April 2009
Volume 50, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2009
Performing Accurate IOL Power Calculations in Patients Undergoing Combined DSEK and Cataract Extraction
Author Affiliations & Notes
  • A. J. Aldave
    Cornea Service, CHS/UCLA, Los Angeles, California
  • Footnotes
    Commercial Relationships  A.J. Aldave, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 638. doi:
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      A. J. Aldave; Performing Accurate IOL Power Calculations in Patients Undergoing Combined DSEK and Cataract Extraction. Invest. Ophthalmol. Vis. Sci. 2009;50(13):638.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To quantitate the expected refractive shift following DSEK surgery to facilitate selection of the appropriate intraocular lens (IOL) power in patients undergoing combined DSEK and cataract extraction.

Methods: : The charts of all patients who underwent combined cataract extraction, IOL implantation and DSEK between May 2006 and November 2008 by a single surgeon were reviewed. The difference between the stable post-operative refraction and the expected post-operative refractive error based on the pre-operative IOL power calculation was determined for each patient.

Results: : Sixteen cases of combined cataract extraction, IOL implantation and DSEK were performed during the study period. In each case, either a one piece or three piece IOL was placed in the capsular bag. A reliable post-operative refraction was obtained in 13 of the 16 cases (81%); two patients had less than 1 month follow-up and 1 patient had significantly limited visual acuity secondary to a submacular choroidal melanoma. A hyperopic refractive shift was observed in 12 of the 13 eyes, with a mean hyperopic shift of +1.30 D, and a range from +0.20 D to +2.96 D (SD = 0.88 D). One patient experienced a myopic refractive shift of -1.98 D, although as the best-corrected visual acuity was 20/70, the validity of the measured refractive error was questioned.

Conclusions: : DSEK surgery is associated with a hyperopic shift of approximately +1.30 D. Given this, as well as the relatively large standard deviation of post-operative refractive errors that was observed, surgeons should select an IOL power that is predicted to result in a post-operative refractive error of -1.50 to -2.00 D when performing combined DSEK and cataract extraction.

Keywords: transplantation • cornea: clinical science • intraocular lens 
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