Changes in Ocular Biometrics Measured after Implantation of a Phakic Intraocular Lens

Jung Hoo Lee; Gyu Won Ryu; Byung Gun Park

doi:10.3341/jkos.2018.59.3.223

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Lee, Ryu, and Park: Changes in Ocular Biometrics Measured after Implantation of a Phakic Intraocular Lens

Original Article

J Korean Ophthalmol Soc 2018;59(3):223-229.

Published online: 7 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.3.223

Changes in Ocular Biometrics Measured after Implantation of a Phakic Intraocular Lens

Jung Hoo Lee, MD¹, Gyu Won Ryu, MD², Byung Gun Park, MD^1,

^¹Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea

^²Nunevit Eye Center, Busan, Korea

Address reprint requests to Byung Gun Park, MD Department of Ophthalmology, Inje University Busan Paik Hospital, #75 Bokji-ro, Busanjin-gu, Busan 47392, Korea Tel: 82-51-890-6016, Fax: 82-51-890-8722, E-mail: Kkul83@hanmail.net

Received 21 September 2017 Revised 26 December 2017 Accepted 19 February 2018

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 measure changes in ocular biometrics required for calculating intraocular lens powers during cataract surgery on phakic eyes undergoing implantation of a collamer lens (AQUA ICL [STAAR Surgical Company, Monrovia, CA, USA] or an Artiflex® lens [Ophtec BV, Groningen, Netherlands]) to correct myopia.

Methods

A total of 45 eyes of 23 patients who underwent implantation of iris-fixated or posterior chamber phakic intraocular lenses (pIOLs) for correction of myopia >−7D were evaluated using the euphakic mode of the IOL Master® 500 (Carl Zeiss Meditec AG, Jena, Germany) prior to pIOL implantation. After implantation, the axial length (AL) and anterior chamber depth (ACD) were measured 1 month postoperatively using both the euphakic and pseudophakic modes of the instrument. We compared differences between predicted IOL powers calculated using the Sanders-Retzlaff-Kraff/Theoretical (SRK/T) and Haigis formulae.

Results

Seventeen eyes (37.8%) receiving ICL and 28 (62.2%) Artiflex® pIOL implants were included in the study. After pIOL implantation, ALs measured by the euphakic and pseudophakic modes of the IOL Master were significantly longer (p = 0.03, p < 0.0001) and ACDs significantly shorter (p < 0.0001, p < 0.0001, respectively) than preoperatively. The changes after surgery were less when the euphakic rather than the pseudophakic measurement mode was employed. The postoperative IOL powers predicted by the SRK/T (−0.03D, p = 0.023) and Haigis formulae (−0.06D, p = 0.001) were significantly lower that the preoperative values. However, the differences were small and did not influence IOL power selection.

Conclusions

After pIOL implantation, AL changes were less when measured using the euphakic rather than the pseudophakic mode of the IOL Master. Although the ACDs differed significantly after pIOL implantation, the changes were too small to influence IOL power calculations. ACD measurements differed significantly from those of AL after IOL implantation. Thus, a pIOL implantation history may affect biometric findings during cataract surgery.

Keywords: Anterior chamber depth, Axial length, Phakic intraocular lens

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Table 1.

Patient characteristics of implantable collamerlens (ICL) and Artiflex® groups

	ICL	Artiflex	p-value
Eyes (n, %)	17 (37.8)	28 (62.2)
Age (years)	26.13 ± 6.21	22.86 ± 1.44	0.063
Gender (male/female)	2/7	5/9
SE (D)	−10.86 ± 4.21	−11.91 ± 3.68	0.435

Values are presented as mean ± SD or n (%) unless otherwise indicated. By student t-test.

SE = spherical equivalent; D = diopter.

Table 2.

Comparision of Ocular biometry measurements and IOL® master mode after phakic intraocular lens implantation

	Preoperative (mm)	IOL® master mode	Postoperative (mm)	Change of biometry	p-value*	p-value^†
AL	26.69 ± 0.99	Euphakic	26.70 ± 0.99	+0.01	0.031*	<0.001^†
		Pseudophakic	26.80 ± 0.99	+0.11	<0.001*
ACD	3.81 ± 0.14	Euphakic	3.69 ± 0.35	−0.11	<0.001*	0.228^†
		Pseudophakic	3.58 ± 0.15	−0.14	<0.001*

Values are presented as mean ± SD unless otherwise indicated. Preoperative values measured by euphakic mode. ‘Change of ocular biometry’ means ‘postoperative ocular biometry-preoperative ocular biometry’.

AL = axial length; ACD = anterior chamber depth.

^* Statistically significant difference (p < 0.05, paired t-test). Comparision of between preoperative and postopertive biometry;

^† Statistically significant difference (p < 0.05, paired t-test). Comparision of between IOL® master mode (euphakic and pseudophakic).

Table 3.

The change of ocular biometry after ICL and Artiflex® lens implantation

	Preoperative (mm)	Postoperative (mm)	p-value
AL
ICL	26.35 ± 0.99	26.36 ± 0.99	0.146
Artiflex	27.06 ± 0.87	27.08 ± 0.89	0.097
Total	26.69 ± 0.99	26.70 ± 0.99	0.030*
ACD
ICL	3.74 ± 0.14	3.58 ± 0.15	<0.001*
Artiflex	3.88 ± 0.17	3.81 ± 0.15	0.011*
Total	3.81 ± 0.31	3.69 ± 0.35	<0.001*

Values are presented as mean ± SD unless otherwise indicated. Postoperative values measured by euphakic mode.

AL = axial length; ICL = implantable collamer lens; ACD = anterior chamber depth.

^* Statistically significant difference (p < 0.05, paired t-test).

Table 4.

Comparision of predicted IOL power after phakic intraocular lens implantation

	Preoperative predicted IOL power (D)	IOL®master mode	Postoperative predicted IOL power (D)	Change of predicted IOL power (D)	p-value*	p-value^†
SRK/T	11.69 ± 2.72	Euphakic	11.66 ± 2.73	−0.03	0.023*	<0.001^†
		Pseudophakic	11.35 ± 2.72	−0.34	<0.001*
Haigis	11.67 ± 2.72	Euphakic	11.61 ± 2.72	−0.06	0.001*	<0.001^†
		Pseudophakic	11.29 ± 2.67	−0.38	<0.001*

Values are presented as mean ± SD unless otherwise indicated. Preoperative values measured by euphakic mode. ‘Change of ocular predicted IOL power’ means ‘postoperative predicted IOL power - preoperative predicted IOL power’.

SRK/T = Sanders-Retzlaff-Kraff/Theoretical; IOL = intraocular lens.

^* Statistically significant difference (p < 0.05, paired t-test). Comparision of between preoperative and postopertivepredicted IOL power;

^† Statistically significant difference (p < 0.05, paired t-test). Comparision of between IOL® master mode (euphakic and pseudophakic).

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