September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Comparison of refractive predictability between third and fourth generation intraocular lens formulas used in the DMEK triple procedure
Author Affiliations & Notes
  • Christopher Sanchez Sales
    Cornea, Ophthalmic Consultants of Boston, Boston, Massachusetts, United States
    Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, United States
  • Zachary Mayko
    Lions VisionGift, Portland, Oregon, United States
  • Joshua L Bockman
    Ophthalmology, Devers Eye Institute, Portland, Oregon, United States
  • R. Wayne Bowman
    Ophthalmology, University of Texas Southwestern, Dallas, Texas, United States
  • Michael D Straiko
    Ophthalmology, Devers Eye Institute, Portland, Oregon, United States
    Lions VisionGift, Portland, Oregon, United States
  • Mark A Terry
    Ophthalmology, Devers Eye Institute, Portland, Oregon, United States
    Lions VisionGift, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Christopher Sales, None; Zachary Mayko, None; Joshua Bockman, None; R. Wayne Bowman, None; Michael Straiko, None; Mark Terry, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1196. doi:
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      Christopher Sanchez Sales, Zachary Mayko, Joshua L Bockman, R. Wayne Bowman, Michael D Straiko, Mark A Terry; Comparison of refractive predictability between third and fourth generation intraocular lens formulas used in the DMEK triple procedure. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1196.

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

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Abstract

Purpose : To compare the refractive predictability of the SRK-T (ST), Hoffer-Q (HQ), Holladay 1 (H1), and Olsen (OS) lens formulas in the DMEK triple procedure in short, medium, and long eyes.

Methods : A retrospective review was conducted of a prospective consecutive series of DMEK triple cases performed at one center. Optical biometry was performed with the Lenstar. Standard cataract surgery with a one piece acrylic IOL was performed followed by DMEK surgery according to a published standardized technique: pre-stripped and S-stamped tissue provided by an eye bank, overstripping of the recipient, modified glass Jones tube, no-touch tap technique, and 20% SF6 gas bubble. Manifest refraction was measured at 6-months. The difference between the achieved spherical equivalent (SE) and the predicted SE was compared between the HQ, ST, H1, and OS formulas. Eyes were grouped by axial length (short: <22 mm; medium: 22-26 mm; and long: >26 mm).

Results : 60 consecutive eyes were included in the study. Among eyes < 22 mm (n=4), the mean differences between the predicted and achieved SE for the ST, HQ, H1, and OS formulas were -0.19 D, -0.43 D, -0.19 D, and 0.13 D, respectively. Among eyes 22-26 mm (n=53), the mean differences were 0.33 D, 0.37 D, 0.36 D, and 0.47 D, respectively. Among eyes > 26 mm (n=3), the mean differences were 0.07 D, 0.54 D, 0.44 D, and 0.17 D, respectively. In the 22-26 mm subgroup, the ST had a smaller difference compared to the H1 (p=0.03) but exhibited equivalence compared to the HQ (p=0.75) and OS (p=0.37).

Conclusions : In eyes undergoing the DMEK triple, the SRK-T, Hoffer-Q, Holladay 1, and Olsen formulas may exhibit different gradations of predictability. If this postulate is confirmed in a larger study, it may be possible to refine the intraocular lens target (at this center it is -0.7 D to achieve emmetropia) according to the formula used by the surgeon.

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

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