Incidence of Complications in Cataract Surgery according to the Availability of Partial Coherence Laser Interferometry

Choi Hannuy; Eom Youngsub; Kang Su-Yeon; Suk Song Jong; Myung Kim Hyo

doi:10.3341/jkos.2017.58.7.804

Journal List > J Korean Ophthalmol Soc > v.58(7) > 1010810

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Hannuy, Youngsub, Su-Yeon, Jong, and Hyo: Incidence of Complications in Cataract Surgery according to the Availability of Partial Coherence Laser Interferometry

Original Article

J Korean Ophthalmol Soc 2017;58(7):804-810.

Published online: 8 September 2017

DOI: https://doi.org/10.3341/jkos.2017.58.7.804

Incidence of Complications in Cataract Surgery according to the Availability of Partial Coherence Laser Interferometry

Choi Hannuy, M.D., Eom Youngsub, M.D., PhD, Kang Su-Yeon, M.D., PhD, Suk Song Jong, M.D., PhD, Myung Kim Hyo, M.D., PhD

Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea

Address reprint requests to Youngsub Eom, MD, PhD Department of Ophthalmology, Korea University Ansan Hospital, #123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea Tel: 82-31-412-5160, Fax: 82-2-924-6820 E-mail: hippotate@hanmail.net

* This study was supported in part by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (Grant No.: NRF-2016R1D1A1A02937003), by a Korea University Grant (K1625491), and by Alumni of department of ophthalmology, Korea University College of Medicine.

* Conflicts of Interest: The authors have no conflicts to disclose.

Received 27 April 20173 June 2017 Accepted 27 June 2017

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 validate the possibility of IOLMaster measurement as a predictor of intraoperative and postoperative complications during phacoemulsification surgery.

Methods

In this study, 2,107 eyes from 1,456 patients who underwent phacoemulsification with intraocular lens (IOL) im-plantation were divided into two groups according to the possibility of performing optical biometry with the IOLMaster (measurable group: 1,746 eyes from 1,141 patients, unmeasurable group: 361 eyes from 315 patients). The intraoperative and postoperative complication rates were compared between the two groups.

Results

Three hundred sixty-one eyes (17.1%) could not be measured using optical biometry. Dense posterior subcapsular cat-aract (56.0%) was the main factor resulting in failed measurements with optical biometry, followed by anterior subcapsular cata-ract (12.5%). The rates of posterior capsule rupture and radial tear were significantly higher in the unmeasurable group than in the measurable group (p = 0.001, p < 0.001, respectively). Corneal edema was significantly higher in the unmeasurable group (16.1%) than in the measurable group (5.3%) at postoperative 1 week (p < 0.001).

Conclusions

Possibility of optical biometry measurement can be used as a simple predictor of intraoperative and postoperative complications of phacoemulsification surgery. Surgeons should pay close attention to patients who cannot be measured using IOLMaster.

Keywords: Cataract surgery, Complication, Optical biometry, Phacoemulsification

References

1. Jin GJ, Crandall AS, Jones JJ. Intraocular lens exchange due to in-correct lens power. Ophthalmology. 2007; 114:417–24.

2. Kora Y, Shimizu K, Yoshida M. . Intraocular lens power calcu-lation for lens exchange. J Cataract Refract Surg. 2001; 27:543–8.

3. Eom Y, Song JS, Kim HM. Spectacle plane add power of multi-focal intraocular lenses according to effective lens position. Can J Ophthalmol. 2017; 52:54–60.

4. Eom Y, Song JS, Kim HM. Modified Haigis formula effective lens position equation for ciliary sulcus-implanted intraocular lenses. Am J Ophthalmol. 2016; 161:142–9.e1-2..

5. Eom Y, Song JS, Kim YY, Kim HM. Comparison of SRK/T and Haigis formulas for predicting corneal astigmatism correction with toric intraocular lenses. J Cataract Refract Surg. 2015; 41:1650–7.

6. Eom Y, Kang SY, Song JS. . Effect of effective lens position on cylinder power of toric intraocular lenses. Can J Ophthalmol. 2015; 50:26–32.

