Abstract

Purpose: To analyze the consistency between preoperatively estimated and postoperatively measured total spherical aberration and to evaluate the feasibility of personalized selection of an aspherical intraocular lens (IOL) based on the corneal spherical aberration measured by the Scheimpflug photography system (Pentacam).

Methods: A total of 47 patients(82 eyes) with age-related cataract received a comprehensive ophthalmologic examination. Corneal spherical aberration was measured by using the Scheimpflug photography system. Patients with corneal spherical aberration ≤0.3 μm were implanted with a zero-spherical aberration advanced optics(AO) aspherical intraocular lens and those with corneal spherical aberration >0.3 μm received a Tecnis ZA9003 aspherical lens(-0.27 μm spherical aberration). Preoperative total remnant spherical aberration was estimated and actual total spherical aberration was measured 3 months postoperatively. The consistency between preoperative and postoperative spherical aberration was analyzed by t-test, correlation analysis, and Blant-Altman plots.

Results: The estimated and measured values of total spherical aberration were (0.189±0.151) μm and (0.141±0.131) μm, with a statistical difference(t=5.347, P<0.01). For 45 eyes implanted with AO lenses, preoperatively estimated and post-operatively measured total spherical aberration were (0.268±0.137) μm and (0.214±0.103) μm. For 37 eyes implanted with Tecnis ZA9003, preoperative estimate of total spherical aberration was (0.092±0.103) μm and postoperative measured value was (0.054±0.106) μm. Statistical significance was noted, as was a positive linear correlation between preoperative and postoperative values(y=0.846, P<0.01). Bland-Altman analysis showed high consistency between the estimated and measured spherical aberration.

Conclusion: The estimated total spherical aberration measured preoperatively differed from the value measured postoperatively, but the two values showed good agreement. It is clinically feasible to conduct personalized selection of aspherical IOL based on Scheimpflug photography system(Pentacam) to measure corneal spherical aberration. (Eye Science 2013; 28: 129-133)

Abstract

Purpose: To analyze the consistency between preoperatively estimated and postoperatively measured total spherical aberration and to evaluate the feasibility of personalized selection of an aspherical intraocular lens (IOL) based on the corneal spherical aberration measured by the Scheimpflug photography system (Pentacam).

Methods: A total of 47 patients(82 eyes) with age-related cataract received a comprehensive ophthalmologic examination. Corneal spherical aberration was measured by using the Scheimpflug photography system. Patients with corneal spherical aberration ≤0.3 μm were implanted with a zero-spherical aberration advanced optics(AO) aspherical intraocular lens and those with corneal spherical aberration >0.3 μm received a Tecnis ZA9003 aspherical lens(-0.27 μm spherical aberration). Preoperative total remnant spherical aberration was estimated and actual total spherical aberration was measured 3 months postoperatively. The consistency between preoperative and postoperative spherical aberration was analyzed by t-test, correlation analysis, and Blant-Altman plots.

Results: The estimated and measured values of total spherical aberration were (0.189±0.151) μm and (0.141±0.131) μm, with a statistical difference(t=5.347, P<0.01). For 45 eyes implanted with AO lenses, preoperatively estimated and post-operatively measured total spherical aberration were (0.268± 0.137) μm and (0.214±0.103) μm. For 37 eyes implanted with Tecnis ZA9003, preoperative estimate of total spherical aberration was (0.092±0.103) μm and postoperative measured value was (0.054±0.106) μm. Statistical significance was noted, as was a positive linear correlation between preoperative and postoperative values(y=0.846, P<0.01). Bland-Altman analysis showed high consistency between the estimated and measured spherical aberration.

