Accuracy of Intraocular Lens Power Estimation in Eyes Having Phacovitrectomy for Rhegmatogenous Retinal Detachment

Rahman, Rubina; Bong, Chun Xiao; Stephenson, John

doi:10.1097/iae.0000000000000072

Cited by 50 publications

(62 citation statements)

References 24 publications

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“…Our previous large case series study has shown the refractive results of phacovitrectomy for RRD to be comparable with cataract surgery outcomes. 1 Overall, although optical biometry (OB) was more accurate than ultrasound (US) (p=0.040), we noted that significantly more US measured ALs were preferentially selected over OB measurements in the macula-off group compared to macula-on group (p=0.016). We concluded that the biometry used for IOL power selection must be checked by comparing with the fellow eye and the known refraction, especially in macula-off RRD cases.…”

Section: Introductionmentioning

confidence: 93%

“…Previous studies have shown that OB is more accurate than US in general [10][11][12][13] , except in macula-off cases where the accuracy of primary OB measurements have to be assessed with caution by careful comparison to the known refraction and AL of the fellow-eye 1 . In the macula-off group of our previous study, significantly more US measured ALs were preferentially selected for IOL power estimation instead of primary OB measurements 1 . The current study however shows that mean pre-operative AL values derived from user-adjusted OB indicate no evidence for a statistically significant difference from AL values derived from US.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] This is as a result of the continual advances in both cataract and vitrectomy surgery, and favourable patient outcomes. The combined procedure reduces costs and offers quicker visual rehabilitation by avoiding the need for additional surgery allowing a single recovery period [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of user-adjusted axial length measurements with optical biometry in eyes having combined phacovitrectomy for macular-off rhegmatogenous retinal detachment

Rahman¹,

Kolb²,

Bong³

et al. 2016

Journal of Cataract and Refractive Surgery

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Accurate measurement of axial length is essential for preventing refractive surprises postoperatively. This can often be difficult in eyes with RRDs. Optical biometry may underestimate axial length in macula off rhegmatogenous retinal detachments; however, we present a novel way of adjusting the optical biometry to accurately measure the axial length. METHODS: Axial lengths (ALs) were measured using OB with user adjustment to identify a posterior peak corresponding to the eye's AL and ultrasound (US). These measurements were compared and analysed for accuracy to each other and the post-operative OB as a more accurate indication of the eye's AL.RESULTS: User-adjusted OB was similar to US and post-operative OB measurements.There was no statistically significant difference between the means of the AL measurements derived from user-adjusted OB and ultrasound AL (p=0.964). User-adjusted OB was not statistically significantly different to post-operative OB (p=0.242). Compared to postoperative OB, IOL power was within 0.5 Dioptre in 12 out of 13 cases (92%; 95% confidence interval (77.8%, 100.0%) for user-adjusted OB, and in only 10 out of 13 cases (77%; 95% confidence interval (54.0%, 99.8%) of US measurements. 4 CONCLUSIONS: User-adjusted OB may be used as an alternative method for the measurement of AL in macula-off RRD for primary repair by combined phacovitrectomy.OB will, however, require assessment of agreement with US AL in cases where a posterior peak is not easily identifiable. We have also shown that user-adjusted OB may outperform US AL when calculating IOL power; however, a larger study may be needed to confirm this.

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Section: Introductionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Accuracy of user-adjusted axial length measurements with optical biometry in eyes having combined phacovitrectomy for macular-off rhegmatogenous retinal detachment

Rahman¹,

Kolb²,

Bong³

et al. 2016

Journal of Cataract and Refractive Surgery

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“…It enables better and faster visual recovery in comparison with isolated vitrectomy [14] and saves a second procedure, which is, furthermore, more complicated in the case of vitrectomised eyes [15,16,17,18]. In contrast to other authors [19], we excluded cases with retinal detachment from any cause since the postoperative incidence of complications is greater, with the formation of proliferative vitreoretinopathy or synechiae in the anterior segment [18,20] (as in 1 of the cases presented in our series) and difficulty in calculating the power of the IOL when there is an associated scleral procedure [21], and IOL stability. …”

Section: Discussionmentioning

confidence: 86%

Combined 23-Gauge Vitrectomy and Femtosecond Laser-Assisted Cataract Surgery

Gómez-Resa

Nieto²,

Corcóstegui³

2014

Ophthalmic Res

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Background: The aim of this study was to assess the safety and surgical results of femtosecond laser-assisted phacovitrectomy. Methods: A retrospective analysis of the medical records of patients over 50 years of age with vitreoretinal pathology, who had undergone pars plana vitrectomy using 23-gauge instruments and femtosecond laser-assisted cataract surgery and implantation of an intraocular lens, was performed at the Instituto de Microcirugía Ocular between June 2012 and September 2013. The diameter of the anterior capsulorhexis was set at 4.8 mm in cases where a gas tamponade was used and at 5 mm in all other cases. During the pars plana vitrectomy, posterior capsulotomy was performed on all eyes. An assessment was carried out of preoperative characteristics, surgical indications, postoperative results and complications. Only patients with a minimum of 3 months of follow-up were included. Results: A total of 21 eyes in 21 patients (71.4% women) were treated. Mean age (±SD) was 65.8 ± 6.4 years (range 53-76). The most common indication for surgery was epiretinal membrane (61.9%), followed by vitreous haemorrhage (23.8%) and macular hole (14.3%). The mean preoperative best corrected visual acuity (BCVA) was 0.81 ± 1.01 logMAR and the mean postoperative BCVA was 0.12 ± 0.19 logMAR (p = 0.003). 85.7% of patients improved their visual acuity. The remaining patients maintained their visual acuity. The only intraoperative complication related to femtosecond laser was 1 case of suction loss (4.8%). A patient with rhegmatogenous retinal detachment discovered during surgery required an additional circular scleral procedure and developed synechiaes in the early postoperative period (<1 month). There were no cases of subluxation of the intraocular lens. Mean follow-up was 6 months (range 3-14). Conclusions: The application of femtosecond laser in phacovitrectomy is a safe and effective technique that presents advantages compared to conventional techniques in cases of macular pathology and/or vitreous haemorrhage.

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“…Scenario 1: A study to evaluate the accuracy of intraocular lens power estimation in eyes having phacovitrectomy for rhegmatogenous retinal detachment4 measured the axial length (in mm) of 71 eyes. The raw data (figure 1A) exhibited a fairly strong positive skew (rather than being symmetric there is an extended tail in the histogram to the right); the same data with a logarithmic transformation applied (figure 1B) appears much more normal (less of a tail to the right), and hence the power of a test conducted on transformed data should be greater.…”

Section: Introductionmentioning

confidence: 99%