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

Lian, Zhangkai; Cao, Qian; Qi, Haotian; Young, Charlotte Aimee; Zhang, Xinyu; Jin, Guangming; Zheng, Danying

doi:10.1097/j.jcrs.0000000000000874

Cited by 3 publications

(7 citation statements)

References 32 publications

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“…Interestingly, in contrast to the BUII and Pearl-DGS formulas, the Kane, even with the affected eye's ACD, demonstrated a level of accuracy comparable to that of the third-generation formulas, consistent with a previous study [5]. Although the exact structure of the Kane formula remains undisclosed, we assumed that the weight of the ACD within the formula may be relatively modest.…”

Section: Discussionsupporting

confidence: 87%

“…Table 1). The present study reflected a real-world scenario, as the IOL constant was adopted from the ULIB, in line with routine clinical practice and a recent study [5,19]. The above-mentioned results suggest that the performance of the newer formulas in the context of lens subluxation can be improved when the unaffected eye's ACD is replaced by the affected eye's ACD.…”

Section: Discussionsupporting

confidence: 59%

“…The accuracy of the newer formulas with and without the unaffected eye's ACD was assessed using the heteroscedastic statistical method [15]. Third-generation formulas were selected as the benchmark because previous studies confirmed their higher accuracy than newer ones in eyes with lens subluxation [4,5]. Holladay et al [15] proposed that SD is the most accurate parameter for evaluating the accuracy of IOL power calculation formulas.…”

Section: Discussionmentioning

confidence: 99%

“…We grouped the formulas based on the input parameters used: group 1 used only the affected eye's AL, K, and ACD in the three newer formulas (the Kane, BUII, and Pearl-DGS formulas); group 2 used the affected eye's AL and K and the unaffected eye's ACD in the three newer formulas. Third-generation formulas (the SRK/T, Holladay 1, and Hoffer Q formulas) predict IOL power more accurately than newer ones in cases of lens subluxation [4,5]. Therefore, the accuracy of the third-generation formulas was analyzed (group 3rd generation) and compared with the above two groups.…”

Section: Eyes With Subluxated Lensesmentioning

confidence: 99%

“…However, even intracapsular IOL implantation can result in unsatisfactory postoperative refractive outcomes for such difficult eyes, especially when using newer formulas that incorporate anterior chamber depth (ACD) as a critical variable to calculate IOL power [4]. While these formulas have outperformed traditional third-generation formulas in routine cataract surgery, their accuracy is notably diminished in eyes with subluxated lenses, and in some studies, they were less accurate than third-generation formulas [4][5][6][7][8][9][10]. Once the crystalline lens leaves its normal physiological position, even when the IOL is placed within the capsular bag, postoperative effective lens position (ELP) estimation using newer formulas can be erroneous because of the preoperatively unstable ACD caused by the dislocated lens.…”

Section: Introductionmentioning

confidence: 99%

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Improving Accuracy of In-the-bag Intraocular Lens Power Calculation in Adult Eyes with Unilateral Subluxated Lenses by Using the Anterior Chamber Depth of the Unaffected Eye

