publications

Comparison of Clinical Outcomes among Conventional Scleral Fixation, Retropupillary Iris-claw Intraocular Lens Implantation, and Intrascleral Fixation

Comparison of Clinical Outcomes among Conventional Scleral Fixation, Retropupillary Iris-claw Intraocular Lens Implantation, and Intrascleral Fixation

Flapless and Conjunctiva‐Sparing Technique for Transscleral Fixation of Intraocular Lens to Correct Refractive Errors in Eyes without Adequate Capsular Support

Accuracy of intraocular lens power formulas for eyes with scleral-sutured intraocular lenses in congenital ectopia lentis

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