Positional accommodative intraocular lens power error induced by the estimation of the corneal power and the effective lens position

• Main Authors: David P Piñero, Vicente J Camps, María L Ramón, Verónica Mateo, Rafael J Pérez-Cambrodí
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2015-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Community; digital imaging; Karnataka Internet-assisted Diagnosis of Retinopathy of Prematurity; retinopathy of prematurity; telemedicine; universal screening; Age-related macular degeneration; en-face optical coherence tomography; polypoidal choroidal vasculopathy; Choroid; enhanced depth imaging technique; swept source optical coherence tomography; Choroidal imaging; choroidal thickness; retinal dystrophies; Choroidal neovascularization; idiopathic juxtafoveal telangiectasis; juxtafoveal retinal telangiectasia; lutein; macular edema; macular pigment; macular telangiectasia; Müller cells; parafoveal telangiectasis; perifoveal telangiectasis; retinal angiomatous proliferation; retinal telangiectasis; subretinal neovascularization; zeaxanthin; Microscope-integrated optical coherence tomography; RESCAN; spectral domain optical coherence tomography; vitreoretinal surgery; Central reading center; randomized controlled trial; standard operating procedure; Fundus autofluorescence; lipofuscin; retina; retinal imaging; Cystoid macular edema; dexamethasone implant; external limiting membrane; optical coherence tomography; Ozurdex; serous retinal detachment; uveitis; Adaptive optics; axial length; cone density; myopia; Artifact; foveal diameter; foveal slope; ocular magnification; Emmetropization; hand-held; spectral-domain optical coherence tomography; visual acuity; Accommodating intraocular lenses; Crystalens HD; effective lens position; intraocular lenses power; keratometry
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2015;volume=63;issue=5;spage=438;epage=444;aulast=Piñero
• ISSN: 0301-4738; 1998-3689

Purpose: To evaluate the predictability of the refractive correction achieved with a positional accommodating intraocular lenses (IOL) and to develop a potential optimization of it by minimizing the error associated with the keratometric estimation of the corneal power and by developing a predictive formula for the effective lens position (ELP). Materials and Methods: Clinical data from 25 eyes of 14 patients (age range, 52-77 years) and undergoing cataract surgery with implantation of the accommodating IOL Crystalens HD (Bausch and Lomb) were retrospectively reviewed. In all cases, the calculation of an adjusted IOL power (P IOLadj ) based on Gaussian optics considering the residual refractive error was done using a variable keratometric index value (n kadj ) for corneal power estimation with and without using an estimation algorithm for ELP obtained by multiple regression analysis (ELP adj ). P IOLadj was compared to the real IOL power implanted (P IOLReal , calculated with the SRK-T formula) and also to the values estimated by the Haigis, HofferQ, and Holladay I formulas. Results: No statistically significant differences were found between P IOLReal and P IOLadj when ELP adj was used (P = 0.10), with a range of agreement between calculations of 1.23 D. In contrast, P IOLReal was significantly higher when compared to P IOLadj without using ELP adj and also compared to the values estimated by the other formulas. Conclusions: Predictable refractive outcomes can be obtained with the accommodating IOL Crystalens HD using a variable keratometric index for corneal power estimation and by estimating ELP with an algorithm dependent on anatomical factors and age.