Lou,

Chen,

Huang

et al. 2024

Ophthalmic Res

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Introduction: This study aimed to determine the interchangeability of bilateral anterior chamber depth (ACD) in intraocular lens (IOL) power calculations for cataractous eyes and refractive outcomes using the unaffected fellow-eye ACD in lens subluxation. Methods: The predicted postoperative spherical equivalent (SE) calculated using the Kane formula with and without fellow-eye ACD in 202 cataract patients was compared. Refractive outcomes of the newer formulas (the Kane, Barrett Universal II (BUII), and Pearl-DGS formulas) with affected-eye ACD and with unaffected fellow-eye ACD were compared in 33 eyes with lens subluxation (the affected eye) undergoing in-the-bag IOL implantation. The SD of the prediction error (PE) was assessed using the heteroscedastic method. Results: In 202 paired cataractous eyes, no marked ACD difference was found bilaterally; the predicted SE obtained without the fellow-eye ACD was comparable with that calculated with the fellow-eye one (P = .90), with a mean absolute difference of 0.03 ± 0.03D. With the affected-eye AL, keratometry, and ACD, the median absolute error (MedAE) was 0.38-0.64D, and the percentage of PE within ±0.50D was 30.30-57.58%. The unaffected-eye ACD improved the results (MedAE, 0.35-0.49D; the percentage of PE within ±0.50D, 54.55-63.64%). The SDs of the BUII (0.82D) and Pearl-DGS formulas (0.87D) with the affected-eye ACD were significantly larger than those of the Kane and Pearl-DGS formulas (both 0.69D) with the unaffected-eye ACD. Conclusion: Bilateral ACD was interchangeable in IOL power calculation for cataractous eyes. Unaffected-eye ACD in lieu of affected-eye ACD can enhance the accuracy of newer formulas in patients with unilateral subluxated lenses undergoing in-the-bag IOL implantation.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Eyes With Subluxated Lensesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improving Accuracy of In-the-bag Intraocular Lens Power Calculation in Adult Eyes with Unilateral Subluxated Lenses by Using the Anterior Chamber Depth of the Unaffected Eye

Lou,

Chen,

Huang

et al. 2024

Ophthalmic Res

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Improving Effective Lens Position Prediction for Transscleral Fixation of Intraocular Lens Among Congenital Ectopia Lentis Patients

Zou¹,

Lian²,

Young³

et al. 2023

American Journal of Ophthalmology

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Influencing factors of effective lens position in patients with Marfan syndrome and ectopia lentis

Shen,

Chen,

Jia

et al. 2024

Br J Ophthalmol

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AimsThe aim of this study was to analyse the effective lens position (ELP) in patients with Marfan syndrome (MFS) and ectopia lentis (EL).MethodsPatients with MFS undergoing lens removal and primary intraocular lens (IOL) implantation were enrolled in the study. The back-calculated ELP was obtained with the vergence formula and compared with the theoretical ELPs. The back-calculated ELP and ELP error were evaluated among demographic and biometric parameters, including axial length (AL), corneal curvature radius (CCR) and white-to-white (WTW).ResultsA total of 292 eyes from 200 patients were included. The back-calculated ELP was lower in patients undergoing scleral-fixated IOL than those receiving in-the-bag IOL implantation (4.54 (IQR 3.65–5.20) mm vs 4.98 (IQR 4.56–5.67) mm, p<0.001). The theoretical ELP of the SRK/T formula exhibited the highest accuracy, with no difference from the back-calculated ELP in patients undergoing in-the-bag IOL implantation (5.11 (IQR 4.83–5.65) mm vs 4.98 (IQR 4.56–5.67) mm, p=0.209). The ELP errors demonstrated significant correlations with refraction prediction error (PE): a 1 mm ELP error led to PE of 2.42D (AL<22 mm), 1.47D (22 mm≤AL<26 mm) and 0.54D (AL≥26 mm). Multivariate analysis revealed significant correlations of ELP with AL (b=0.43, p<0.001), CCR (b=−0.85, p<0.001) and WTW (b=0.41, p=0.004).ConclusionThis study provides novel insights into the origin of PE in patients with MFS and EL and potentially refines existing formulas.

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

Abstract: For CEL patients with scleral-sutured IOL surgery, the SRK/T and EVO formulas were 2 of the recommended IOL formulas that had the lowest PEs after constant optimization.

Cited by 3 publications

References 32 publications

Improving Accuracy of In-the-bag Intraocular Lens Power Calculation in Adult Eyes with Unilateral Subluxated Lenses by Using the Anterior Chamber Depth of the Unaffected Eye

Improving Accuracy of In-the-bag Intraocular Lens Power Calculation in Adult Eyes with Unilateral Subluxated Lenses by Using the Anterior Chamber Depth of the Unaffected Eye

Improving Effective Lens Position Prediction for Transscleral Fixation of Intraocular Lens Among Congenital Ectopia Lentis Patients

Influencing factors of effective lens position in patients with Marfan syndrome and ectopia lentis

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