September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Lens Power Calculation for Aphakic Patients Undergoing Small-Gauge Vitrectomy Aided 4 Point Scleral Fixation Intraocular Lens (IOL) Implantation
Author Affiliations & Notes
  • Reema Syed
    Ophthalmology, University of Louisville, Louisville, Kentucky, United States
  • Amir Hadayer
    Ophthalmology, University of Louisville, Louisville, Kentucky, United States
  • Denis Jusufbegovic
    Ophthalmology, University of Louisville, Louisville, Kentucky, United States
  • Wei Wang
    Ophthalmology, University of Louisville, Louisville, Kentucky, United States
  • Shlomit Schaal
    Ophthalmology, University of Louisville, Louisville, Kentucky, United States
  • Footnotes
    Commercial Relationships   Reema Syed, None; Amir Hadayer, None; Denis Jusufbegovic, None; Wei Wang, None; Shlomit Schaal, None
  • Footnotes
    Support  unrestricted institutional grant from Research to Prevent Blindness (RPB)
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4458. doi:
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      Reema Syed, Amir Hadayer, Denis Jusufbegovic, Wei Wang, Shlomit Schaal; Lens Power Calculation for Aphakic Patients Undergoing Small-Gauge Vitrectomy Aided 4 Point Scleral Fixation Intraocular Lens (IOL) Implantation. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4458.

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

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Abstract

Purpose : To report visual results and accuracy of IOL power calculation for small gauge vitrectomy aided 4 point scleral fixated IOLs in aphakic patients

Methods : Outcomes of 17 eyes that underwent small gauge vitrectomy assisted scleral fixation of IOL using Bausch and Lomb Akreos (4 haptic) AO60 lens and CV-8 Gore-Tex sutures were reviewed. Surgery involved needle-less introduction of sutures into the eye using intra-ocular small gauge forceps, passing sutures through the 4 haptic loops of IOL, and scleral fixation of sutures 2mm posterior to the limbus. Two month post-op best-corrected visual acuity (BCVA), intraocular pressure (IOP) and refractive error were measured. Anterior segment photography using Galilei Dual Scheimpflug Analyzer (GDSA) (Ziemer Group, Port, Switzerland) was used to measure actual IOL position post-operatively. Lens power selection formula was derived to achieve emmetropia

Results : Patients underwent 23G (n=2), 25G (n=10) and 27G (n=5) vitrectomy-assisted scleral fixation of IOL. Indications for surgery were aphakia secondary to lensectomy after traumatic retinal detachment and open globe repair, subluxed crystalline lens after blunt trauma and dislocated IOLs. There were 5 females and 11 males. Mean age was 57yrs(±SD10, 37-82yrs). VA ranged from 20/40 to 20/20000 pre-op (LogMAR mean 1.4±SD1.0) and 20/20 to 20/20000 post-op (LogMAR mean 0.9±SD1.1). Mean improvement in VA was 1.2 Snellen lines(±SD1.2,0-3 lines), LogMAR mean 0.1(±SD 0.1,0-0.4). Mean post-op IOP was 13 mmHg (±SD 4, 7-19mmHg). Mean follow-up was 5 months (±SD 3 months). Mean post-op effective lens position, measured from corneal endothelium to anterior surface of IOL was 4.1mm (±SD 0.2, 3.6-4.3mm). Mean post-op spherical equivalent was -0.7D(±SD 0.7, -1.5 to +0.4D). There were no complications.

Conclusions : Small gauge vitrectomy aided scleral fixation of PC-IOL for aphakic patients post trauma results in reproducible visual outcomes and no complications. To achieve emmetropia, IOL power should be reduced by +0.75-1D. Although traumatic optic neuropathy or maculopathy hindered visual outcome in some patients, this study showed that visual improvement is possible with appropriate surgical planning

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Anterior segment photograph using Galilei Dual Scheimpflug Analyzer. Post-operative IOL position is shown measured from corneal endothelium to anterior surface of IOL.

Anterior segment photograph using Galilei Dual Scheimpflug Analyzer. Post-operative IOL position is shown measured from corneal endothelium to anterior surface of IOL.

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