Stability of Four-Haptic Intraocular Lens in Combined Phacoemulsification and Vitrectomy

Jae Woo Kim; Ji Wook Yang; Dong Hyun Jee

doi:10.3341/jkos.2010.51.6.829

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Kim, Yang, and Jee: Stability of Four-Haptic Intraocular Lens in Combined Phacoemulsification and Vitrectomy

Original Article

J Korean Ophthalmol Soc 2010;51(6):829-834.

Published online: 3 August 2010

DOI: https://doi.org/10.3341/jkos.2010.51.6.829

Stability of Four-Haptic Intraocular Lens in Combined Phacoemulsification and Vitrectomy

Jae Woo Kim, MD, Ji Wook Yang, MD, Dong Hyun Jee, MD

Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Suwon, Korea

Address reprint requests to Dong Hyun Jee, MD Department of Ophthalmology and Visual Science, The Catholic University of Korea St. Vincent’s Hospital #93-6 Ji-dong, Paldal-gu, Suwon 442-723, Korea Tel: 82-31-249-7343, Fax: 82-31-251-6625, E-mail: Dhjee73@nate.com

Received 28 January 2010 Accepted 27 April 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the stability of intraocular lenses (IOLs) according to the haptic design in combined surgery (phacoemulsification, intraocular lens insertion, and vitrectomy) by comparing early IOP elevation and the accuracy of IOL power.

Methods

A retrospective study was conducted for 85 eyes of 85 patients who had undergone combined surgery. IOP elevation one week postoperatively and the difference between target refraction and postoperative refraction after two months were evaluated in all patients. All eyes were allocated to either a 2-haptic IOL group or a 4-haptic IOL group, and then each group was divided into three subgroups: gas-filled, silicone oil-filled, or balanced salt solution-filled.

Results

In the balanced salt solution-filled group, the early IOP increase was significantly less in the 4-haptic IOL group than it was in the 2-haptic IOL group (3.24 mmHg vs. 6.15 mm Hg, p=0.025).

The myopic shifts of the 2-haptic IOL group were significantly greater than those of the 4-haptic IOL group for all of the sub-groups (gas subgroup -0.71D vs. -0.31D, p=0.045; balanced salt solution subgroup -0.66D vs. -0.16D, p=0.018).

Conclusions

In combined surgery, 4-haptic IOL implantation showed significantly less early IOP elevation and less myopic shift than those of 2-haptic IOL implantation.

Keywords: Combined surgery, 4-haptic IOL, Intraocular pressure, Myopic shift

References

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Table 1.

Characteristics of two Intraocular lenses (IOL) in the study

	2-haptic IOL (n=46)	4-haptic IOL (n=39)
Model	Acrysof IQ, Alcon^®, U.S.A.	MI60, Bausch & Lomb^®, Germany
Material	hydrophobic acrylic	hydrophilic acrylic
Optic diameter (mm)	6.0	5.6-6.2
Overall diameter (mm)	13.0	10.5-11.0
Haptic angle	0 degree	10 degree
A-constant	118.7	118.4

Table 2.

Patient demographics

	2-haptic IOL group	4-haptic IOL group
Age (years)	63.40±10.25	66.15±6.17
Sex
Male (n)	22	15
Female (n)	24	24
Systemic disease
Diabetes (n)	37	29
Hypertension (n)	29	26
Cause (%)
^* PDR vitreous hemorrhage	20 (43.5)	16 (41.0)
PDR c ^† TRD	8 (17.4)	9 (23.1)
^‡ BRVO vitreous hemorrhage	7 (15.2)	5 (12.8)
Retinal tear c ^§ RD	7 (15.2)	4 (12.3)
Macular hole	2 (4.3)	3 (7.7)
Macular hemorrhage	2 (4.3)	2 (5.1)
Total	46 (100)	39 (100)

^* PDR=proliferative diabetic retinopathy;

^† TRD=tractional retinal detachment;

^‡ BRVO=branched retinal vein occlusion;

^§ RD= retinal detachment.

Table 3.

Comparison of postoperative IOP increase and refractive errors in the 2-haptic and 4-haptic IOL group

	2-haptic IOL (n=46)	4-haptic IOL (n=39)	^§ p-value
Preoperative
Axial length (mm)	23.10±0.98	23.45±1.14	0.203
Anterior chamber depth (mm)	3.06±0.32	3.09±0.43	0.368
Intraocular pressure (mm Hg)	11.47±2.94	12.55±2.66	0.604
Material of tamponade
C3F8 gas tamponade (n)	17	12
^* IOP increase (mm Hg)	9.17±10.25	9.75±14.82	0.512
^† Myopic shift (Diopter)	-0.71±1.09	-0.31±0.84	0.045
Silicone oil tamponade	10	13
^* IOP increase (mm Hg)	11.22±9.74	9.34±10.25	0.429
With removal (n)	4	5
^‡ Myopic shift (Diopter)	-0.69±0.81	-0.87±0.62	0.102
Balanced salt solution (n)	19	14
^* IOP increase (mm Hg)	6.15±8.13	3.24±4.12	0.025
^† Myopic shift (Diopter)	-0.66±1.02	-0.16±0.70	0.018

^* Difference between maximum value of postoperative IOP within postoperative 1-week and preoperative IOP;

^† Difference between post-vitrectomy 2 months spherical equivalent and preoperative target spherical equivalent;

^‡ Difference between post-silicone oil removal 2 months spherical equivalent and pre-silicone oil removal target spherical equivalent;

^§ p-value was determined by Mann-Whitney U-test.

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