Choice of One-Piece Intraocular Lens Power and Changes of Anterior Chamber in Sulcus Implantation due to Posterior Capsular Rupture during Cataract Surgery

Jong Yun Yang; Kyoung Tak Ma; Ji Hyun Kim

doi:10.3341/jkos.2012.53.6.775

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Yang, Ma, and Kim: Choice of One-Piece Intraocular Lens Power and Changes of Anterior Chamber in Sulcus Implantation due to Posterior Capsular Rupture during Cataract Surgery

Original Article

Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(6): 775-780.

Published online: 16 June 2012

DOI: https://doi.org/10.3341/jkos.2012.53.6.775

Choice of One-Piece Intraocular Lens Power and Changes of Anterior Chamber in Sulcus Implantation due to Posterior Capsular Rupture during Cataract Surgery

Jong Yun Yang, MD^1,², Kyoung Tak Ma, MD³, Ji Hyun Kim, MD²

¹Department of Ophthalmology and The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.

²Siloam Eye Hospital, Seoul, Korea.

³Jeil Eye Clinic, Suwon, Korea.

Address reprint requests to Ji Hyun Kim, MD. Siloam Eye Hospital, #181 Deungchon-ro, Gangseo-gu, Seoul 157-836, Korea. Tel: 82-2-2650-0880, Fax: 82-2-2650-0895, jhkim32@hanmail.net

Received 24 October 2011 Accepted 24 April 2012

Abstract

Purpose

To evaluate the appropriate correction of predicted intraocular lens (IOL) power when sulcus implantation due to posterior capsular rupture was performed and to compare the anterior chamber angle of sulcus-implanted eyes with in-the-bag implanted eyes using anterior segment optical coherence tomography (Visante OCT).

Methods

Fifty-two eyes of 52 patients who had IOL implantation in the sulcus due to posterior capsular rupture during cataract surgery were retrospectively reviewed. A 0.5 lower diopter IOL than predicted IOL power using SRK-T formula was chosen. The difference between the predicted refractive error and the spherical equivalence at the 3-month time-point after sulcus implantation were evaluated. Among 52 patients, 16 patients whose fellow eye had an in-the-bag IOL implantation underwent Visante OCT and the anterior angle of affected eyes and normal fellow eyes were compared.

Results

The difference between the predicted refractive error using SRK-T formula and the spherical equivalence after sulcus implantation was a myopic shift of 0.597 ± 0.879 diopter. The mean iridocorneal angles, angle opening distance (AOD), trabecular iris surface area (TISA) at 500 um and 750 um for both nasal and temporal sides in sulcus implantation were all significantly lower than in-the-bag implantation.

Conclusions

A choice of a 0.5 lower diopter power IOL than the power for in-the-bag implantation may be considered because of greater myopic shift than predicted refractive error when sulcus implantation due to posterior rupture is performed. Anterior chamber angle in sulcus IOL implantation was shallower than in-the-bag IOL implantation.

Keywords: Angle, Anterior segment optical coherence tomography, Intraocular lens implantation, Posterior capsular rupture

Figures and Tables

Figure 1

Anterior segment optical coherence tomography (Visante OCT) images show implanted intraocular lens (IOL) in the sulcus (A) and in the bag (B). IOL is placed more anterior than predicted position when implanted in the sulcus, which leads to myopic shift.

Table 1

Demographic characteristics of the patients in sulcus implantation

Values are presented as mean ± SD or number (%).

BCVA = best collected vision acuity; IOP = intraocular pressure.

^*Calculated using SRK/T formula.

Table 2

Differences between predicted refractive error and postoperative spherical equivalent after sulcus implantation when assuming 0.5 diopter lesser than predicted IOL power in the bag

SD = standard deviation; SE = spherical equivalent.

^*Calculated using SRK/T formula.

Table 3

Difference between the predicted refractive error and postoperative spherical equivalent in sulcus implantation using various formulas when assuming 0.5 D less than predicted IOL power in the bag

Values are presented as mean ± SD.

