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Eva Juhasz, Tamas Filkorn, Kinga Kranitz, Gábor László Sándor, Illes Kovacs, Andrea Gyenes, Lorant Dienes, Zoltan Nagy, Cornea Study Group; IOL calculation after hyperopic refractive treatments-case report. Invest. Ophthalmol. Vis. Sci. 2013;54(15):818.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study was to show the importance of proper inraocular lens designing after refractive treatments. Ten years after hyperopic photorefractive keratectomy (PRK) two patients, who had symptoms of visual impairment because of cataract, underwent phacoemulsification. Medical history was not available regarding preoperative keratometry-readings.
To define the axial length and the depth of the anterior chamber, low coherence optical reflectometry (Lenstar LS 900, Haag-Streit, Heidelberg, Germany) was used. Keratometry values were measured by Scheimpflug-camera (Pentacam HR, Oculus, Wetzlar, Germany) and were calculated using Holladay EKR (Equivalent Keratometry Reading) formula in the corneal diameter of 3 millimeters. To calculate the proper intracular lens diopter Haigis, fourth generation formula was used. Postoperative wavefront analysis was performed using WASCA (Carl Zeiss Meditec AG, Jena, Germany).
Patient 1. was a 66-year-old male, who had underwent hyperopic PRK treatment in 2000 and the visual impairment symptoms of his left eye started in 2011: his uncorrected visual acuity was 20/200. In 2011 November he had phacoemulsification (with the implantation of +23.0D Bausch&Lomb LI61AO aspheric posterior chamber lens) on his left eye. 2 months after the surgery he had uncorrected visual acuity (UCVA) of 20/20. Patient 2. was a 55-year-old male, who also had underwent hyperopic refractive surgery in 2002 and his vision decreased also in 2011: the UCVA was 5/150 on his right eye and 20/40 on his left eye. The phacoemulsification was performed in April of 2011 (with the implantation of +27.0D SN60WaveFront Optimized Acrysof IQ posterior chamber lens) on his right eye and in November of 2011 (with the implantation of +26.0D Acrysof SA60AT posterior chamber lens) on his left eye. 2 months after the surgery he had UCVA of 20/20 on both eyes. The total eye root mean square and the higher order root mean square was 0.99 and 0.63 respectively on his right eye, and 0.77 and 0.43 respectively on his left eye. The increase of corneal induced astigmia was within 0.5 diopter according to Scheimpflug topographic results in both cases.
In conclusion results suggest that the Holladay EKR formula in the central corneal diameter of 3 millimeter was useful to calculate the diopter of the intraocular lenses following hyperopic refractive treatment if preoperative data are not available.
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