Conclusion: The estimated total spherical aberration measured preoperatively differed from the value measured postoperatively, but the two values showed good agreement. It is clinically feasible to conduct personalized selection of aspherical IOL based on Scheimpflug photography system(Pentacam) to measure corneal spherical aberration. (Eye Science 2013; 28: 129-133)

Purpose: The surgical risk and complication rate after cataract surgery are extremely high in patients with nanophthalmos. This study is designed to compare the visual and refractive outcomes before and after coaxial micro-incision phacoemulsification and evaluate postoperative complications．

Methods: Fifty nine patients (89 eyes) with axial length (AL)＜21 mm diagnosed with nanophthalmos were enrolled in this retrospective study. All patients underwent coaxial micro-incision phacoemulsification and IOL implantation. The main outcome measures included anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), intraocular pressure (IOP) and best corrected visual acuity (BCVA). Wilcoxon signed rank test or Mann-Whitney test, and Chi-square test and logistic regression analysis were performed for statistical tests as appropriate．

Results: The median AL was 19．63 mm. Sixty-six eyes (74.16％) had a history of surgical intervention. Postoperative ACD, ACV and ACA were increased significantly (all P＜0.001), whereas postoperative IOP was decreased significantly. (P＜ 0.001) after surgery. Previous surgical intervention was related to a reduction in the postoperative ACD and ACA (P＜0.01), and both preoperative and postoperative IOP (P＜0.001). Postoperative BCVA was improved in 94．38％ of the cases. Intraoperative complications mainly included iridoschisis (6 eyes, 6.74％). Early postoperative complications included temporary corneal edema (TCE) (23 eyes, 25.84％), anterior inflammatory response (AIR) (19 eyes, 21.35％), cystoid macular edema (CME) (14 eyes, 15.73％), and uveal effusion (4 eyes, 4.49％). Late postoperative complications included CME (8 eyes, 8.99％),  uveal effusion (8 eyes, 8.99％), malignant glaucoma (2 eyes, 2.25％) and posterior capsular opacification (PCO)(10 eyes, 11.24％). The majority of complications (80％) were successfully resolved by pharmacotherapy or operation. The risk of surgical complications was greater in patients with lower AL, ACD, ACV or ACA and higher nuclear hardness or mean keratometry (Km).

Conclusion: With reasonable preoperative management, prudent selection of the lens, rigorous surgical technique and unerring cognition of potential complications, coaxial microincision phacoemulsification lens surgery can be performed in patients with nanophthalmos and yield favorable outcomes and a low incidence of complications.

Purpose: The surgical risk and complication rate after cataract surgery are extremely high in patients with nanophthalmos. This study is designed to compare the visual and refractive outcomes before and after coaxial micro-incision phacoemulsification and evaluate postoperative complications．

Methods: Fifty nine patients (89 eyes) with axial length (AL)＜21 mm diagnosed with nanophthalmos were enrolled in this retrospective study. All patients underwent coaxial micro-incision phacoemulsification and IOL implantation. The main outcome measures included anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), intraocular pressure (IOP) and best corrected visual acuity (BCVA). Wilcoxon signed rank test or Mann-Whitney test, and Chi-square test and logistic regression analysis were performed for statistical tests as appropriate．

Results: The median AL was 19．63 mm. Sixty-six eyes (74.16％) had a history of surgical intervention. Postoperative ACD, ACV and ACA were increased significantly (all P＜0.001), whereas postoperative IOP was decreased significantly. (P＜ 0.001) after surgery. Previous surgical intervention was related to a reduction in the postoperative ACD and ACA (P＜0.01), and both preoperative and postoperative IOP (P＜0.001). Postoperative BCVA was improved in 94．38％ of the cases. Intraoperative complications mainly included iridoschisis (6 eyes, 6.74％). Early postoperative complications included temporary corneal edema (TCE) (23 eyes, 25.84％), anterior inflammatory response (AIR) (19 eyes, 21.35％), cystoid macular edema (CME) (14 eyes, 15.73％), and uveal effusion (4 eyes, 4.49％). Late postoperative complications included CME (8 eyes, 8.99％),  uveal effusion (8 eyes, 8.99％), malignant glaucoma (2 eyes, 2.25％) and posterior capsular opacification (PCO)(10 eyes, 11.24％). The majority of complications (80％) were successfully resolved by pharmacotherapy or operation. The risk of surgical complications was greater in patients with lower AL, ACD, ACV or ACA and higher nuclear hardness or mean keratometry (Km).

Conclusion: With reasonable preoperative management, prudent selection of the lens, rigorous surgical technique and unerring cognition of potential complications, coaxial microincision phacoemulsification lens surgery can be performed in patients with nanophthalmos and yield favorable outcomes and a low incidence of complications.