J Korean Ophthalmol Soc.  2015 May;56(5):737-744. 10.3341/jkos.2015.56.5.737.

Accuracy of Intraocular Lens Power Estimation in Eyes Undergoing Phacovitrectomy for Proliferative Diabetic Retinopathy

Affiliations
  • 1Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, Korea. eunjee95@nhimc.or.kr

Abstract

PURPOSE
To evaluate the accuracy of intraocular lens (IOL) power estimation and the factors associated with outcome in eyes undergoing combined phacovitrectomy for proliferative diabetic retinopathy.
METHODS
We performed a retrospective case review of 39 consecutive patients (44 eyes) that underwent phacovitrectomy for proliferative diabetic retinopathy. Axial lengths were measured using ultrasound (A-scan) and/or optical biometry (IOL Master). Achieved and predicted refractions were compared to calculate the mean postoperative refractive prediction error (ME) and the mean absolute prediction error (MAE). Systemic conditions of patients and several preoperative and postoperative factors related to the postoperative refraction were analyzed.
RESULTS
The ME of 44 eyes were -0.23 +/- 0.52 diopters (D) and -0.23 +/- 0.47 D after 3 and 6 months, respectively (range, -1.40~+0.79 D). There was no statistically significant difference in the refractive outcomes between the refractive errors (p = 0.959). The MAEs were 0.45 +/- 0.35 D and 0.40 +/- 0.33 D after 3 and 6 months, respectively with no statistical significant difference between the results (p = 0.196). When comparing ME in the 20 eyes that achieved both results, ultrasound was more accurate than optical biometry (p = 0.002, 0.002). The factors associated with more inaccurate ME and MAE after phacovitrectomy were diabetic nephropathy and neovascular glaucoma.
CONCLUSIONS
Combined phacovitrectomy in proliferative diabetic retinopathy showed small biometric errors within the tolerable range in most cases. Patients with neovascular glaucoma and diabetic nephropathy had more inaccurate postoperative refractive power. Both optical biometry and ultrasound should be used to estimate axial lengths for improving the accuracy of IOL power calculation.

Keyword

Biometry; Phacovitrectomy; Proliferative diabetic retinopathy; Refractive error

MeSH Terms

Biometry
Diabetic Nephropathies
Diabetic Retinopathy*
Glaucoma, Neovascular
Humans
Lenses, Intraocular*
Refractive Errors
Retrospective Studies
Ultrasonography

Cited by  1 articles

Intracameral Epinephrine Injection after Phacoemulsification on Pupil Dilation during Phacovitrectomy for Proliferative Diabetic Retinopathy
Sangbum Kim, Jongyeop Park, Jaeryung Shin, Seungwoo Lee
J Korean Ophthalmol Soc. 2018;59(12):1137-1141.    doi: 10.3341/jkos.2018.59.12.1137.


