Journal List > J Korean Ophthalmol Soc > v.57(6) > 1010606

TOOLS
Kim, Shin, Jeong, and Choi: Clinical Features of Cataract Extraction with Negative-Power Intraocular Lens Implantation in High Myopia
Original Article

J Korean Ophthalmol Soc 2016;57(6):898-904.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.6.898

Clinical Features of Cataract Extraction with Negative-Power Intraocular Lens Implantation in High Myopia

Min Kyo Kim, MD1, 2, Woo Beom Shin, MD1, 2, Hyun Kyo Jeong, MD1, 2, Jung Bum Choi, MD1

1Siloam Eye Hospital, Seoul, Korea

2The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

Address reprint requests to Jung Bum Choi, MD Siloam Eye Hospital, #181 Deungchon-ro, Gangseo-gu, Seoul 07668, Korea Tel: 82-2-2650-0880, Fax: 82-2-2650-0895 E-mail: cjb1220@siloam.co.kr

Received 30 April 2015       Revised 11 November 2015       Accepted 14 January 2016

Copyright © 2016 Korean Ophthalmological Society

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 clinical features of high myopic eyes with cataracts implanted with negative power intraocular lenses (IOLs) at the time of cataract surgery.

Methods

A retrospective chart review was conducted of 18 eyes of 14 patients who underwent cataract surgery with negative power IOLs and 10 eyes in 9 patients with low power IOLs. We investigated axial length, IOL power, preoperative and post-operative best-corrected visual acuity (BCVA) and preoperative and postoperative spherical equivalent (SE) refractive errors.

Results

Mean BCVA showed significant improvement in both groups. We measured postoperative SE refraction and the difference between the mean intended and the mean achieved SE refractive errors in the negative power group (17 eyes) was +1.59 ± 1.34 D and +0.31 ± 0.50 D in the low power group.

Conclusions

BCVA was significantly improved in the majority of eyes, although they had myopic macular degeneration or posterior staphyloma. However, the mean achieved postoperative SE refraction was more hyperopic than the predicted postoperative SE error. Additionally, hyperopic refractive error was greater in the negative power group than the low power group. Therefore, we recommend that postoperative hyperopic refractive error should be considered when performing cataract surgery in high myopic patients.

Keywords: Cataract, High myopia, Negative power intraocular lens

References

1. Hyman L. Myopic and hyperopic refractive error in adults: an overview. Ophthalmic Epidemiol. 2007; 14:192–7.
crossref
2. Saw SM, Chan YH, Wong WL, et al. Prevalence and risk factors for refractive errors in the Singapore Malay Eye Survey. Ophthalmology. 2008; 115:1713–9.
crossref
3. Lim R, Mitchell P, Cumming RG. Refractive associations with abdominal: the Blue Mountains Eye Study. Invest Ophthalmol Vis Sci. 1999; 40:3021–6.
4. Wong TY, Klein BE, Klein R, et al. Refractive errors and incident cataracts: the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 2001; 42:1449–54.
5. Leske MC, Wu SY, Nemesure B, et al. Risk factors for incident abdominal opacities. Ophthalmology. 2002; 109:1303–8.
6. Kohnen S, Brauweiler P. First results of cataract surgery and abdominalation of negative power intraocular lenses in highly myopic eyes. J Cataract Refract Surg. 1996; 22:416–20.
7. Holladay JT. Visual acuity measurements. J Cataract Refract Surg. 2004; 30:287–90.
crossref
8. Jung SK, Lee JH, Kakizaki H, Jee D. Prevalence of myopia and its association with body stature and educational level in 19-year-old male conscripts in seoul, South Korea. Invest Ophthalmol Vis Sci. 2012; 53:5579–83.
crossref
9. Nielsen NE, Naeser K. Epidemiology of retinal detachment abdominal extracapsular cataract extraction: a follow-up study with an analysis of risk factors. J Cataract Refract Surg. 1993; 19:675–80.
10. Petermeier K, Gekeler F, Messias A, et al. Intraocular lens power calculation and optimized constants for highly myopic eyes. J Cataract Refract Surg. 2009; 35:1575–81.
crossref
11. Kapamajian MA, Miller KM. Efficacy and safety of cataract abdominal with negative power intraocular lens implantation. Open Ophthalmol J. 2008; 2:15–9.
12. Kwon JW, Lee HS, Park SH, Joo CK. Clinical result after abdominalation of minus diopter intraocular lens in the high myopia patients. J Korean Ophthalmol Soc. 2009; 50:1308–12.
13. Zuberbuhler B, Seyedian M, Tuft S. Phacoemulsification in eyes with extreme axial myopia. J Cataract Refract Surg. 2009; 35:335–40.
crossref
14. Chang YH, Lim SJ, Kim TH, Kim HB. Prediction of the refractive power after cataract surgery on myopic eyes. J Korean Ophthalmol Soc. 1999; 40:424–9.
15. Kora Y, Yaguchi S, Inatomi M, Ozawa T. Preferred postoperative refraction after cataract surgery for high myopia. J Cataract Refract Surg. 1995; 21:35–8.
crossref
16. Hayashi K, Hayashi H. Optimum target refraction for highly and moderately myopic patients after monofocal intraocular lens implantation. J Cataract Refract Surg. 2007; 33:240–6.
crossref
17. Haigis W. Intraocular lens calculation in extreme myopia. J Cataract Refract Surg. 2009; 35:906–11.
crossref

Figure 1.
Distribution of the difference between postoperative spherical equivalent (SE) and target refraction. (A) Negative-power group.(B) Low-power group. Postop. = postoperative.
jkos-57-898f1.tif
Figure 2.
Pearson correlation of axial length with (A) the difference between postoperative spherical equivalent (SE) and target refraction (r = 0.560, p = 0.019), (B) intraocular lens (IOL) power (r = −0.559, p = 0.016) in negative-power group. Postop. = postoperative.
jkos-57-898f2.tif
Figure 3.
Pearson correlation of axial length with (A) the difference between postoperative spherical equivalent (SE) and target re+fraction (r = 0.508, p = 0.134), (B) intraocular lens (IOL) power (r = −0.578, p = 0.080) in low-power group. Postop. = postoperative.
jkos-57-898f3.tif
Table 1.
Demographics of patients and implanted IOL
  Negative-power Low-power
Eyes (n) 18 10
Patients (n) 14 9
Age (years) 59.7 ± 12.9 62.2 ± 10.3
Sex (male:female) 3:11 1:8
Follow up (months) 9.08 ± 6.71 10.52 ± 8.45
Axial length (mm) 32.17 ± 2.20 29.49 ± 1.44
Preoperative SE (D) −19.63 ± 4.72 −12.84 ± 2.48
IOL power (D) −4.33 ± 3.36 4.00 ± 2.75

Values are presented as mean ± SD unless otherwise indicated.

IOL = intraocular lens; SE = spherical equivalent.

Table 2.
Demographic and surgical information of patients implanted with negative-power IOL*
Patient Age (years) Sex Eye AXL (mm) IOL power (D) Target refraction (D) Postop. SE (D)
1 56 F L 30.72 −2 −0.45 1.50
2 75 F R 31.23 −1 −0.21 0.00
3 55 F R 32.86 −8 −0.74 −0.13
4 56 F L 32.33 −7 −0.81 1.25
5 74 F R 32.55 −1 −2.43 0.00
      L 33.43 −1 −3.23 0.38
6 63 F R 31.60 −6 −0.47 1.38
7 55 F R 35.39 −9 −1.86 0.88
      L 36.35 −9 −1.70 0.13
8 84 F R 30.35 −3 −0.56 UC
9 60 F L 30.86 −1 −0.75 1.00
10 68 F L 29.57 −2 −0.20 1.88
11 47 M R 34.73 −5 −0.94 0.50
      L 33.42 −1 −0.75 0.38
12 60 M L 27.37 −3 −0.12 −2.75
13 33 M R 33.17 −9 −0.62 2.00
      L 33.10 −9 −0.66 1.13
14 50 F L 30.08 −1 −0.41 1.13
Mean 59.7 ± 12.9     32.17 ± 2.20 −4.33 ± 3.36 −0.94 ± 0.83 0.63 ± 1.09

Values are presented as mean ± SD unless otherwise indicated.

IOL = intraocular lens; AXL = axial length; Postop. = postoperative; SE = spherical equivalent; F = female; M = male; L =left; R = right; UC = uncheckable.

* Count fingers (CF) = 2.0 (log MAR), hand movements (HM) = 3.0 (log MAR).

Table 3.
Demographic and surgical information of patients implanted with low-power IOL*
Patient Age (years) Sex Eye AXL (mm) IOL power (D) Target refraction (D) Postop. SE (D)
1 75 F L 27.97 4 −0.49 −0.13
2 67 F R 31.86 1 −0.73 0.00
      L 31.65 1 −0.93 0.00
3 59 M R 29.55 8 −0.61 −0.25
4 63 F L 28.62 4 −1.09 −0.25
5 77 F L 27.51 9 −0.31 −0.63
6 67 F R 28.74 2 −0.29 −0.38
7 49 F R 29.40 4 −0.45 −1.00
8 51 F R 29.31 2 −0.60 0.00
9 52 F L 30.33 5 −1.21 −1.00
Mean 62.2 ± 10.3     29.49 ± 1.44 4.00 ± 2.75 −0.67 ± 0.32 −0.36 ± 0.39

Values are presented as mean ± SD unless otherwise indicated.

IOL = intraocular lens; AXL = axial length; Postop. = postoperative; SE = spherical equivalent; F = female; M = male; L =left; R = right.

* Count fingers (CF) = 2.0 (log MAR), hand movements (HM) = 3.0 (log MAR).

TOOLS
Similar articles