Yonsei Med J.  2015 May;56(3):805-811. 10.3349/ymj.2015.56.3.805.

Intraocular Lens Power Estimation in Combined Phacoemulsification and Pars Plana Vitrectomy in Eyes with Epiretinal Membranes: A Case-Control Study

Affiliations
  • 1Department of Ophthalmology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.
  • 2Institute of Vision Research, Department of Ophthalmology, Severance Eye and ENT Hospital, Yonsei University College of Medicine, Seoul, Korea. semekim@yuhs.ac

Abstract

PURPOSE
To evaluate the accuracy of postoperative refractive outcomes of combined phacovitrectomy for epiretinal membrane (ERM) in comparison to cataract surgery alone.
MATERIALS AND METHODS
Thirty-nine eyes that underwent combined phacovitrectomy with intraocular lens (IOL) implantation for cataract and ERM (combined surgery group) and 39 eyes that received phacoemulsification for cataract (control group) were analyzed, retrospectively. The predicted preoperative refractive aim was compared with the results of postoperative refraction.
RESULTS
In the combined surgery group, refractive prediction error by A-scan and IOLMaster were -0.305+/-0.717 diopters (D) and -0.356+/-0.639 D, respectively, compared to 0.215+/-0.541 and 0.077+/-0.529 in the control group, showing significantly more myopic change compared to the control group (p=0.001 and p=0.002, respectively). Within each group, there was no statistically significant difference in refractive prediction error between A-scan and IOLMaster (all p>0.05). IOL power calculation using adjusted A-scan measurement of axial length based on the macular thickness of the normal contralateral eye still resulted in significant postoperative refractive error (all p<0.05). Postoperative refraction calculated with adjusted axial length based on actual postoperative central foveal thickness change showed the closest value to the actual postoperative achieved refraction (p=0.599).
CONCLUSION
Combined phacovitrectomy for ERM resulted in significantly more myopic shift of postoperative refraction, compared to the cataract surgery alone, for both A-scan and IOLMaster. To improve the accuracy of IOL power estimation in eyes with cataract and ERM, sequential surgery for ERM and cataract may need to be considered.

Keyword

Cataract surgery with vitrectomy; epiretinal membranes; myopic shift; phacovitrectomy; IOL power calculation

MeSH Terms

Aged
Biometry/methods
Case-Control Studies
Cataract Extraction
Epiretinal Membrane/*surgery
Eye
Female
Humans
*Lens Implantation, Intraocular
*Lenses, Intraocular
Male
Optics and Photonics
Phacoemulsification/*methods
Postoperative Period
Refraction, Ocular/physiology
Retrospective Studies
Treatment Outcome
Vision Tests
Visual Acuity
Vitrectomy/*methods

Cited by  1 articles

The Clinical Characteristics of Spontaneous Separated Idiopathic Epiretinal Membrane
Dong Hyun Kang, Seok Hyun Lee
J Korean Ophthalmol Soc. 2019;60(12):1216-1222.    doi: 10.3341/jkos.2019.60.12.1216.