Reference

References

1. Thompson JT, Glaser BM, Sjaarda RN, Murphy RP. Progression of nuclear sclerosis and long-term visual results of vitrectomy with transforming growth factor beta-2 for macular holes. Am J Ophthalmol. 1995; 119:48–54.
Article
2. Holekamp NM, Shui YB, Beebe DC. Vitrectomy surgery increases oxygen exposure to the lens: a possible mechanism for nuclear cataract formation. Am J Ophthalmol. 2005; 139:302–10.
Article
3. Melberg NS, Thomas MA. Nuclear sclerotic cataract after vitrectomy in patients younger than 50 years of age. Ophthalmology. 1995; 102:1466–71.
Article
4. 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; 33:108–14.
5. Chung TY, Chung H, Lee JH. Combined surgery and sequential surgery comprising phacoemulsification, pars plana vitrectomy, and intraocular lens implantation: comparison of clinical outcomes. J Cataract Refract Surg. 2002; 28:2001–5.
6. Patel D, Rahman R, Kumarasamy M. Accuracy of intraocular lens power estimation in eyes having phacovitrectomy for macular holes. J Cataract Refract Surg. 2007; 33:1760–2.
Article
7. Manvikar SR, Allen D, Steel DH. Optical biometry in combined phacovitrectomy. J Cataract Refract Surg. 2009; 35:64–9.
Article
8. Chylack LT Jr, Wolfe JK, Singer DM, et al. The lens opacities classification system III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol. 1993; 111:831–6.
9. Rice TA, Michels RG, Maguire MG, Rice EF. The effect of lensec-tomy on the incidence of iris neovascularization and neovascular glaucoma after vitrectomy for diabetic retinopathy. Am J Ophthalmol. 1983; 95:1–11.
Article
10. Scharwey K, Pavlovic S, Jacobi KW. Combined clear corneal phacoemulsification, vitreoretinal surgery, and intraocular lens implantation. J Cataract Refract Surg. 1999; 25:693–8.
Article
11. Demetriades AM, Gottsch JD, Thomsen R, et al. Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology. Am J Ophthalmol. 2003; 135:291–6.
Article
12. Suzuki Y, Sakuraba T, Mizutani H, et al. Postoperative refractive error after simultaneous vitrectomy and cataract surgery. Ophthalmic Surg Lasers. 2000; 31:271–5.
Article
13. Shioya M, Ogino N, Shinjo U. Change in postoperative refractive error when vitrectomy is added to intraocular lens implantation. J Cataract Refract Surg. 1997; 23:1217–20.
Article
14. 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; 34:1754–60.
15. Kucumen RB, Yenerel NM, Gorgun E, et al. Anterior segment optical coherence tomography measurement of anterior chamber depth and angle changes after phacoemulsification and intraocular lens implantation. J Cataract Refract Surg. 2008; 34:1694–8.
Article
16. Díaz Lacalle V, Orbegozo Gárate FJ, Martinez Alday N, et al. Phacoemulsification cataract surgery in vitrectomized eyes. J Cataract Refract Surg. 1998; 24:806–9.
17. McDermott ML, Puklin JE, Abrams GW, Eliott D. Phacoemulsification for cataract following pars plana vitrectomy. Ophthalmic Surg Lasers. 1997; 28:558–64.
Article
18. Rahman R, Bong CX, Stephenson J. Accuracy of intraocular lens power estimation in eyes having phacovitrectomy for rhegmatogenous retinal detachment. Retina. 2014; 34:1415–20.
Article
19. Song WK, Kim SS, Kim SE, Lee SC. Refractive status and visual acuity changes after oil removal in eyes following phacovitrectomy, intraocular lens implantation, and silicone oil tamponade. Can J Ophthalmol. 2010; 45:616–20.
Article
20. Lee DK, Lee SJ, You YS. Prediction of refractive error in combined vitrectomy and cataract surgery with one-piece acrylic intraocular lens. Korean J Ophthalmol. 2008; 22:214–9.
Article
21. Findl O, Kriechbaum K, Sacu S, et al. Influence of operator experience on the performance of ultrasound biometry compared to optical biometry before cataract surgery. J Cataract Refract Surg. 2003; 29:1950–5.
Article
22. Lee AC, Qazi MA, Pepose JS. Biometry and intraocular lens power calculation. Curr Opin Ophthalmol. 2008; 19:13–7.
Article
23. Kunavisarut P, Poopattanakul P, Intarated C, Pathanapitoon K. Accuracy and reliability of IOL master and A-scan immersion biometry in silicone oil-filled eyes. Eye (Lond). 2012; 26:1344–8.
Article
24. Findl O, Drexler W, Menapace R, et al. Improved prediction of intraocular lens power using partial coherence interferometry. J Cataract Refract Surg. 2001; 27:861–7.
Article
25. Kovács I, Ferencz M, Nemes J, et al. 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
26. Sun HJ, Choi KS. Improving intraocular lens power prediction in combined phacoemulsification and vitrectomy in eyes with macular oedema. Acta Ophthalmol. 2011; 89:575–8.
Article
27. Lim SS, Kim SD. Simulated operation of phacoemulsification, vitrectomy and posterior chamber intraocular lens implantation in proliferative diabetic retinopathy patients. J Korean Ophthalmol Soc. 1999; 40:2205–11.
28. Sung MS, Park TK, Ohn YH. Clinical analysis of combined vitrectomy and phacoemulsification with intraocular lens implantation for proliferative diabetic retinopathy. J Korean Ophthalmol Soc. 2005; 46:1333–41.
29. Christensen PK, Larsen S, Horn T, et al. Renal function and structure in albuminuric type 2 diabetic patients without retinopathy. Nephrol Dial Transplant. 2001; 16:2337–47.
Article
30. Weinreb RN, Wasserstrom JP, Parker W. Neovascular glaucoma following neodymium-YAG laser posterior capsulotomy. Arch Ophthalmol. 1986; 104:730–1.
Article
31. Blankenship GW, Machemer R. Long-term diabetic vitrectomy results. Report of 10 year follow-up. Ophthalmology. 1985; 92:503–6.
32. Benson WE, Brown GC, Tasman W, McNamara JA. Extracapsular cataract extraction, posterior chamber lens insertion, and pars plana vitrectomy in one operation. Ophthalmology. 1990; 97:918–21.
Article
33. Chung HY, Chung HJ, Choi JY, et al. Risk factors for neovascular glaucoma after vitrectomy in patients with proliferative diabetic retinopathy. J Korean Ophthalmol Soc. 2013; 54:1868–74.
Article
34. Lee JH, Kwon SJ, Shin JP, et al. Neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy and the Ahmed valve implantation. J Korean Ophthalmol Soc. 2006; 47:1417–26.
35. Wand M, Madigan JC, Gaudio AR, Sorokanich S. Neovascular glaucoma following pars plana vitrectomy for complications of diabetic retinopathy. Ophthalmic Surg. 1990; 21:113–8.
Article
36. Striga M, Ivanisević M. Comparison between efficacy of full-and mild-scatter (panretinal) photocoagulation on the course of diabetic rubeosis iridis. Ophthalmologica. 1993; 207:144–7.
Full Text Links
  • JKOS
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