The Effect of Preoperative Corneal Asphericity on the Refractive Outcomes of Multifocal Intraocular Lens Implantation

Jin Uk Beak; Hee Jong Shin; Chang Hyun Park; Woong Joo Whang; Kyung Sun Na; Hyun Seung Kim

doi:10.3341/jkos.2019.60.1.9

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Beak, Shin, Park, Whang, Na, and Kim: The Effect of Preoperative Corneal Asphericity on the Refractive Outcomes of Multifocal Intraocular Lens Implantation

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(1): 9-15.

Published online: 16 January 2019

DOI: https://doi.org/10.3341/jkos.2019.60.1.9

The Effect of Preoperative Corneal Asphericity on the Refractive Outcomes of Multifocal Intraocular Lens Implantation

Jin Uk Beak, MD, Hee Jong Shin, MD, Chang Hyun Park, MD, Woong Joo Whang, MD, Kyung Sun Na, MD, PhD, Hyun Seung Kim, MD, PhD

Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Address reprint requests to Hyun Seung Kim, MD, PhD. Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #10 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea. Tel: 82-2-3779-1240, Fax: 82-2-761-6869, sara514@catholic.ac.kr

Received 13 September 2018 Revised 18 October 2018 Accepted 28 December 2018

The Korean Ophthalmological Society

(open-access):

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 analyze the effects of preoperative corneal asphericity on the refractive outcomes of multifocal intraocular lens implantation by correlating Q-values on anterior corneal surfaces and the prediction errors after surgery.

Methods

Fifty-six eyes of 39 patients who underwent phacoemulsification, and multifocal intraocular lens implantation were included in this retrospective study. Intraocular lens power was calculated using the SRK/T, Hoffer Q, and Haigis formulas. The Q-values were measured at 6 mm, 7 mm, 8 mm, 9 mm, and 10 mm with a rotating Sheimpflug camera (Pentacam®, Oculus, Wetzlar, Germany). The relationship between the prediction errors and the Q-values at 6 mm, 7 mm, 8 mm, 9 mm, and 10 mm were assessed by linear regression.

Results

Two different multifocal intraocular lens models (Acrysof IQ RESTOR +2.5D SV25T0 [Alcon Laboratories Inc., Fort Worth, TX, USA] and ZEISS AT LISA tri 839MP [Carl Zeiss Meditec AG, Inc., Jena, Germany]) were implanted in 56 eyes. In both groups, regression analyses showed statistically significant relationships between the prediction errors and the Q-values at 6 mm, 7 mm, and 8 mm using the SRK/T formula. The correlation coefficient between the Q-values and the prediction errors were higher using the SRK/T formula than using the Hoffer-Q and Haigis formulas.

Conclusions

Corneal asphericity affected refractive power during implantation of a multifocal intraocular lens and, as the preoperative Q-value increased, it resulted in a hyperopic refractive outcome for oblate corneas. These results were especially prominent when the SRK/T formula was used.

Keywords: Cataract, Cornea, Intraocular lenses, Refractive errors

Figures and Tables

Figure 1

Scatter spot of axial length and the PE of the SRK/T formula. PE = prediction error; D = diopter.

Figure 2

Regression line showing the relationship between the PE of the SRK/T formula and corneal asphericity (Q-value 6 mm, 7 mm, 8 mm) in the (A) Acrysof group (left) and (B) ZEISS group (right). Straight line represent regression line, and two curved lines represent the 95% prediction interval. Scatter spot means patient distribution. PE = prediction error.

Table 1

Demographic data and ocular characteristics of the total patients

Values are presented as mean ± standard deviation or number unless otherwise indicated.

UCVA = uncorrected visual acuity; logMAR = the logarithm of the minimum angle of resolution; BCVA = best corrected visual acuity; D = diopter; IOL = intraocular lens.

Table 2

Demographic data and ocular charateristics of Acrysof IQ Restor (Alcon Laboratories Inc., Fort Worth, TX, USA) group and Zeiss AT LISA (Carl Zeiss Meditec AG, Inc., Jena, Germany) tri group

Values are presented as mean ± standard deviation unless or number otherwise indicated.

UCVA = uncorrected visual acuity; logMAR = the logarithm of the minimum angle of resolution; BCVA = best corrected visual acuity; D = diopter; IOL = intraocular lens.

Table 3

Refractive outcomes of IOL power calculation with the formulas evaluated after multifocal IOL implantation

Values are presented as mean ± standard deviation unless otherwise indicated.

IOL = intraocular lens; PE = prediction error; D = diopter; MAE = mean absolute error; MedAE = median absolute error.

Table 4

Correlation coefficients of 3 IOL formulas showing the relationship between the prediction error and corneal asphericity (Q-value)

IOL = intraocular lens; r = Pearson correlation coefficient.

^*Statistically significant.

Table 5

Correlation coefficients of the relationship between the mean keratometry and the corneal asphericity (Q-value)

D = diopter; r = correlation coefficient.

^*p-values were calculated by Pearson correlation test.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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