Refractive Changes After Nd:YAG Capsulotomy in Pseudophakic Eyes

Moshirfar, Majid; Basharat, Noor F; Seitz, Tanner S; Peterson, Christian M; Stapley, Seth R; Ziari, Melody; Bundogji, Nour; Ronquillo, Yasmyne C; Hoopes, Phillip C

doi:10.2147/opth.s395605

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…To avoid capsule striae, 6/12 o/c positioning is better. Although there is no direct study addressing the safety of Nd:YAG capsulotomy, there is evidence from a subgroup of 16 LAL patients included in other studies [37]. After capsulotomy, no significant changes in sphere or cylinder were observed, unlike other subgroups using different lenses.…”

Section: Posterior Capsular Opacificationmentioning

confidence: 97%

Light adjustable intraocular lenses in cataract surgery: considerations

Jun,

Lieu,

Afshari

2023

Current Opinion in Ophthalmology

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Purpose of review Light adjustable intraocular lens (LAL) is a promising concept in cataract surgery. This review explores considerations for the use of LALs. Recent findings Through updates, the safety of LALs and light delivery devices have been enhanced, enabling more efficient treatment with lower ultraviolet (UV) energy. Preoperative topography and aberration are essential for understanding indications for LALs. Furthermore, when determining intraocular lens power, it is crucial to factor in potential postoperative myopia or hyperopic adjustments. This is achieved by establishing a proper postimplantation refractive target and considering potential wavefront changes. Postoperative adjustments for defocus and astigmatism have demonstrated excellent outcomes. Monovision strategy by adjustable blended vision of LALs revealed distance vision of 20/20 along with near vision of J2 in 96% of patients. However, the results of clinical studies on postrefractive cataract surgery showed contrasting outcomes at distance, indicating the need for further research results regarding its effectiveness. A new postoperative workflow needs to be designed to enable a systematic follow-up process. Summary LALs are safe and demonstrate promising refractive outcomes. To achieve appropriate results, understanding the changes in optical characteristics associated with adjustment and constructing a new postoperative workflow are necessary.

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Section: Posterior Capsular Opacificationmentioning

confidence: 97%

Light adjustable intraocular lenses in cataract surgery: considerations

Jun,

Lieu,

Afshari

2023

Current Opinion in Ophthalmology

View full text Add to dashboard Cite

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Bilateral Light-Adjustable Lens Implantation in a Patient With 50-Cut Radial Keratotomy

Jiang,

Coulter,

Myung

et al. 2024

Cornea Open

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Purpose: The purpose of this study was to report a case of light-adjustable lens (LAL; RxSight, Aliso Viejo, CA) implantation in a patient with bilateral 50-cut radial keratotomy (RK) and discuss related preoperative, intraoperative, and postoperative considerations. Methods: A 78-year-old patient with a history of bilateral 50-cut RK underwent phacoemulsification with implantation of LALs in both eyes 1 month apart. Although LAL technology was not approved specifically for addressing limitations in intraocular lens calculation post-RK due to corneal topography irregularity, the patient opted for this lens due to its ability to make postoperative adjustments to its refractive power. At postoperative month 1 following the second-eye surgery, YAG capsulotomy was performed in both eyes. At postoperative month 2 following the second-eye surgery, the patient began LAL adjustments spaced 1 to 2 weeks apart for a total of 2 LAL adjustments and 2 lock-in sessions. Results: Our patient achieved a final refraction of −0.25 +0.25 × 110 with an UDVA of 20/20-2 in the right eye and −0.25 + 0.50 × 135 with an UDVA 20/25-1 in the left eye. Conclusions: The LAL may be a promising option for patients undergoing cataract surgery after RK, although further studies are needed to understand long-term changes in eyes with RK and the inability of LAL to address all aspects of corneal aberration.

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Fluctuations of Anterior Chamber Depth and Astigmatism in Pseudophakic Eyes

Tutchenko,

Patel,

Skovron

et al. 2024

OPTH

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Purpose To explore the significance of changes in anterior chamber depth (ΔACD) and astigmatism between 4 and 8 weeks following uneventful phacoemulsification. Patients and Methods Anterior chamber depth (ACD, mm), autorefractometry and subjective refraction were monitored in pseudophakic eyes implanted with non-toric IOLs (group 1, SA60AT, n=36; group 2, SN60WF, n=34; group 3, ICBOO, n=16) and phakic control group (n=30, group 4a, for ACD and autorefractometry) over four weeks. Changes in subjective refractions were compared with repeatability in normal phakic eyes (n=30, group 4b). Results Reporting key results (p<0.01), mean (±sd 95% CI) ΔACD values (ACD at start minus ACD at four weeks) were +0.02 (±0.37, −0.16 to 0.08), +0.22 (±0.51,0.05 to 0.39), −0.33 (±0.51, −0.58 to −0.08), −0.02 (±0.07, −0.04 to 0.01) in groups 1–4a respectively. Differences were significant (1-way ANOVA, F=7.02). Pooling data from the pseudophakic eyes (n=86) induced astigmatism (IA) by autorefractometry was significantly greater in comparison with group 4a [−0.78D (±0.67, −0.92 to −0.64) and −0.19D (±0.16, −0.25 to - 0.13)]. IA power correlated with the initial power of refractive astigmatism at 4 weeks (A), [IA = 0.36A−0.30 (r 2 =0.207) and IA = 0.39A−0.29 (r 2 =0.232) by autorefractometry and subjective refraction, respectively]. In groups 1–3, vector analysis revealed i) the change in refraction in over 55% of eyes was beyond the 95% confidence interval limits observed in groups 4a and 4b, ii) some significant associations between changes in vectors describing astigmatism with ΔACD and IOL labelled power. Conclusion Changes in ACD and refraction still occur four weeks after unremarkable phacoemulsification and the inter-relationship depends on IOL design/type. Other factors, such as tilt or dislocation of the IOL along the X-Y axes parallel to Listing’s plane, accompanying changes in ACD are expected to affect the postop astigmatism.

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Refractive Changes After Nd:YAG Capsulotomy in Pseudophakic Eyes

Cited by 3 publications

References 33 publications

Light adjustable intraocular lenses in cataract surgery: considerations

Light adjustable intraocular lenses in cataract surgery: considerations

Bilateral Light-Adjustable Lens Implantation in a Patient With 50-Cut Radial Keratotomy

Fluctuations of Anterior Chamber Depth and Astigmatism in Pseudophakic Eyes

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