7. Olsen T. Sources of error in intraocular lens power calculation. J Cataract Refract Surg. 1992; 18:125–9.

8. Findl O, Drexler W, Menapace R. . Improved prediction of in-traocular lens power using partial coherence interferometry. J Cataract Refract Surg. 2001; 27:861–7.

9. Fercher AF, Mengedoht K, Werner W. Eye-length measurement by interferometry with partially coherent light. Opt Lett. 1988; 13:186–8.

10. Haigis W, Lege B, Miller N, Schneider B. Comparison of im-mersion ultrasound biometry and partial coherence interferometry for intraocular lens calculation according to Haigis. Graefes Arch Clin Exp Ophthalmol. 2000; 238:765–73.

11. Connors R 3rd, Boseman P 3rd, Olson RJ. Accuracy and reproduci-bility of biometry using partial coherence interferometry. J Cataract Refract Surg. 2002; 28:235–8.

12. Goyal R, North RV, Morgan JE. Comparison of laser inter-ferometry and ultrasound A-scan in the measurement of axial length. Acta Ophthalmol Scand. 2003; 81:331–5.

13. Olsen T. Improved accuracy of intraocular lens power calculation with the Zeiss IOLMaster. Acta Ophthalmol Scand. 2007; 85:84–7.

14. Vogel A, Dick HB, Krummenauer F. Reproducibility of optical biometry using partial coherence interferometry: intraobserver and interobserver reliability. J Cataract Refract Surg. 2001; 27:1961–8.

15. Hitzenberger CK, Drexler W, Dolezal C. . Measurement of the axial length of cataract eyes by laser Doppler interferometry. Invest Ophthalmol Vis Sci. 1993; 34:1886–93.

16. Tehrani M, Krummenauer F, Blom E, Dick HB. Evaluation of the practicality of optical biometry and applanation ultrasound in 253 eyes. J Cataract Refract Surg. 2003; 29:741–6.

17. Freeman G, Pesudovs K. The impact of cataract severity on meas-urement acquisition with the IOLMaster. Acta Ophthalmol Scand. 2005; 83:439–42.

18. Hirnschall N, Murphy S, Pimenides D. . Assessment of a new averaging algorithm to increase the sensitivity of axial eye length measurement with optical biometry in eyes with dense cataract. J Cataract Refract Surg. 2011; 37:45–9.

19. Osher RH, Yu BC, Koch DD. Posterior polar cataracts: a predis-position to intraoperative posterior capsular rupture. J Cataract Refract Surg. 1990; 16:157–62.

20. Brazitikos PD, Tsinopoulos IT, Papadopoulos NT. . Ultrasonographic classification and phacoemulsification of white senile cataracts. Ophthalmology. 1999; 106:2178–83.

21. Vasavada A, Singh R. Phacoemulsification in eyeswith posterior polar cataract. J Cataract Refract Surg. 1999; 25:238–45.

22. Chakrabarti A, Singh S. Phacoemulsification in eyes with white cataract. J Cataract Refract Surg. 2000; 26:1041–7.

23. Singh R, Vasavada AR, Janaswamy G. Phacoemulsification of bru-nescent and black cataracts. J Cataract Refract Surg. 2001; 27:1762–9.

24. Artzén D, Lundström M, Behndig A. . Capsule complication during cataract surgery: case-control study of preoperative and in-traoperative risk factors: Swedish Capsule Rupture Study Group report 2. J Cataract Refract Surg. 2009; 35:1688–93.

25. Langwiń ska-Woś ko E, Szulborski K, Broniek-Kowalik K. The complications during phacoemulsification in patients with posteri-or polar cataract. Klin Oczna. 2011; 113:16–8.

26. Dick HB, Kohnen T, Jacobi FK, Jacobi KW. Long-term endothelial cell loss following phacoemulsification through a temporal clear corneal incision. J Cataract Refract Surg. 1996; 22:63–71.

27. Hayashi K, Hayashi H, Nakao F, Hayashi F. Risk factors for cor-neal endothelial injury during phacoemulsification. J Cataract Refract Surg. 1996; 22:1079–84.

28. Lundberg B, Jonsson M, Behndig A. Postoperative corneal swel-ling correlates strongly to corneal endothelial cell loss after pha-coemulsification cataract surgery. Am J Ophthalmol. 2005; 139:1035–41.

29. Mencucci R, Ambrosini S, Ponchietti C. . Ultrasound thermal damage to rabbit corneas after simulated phacoemulsification. J Cataract Refract Surg. 2005; 31:2180–6.

30. Mencucci R, Ponchietti C, Virgili G. . Corneal endothelial damage after cataract surgery: Microincision versus standard technique. J Cataract Refract Surg. 2006; 32:1351–4.

31. Díez-Ajenjo MA, García-Domene MC, Artigas JM. . Lens opacities in Valencia, Spain. Eur J Ophthalmol. 2011; 21:715–22.

32. Praveen MR, Shah GD, Vasavada AR. . A study to explore the risk factors for the early onset of cataract in India. Eye (Lond). 2010; 24:686–94.

33. Xu L, Cui T, Zhang S. . Prevalence and risk factors of lens opacities in urban and rural Chinese in Beijing. Ophthalmology. 2006; 113:747–55.

Table 1.

Causes of IOL Master measurement failure (N = 361)

Causes	N (%)
Posterior subcapsular cataract	202 (56.0)
Anterior subcapsular cataract	45 (12.5)
Anterior with posterior subcapsular cataract	23 (6.4)
Posterior polar cataract	21 (5.8)
White cataract	20 (5.5)
Unexplained cases	14 (3.9)
Brunescent cataract	13 (3.6)
Low visual acuity resulted in failed fixation	7 (1.9)
Morgagnian cataract	6 (1.7)
Cortical cataract	5 (1.4)
Corneal opacity	3 (0.8)
Ocular dyskinesia	1 (0.3)
Anterior polar cataract	1 (0.3)

Values are presented as n (%). N = number of eyes.

Table 2.

Preoperative clinical characteristics of the participants and their eyes in each group

	Measurable group (n = 1,746)	Unmeasurable group (n = 361)	p-value^*
Age (years) (SD)	67.4 (10.1)	66.9 (12.9)	0.477^†
Sex (n, %)^‡
Male	687 (39.3)	195 (54.0)	<0.001
Female	1,059 (60.7)	166 (46.0)
Laterality (n, %)^‡
Right eye	862 (49.4)	175 (48.5)	0.812
Left eye	883 (50.6)	186 (51.5)
Endothelial cell density (cells/mm²) (SD)	2,868 (422)	2,919 (433)	0.040^†
Cataract grade
Nuclear opalescence (SD)	2.4 (0.8)	2.7 (1.4)	<0.001^†
Brunescent (n, %)^‡	3 (0.2)	13 (3.6)	<0.001
Posterior polar (n, %)^‡	5 (0.3)	21 (5.8)	<0.001
White (n, %)^‡	3 (0.2)	20 (5.5)	<0.001
Morgagnian (n, %)^‡	0 (0.0)	6 (1.7)	<0.001

SD = standard deviation.

^* Fisher’s exact test.

^† Independent t-test.

^‡ Frequency count.

Table 3.

Intraoperative and postoperative complication rate in the two groups

	Measurable group (n = 1,746)	Unmeasurable group (n = 361)	p-value^*
Intraoperative complication (n, %)
Posterior capsule rupture	7 (0.4)	8 (2.2)	0.001
Radial tear	4 (0.2)	9 (2.5)	<0.001
Hyphema	1 (0.1)	0 (0.0)	>0.999
Corneal burn	0 (0.0)	0 (0.0)	-
Tear of descemet’s membrane	2 (0.1)	0 (0.0)	>0.999
Postoperative complication (n, %)
Corneal edema	93 (5.3)	58 (16.1)	<0.001
Increased IOP	49 (2.8)	16 (4.4)	0.130
Hyphema	1 (0.1)	1 (0.3)	0.313

Values are presented as n (%) unless otherwise indicated. IOP = intraocular pressure.

^* Fisher’s exact test.

TOOLS

Similar articles