Reference

1. Demetriades AM, Gottsch JD, Thomsen R, Azab A, Stark WJ, Campochiaro PA, et al. Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology. Am J Ophthalmol. 2003; 135:291–296.
Article
2. Hwang JU, Yoon YH, Kim DS, Kim JG. Combined phacoemulsification, foldable intraocular lens implantation, and 25-gauge transconjunctival sutureless vitrectomy. J Cataract Refract Surg. 2006; 32:727–731.
Article
3. Heiligenhaus A, Holtkamp A, Koch J, Schilling H, Bornfeld N, Lösche CC, et al. Combined phacoemulsification and pars plana vitrectomy: clear corneal versus scleral incisions: prospective randomized multicenter study. J Cataract Refract Surg. 2003; 29:1106–1112.
Article
4. McEwan JR, Massengill RK, Friedel SD. Effect of keratometer and axial length measurement errors on primary implant power calculations. J Cataract Refract Surg. 1990; 16:61–70.
Article
5. Olsen T. Sources of error in intraocular lens power calculation. J Cataract Refract Surg. 1992; 18:125–129.
Article
6. Kovács I, Ferencz M, Nemes J, Somfai G, Salacz G, Récsán Z. Intraocular lens power calculation for combined cataract surgery, vitrectomy and peeling of epiretinal membranes for macular oedema. Acta Ophthalmol Scand. 2007; 85:88–91.
Article
7. Suzuki Y, Sakuraba T, Mizutani H, Matsuhashi H, Nakazawa M. Postoperative refractive error after simultaneous vitrectomy and cataract surgery. Ophthalmic Surg Lasers. 2000; 31:271–275.
Article
8. Jeoung JW, Chung H, Yu HG. Factors influencing refractive outcomes after combined phacoemulsification and pars plana vitrectomy: results of a prospective study. J Cataract Refract Surg. 2007; 33:108–114.
Article
9. Patel D, Rahman R, Kumarasamy M. Accuracy of intraocular lens power estimation in eyes having phacovitrectomy for macular holes. J Cataract Refract Surg. 2007; 33:1760–1762.
Article
10. Hotta K, Sugitani A. Refractive changes in silicone oil-filled pseudophakic eyes. Retina. 2005; 25:167–170.
Article
11. Iwase T, Sugiyama K. Investigation of the stability of one-piece acrylic intraocular lenses in cataract surgery and in combined vitrectomy surgery. Br J Ophthalmol. 2006; 90:1519–1523.
Article
12. Falkner-Radler CI, Benesch T, Binder S. Accuracy of preoperative biometry in vitrectomy combined with cataract surgery for patients with epiretinal membranes and macular holes: results of a prospective controlled clinical trial. J Cataract Refract Surg. 2008; 34:1754–1760.
Article
13. Manvikar SR, Allen D, Steel DH. Optical biometry in combined phacovitrectomy. J Cataract Refract Surg. 2009; 35:64–69.
Article
14. Verhulst E, Vrijghem JC. Accuracy of intraocular lens power calculations using the Zeiss IOL master. A prospective study. Bull Soc Belge Ophtalmol. 2001; 61–65.
15. Petternel V, Menapace R, Findl O, Kiss B, Wirtitsch M, Rainer G, et al. Effect of optic edge design and haptic angulation on postoperative intraocular lens position change. J Cataract Refract Surg. 2004; 30:52–57.
Article
16. Gao Q, Chen X, Ge J, Liu Y, Jiang Z, Lin Z, et al. Refractive shifts in four selected artificial vitreous substitutes based on Gullstrand-Emsley and Liou-Brennan schematic eyes. Invest Ophthalmol Vis Sci. 2009; 50:3529–3534.
Article
17. Mehdizadeh M, Nowroozzadeh MH. Postoperative induced myopia in patients with combined vitrectomy and cataract surgery. J Cataract Refract Surg. 2009; 35:798–799.
Article
18. Byrne S, Ng J, Hildreth A, Danjoux JP, Steel DH. Refractive change following pseudophakic vitrectomy. BMC Ophthalmol. 2008; 8:19.
Article
19. Hamoudi H, La Cour M. Refractive changes after vitrectomy and phacovitrectomy for macular hole and epiretinal membrane. J Cataract Refract Surg. 2013; 39:942–947.
Article
20. Kojima T, Tamaoki A, Yoshida N, Kaga T, Suto C, Ichikawa K. Evaluation of axial length measurement of the eye using partial coherence interferometry and ultrasound in cases of macular disease. Ophthalmology. 2010; 117:1750–1754.
Article
21. Yuen CY, Cheung BT, Tsang CW, Lam RF, Baig NB, Lam DS. Surgically induced astigmatism in phacoemulsification, pars plana vitrectomy, and combined phacoemulsification and vitrectomy: a comparative study. Eye (Lond). 2009; 23:576–580.
Article
22. Sun HJ, Choi KS. Improving intraocular lens power prediction in combined phacoemulsification and vitrectomy in eyes with macular oedema. Acta Ophthalmol. 2011; 89:575–578.
Article
Full Text Links
  • YMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr