Abstract
Purpose :
To analyze the refractive outcomes of patients that underwent Descemet membrane endothelial keratoplasty (DMEK) combined with phacoemulsification comparing preoperative intraocular lens (IOL) power calculation with IOLMaster® 500 (Carl Zeiss Meditec AG, Jena, Germany) and Pentacam® AXL (OCULUS Optikgeraete GmbH, Wetzlar, Germany).
Methods :
70 eyes of 70 consecutive patients with Fuchs endothelial corneal dystrophy (FECD) were included in this retrospective analysis. Preoperative IOL power calculation was done using IOLMaster® 500 and Pentacam® AXL. Based on previous data, a hyperopic refractive shift of about -1.0 diopters (dpt.) had been expected and was therefore added to the target refraction. All eyes received the same intraocular lens. The calculated target refraction of both methods was compared to the refractive error at follow-up. Patients were examined 3 months postoperatively after stable refraction was achieved. Main outcome measures included postoperative refractive shift, preoperative axial length and preoperative anterior corneal curvature.
Results :
IOL power selection was based on the IOL power calculation by IOLMaster® 500 as our standard routine procedure. Preoperative anterior corneal radii and axial length showed no statistical difference (corneal radii: p=0.58, Mann-Whitney-U, axial length: p=0.86, Mann-Whitney-U). Comparing the postoperative refractive shift, the two methods showed a statistically significant difference (p<0.001, Mann-Whitney-U). Postoperative refractive shift was less in the Pentacam® AXL (IOLMaster® 500 mean +0.53 ± 1.0dpt.; Pentacam® AXL mean -0.14 ± 0.9dpt.).
Conclusions :
IOL power calculation in DMEK combined with phacoemulsification based on the Scheimpflug principle Pentacam® AXL showed preoperatively calculated target refractions which were closer to the postoperative outcome than in IOL power calculations by interferometry IOLMaster® 500. This might be explained by inclusion of the posterior corneal power into the calculation by the Pentacam® AXL.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.