SE = spherical equivalent; SD = standard deviation.

Table 4

Demographic characteristics of the patients with intraocular lens fixed in the sulcus in one eye and in-the-bag in the other eye

Values are presented as mean ± SD.

Table 5

Mean anterior chamber depth in two groups

Values are presented as mean ± SD.

Table 6

Anterior segment parameters (mean ± SD) in two groups, as measured by Visante OCT

SD = standard deviation; AOD = angle opening distance; TISA = trabecular iris surface area.

References

1. Jaycock P, Johnston RL, Taylor H, et al. The Cataract National Dataset electronic multi-centre audit of 55,567 operations: updating benchmark standards of care in the United Kingdom and internationally. Eye (Lond). 2009. 23:38–49.

2. Zaidi FH, Corbett MC, Burton BJ, Bloom PA. Raising the benchmark for the 21st century--the 1000 cataract operations audit and survey: outcomes, consultant-supervised training and sourcing NHS choice. Br J Ophthalmol. 2007. 91:731–736.

3. Bayramlar H, Hepsen IF, Yilmaz H. Myopic shift from the predicted refraction after sulcus fixation of PMMA posterior chamber intraocular lenses. Can J Ophthalmol. 2006. 41:78–82.

4. Spokes DM, Norris JH, Ball JL. Refinement of lens power selection for sulcus placement of intraocular lens. J Cataract Refract Surg. 2010. 36:1436–1437.

5. Suto C, Hori S, Fukuyama E, Akura J. Adjusting intraocular lens power for sulcus fixation. J Cataract Refract Surg. 2003. 29:1913–1917.

6. Shin CJ, Lee JE, Kim JY, Tchah HW. Changes in anterior chamber depth and angle after phacoemulsification measured by anterior segment optical coherence tomography. J Korean Ophthalmol Soc. 2010. 51:353–358.

7. Kucumen RB, Yenerel NM, Gorgun E, et al. Anterior segment optical coherence tomography measurement of anterior chamber depth and angle changes after phacoemulsification and intraocular lens implantation. J Cataract Refract Surg. 2008. 34:1694–1698.

8. Nolan WP, See JL, Aung T, et al. Changes in angle configuration after phacoemulsification measured by anterior segment optical coherence tomography. J Glaucoma. 2008. 17:455–459.

9. Knox Cartwright NE, Aristodemou P, Sparrow JM, Johnston RL. Adjustment of intraocular lens power for sulcus implantation. J Cataract Refract Surg. 2011. 37:798–799.

10. Maeng HS, Ryu EH, Chung TY, Chung ES. Effects of anterior chamber depth and axial length on refractive error after intraocular lens implantation. J Korean Ophthalmol Soc. 2010. 51:195–202.

11. Vasavada AR, Raj SM, Karve S, et al. Retrospective ultrasound biomicroscopic analysis of single-piece sulcus-fixated acrylic intraocular lenses. J Cataract Refract Surg. 2010. 36:771–777.

12. Taskapili M, Gulkilik G, Kocabora MS, et al. Comparison of sulcus implantation of single-piece hydrophilic foldable acrylic and polymethylmethacrylate intraocular lenses in eyes with posterior capsule tear during phacoemulsification surgery. Eur J Ophthalmol. 2007. 17:595–600.

13. Chang DF, Masket S, Miller KM, et al. Complications of sulcus placement of single-piece acrylic intraocular lenses: recommendations for backup IOL implantation following posterior capsule rupture. J Cataract Refract Surg. 2009. 35:1445–1458.

14. LeBoyer RM, Werner L, Snyder ME, et al. Acute haptic-induced ciliary sulcus irritation associated with single-piece AcrySof intraocular lenses. J Cataract Refract Surg. 2005. 31:1421–1427.

15. Micheli T, Cheung LM, Sharma S, et al. Acute haptic-induced pigmentary glaucoma with an AcrySof intraocular lens. J Cataract Refract Surg. 2002. 28:1869–1872.

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