Refractive Change after Transscleral Fixation of Intraocular Lens.

Ahn, Yong Sun; Park, Yu Li; Kim, Hyun Seung

doi:2015.56.4.548

J Korean Ophthalmol Soc > Volume 56(4); 2015 > Article

Original Article

Journal of the Korean Ophthalmological Society 2015;56(4):548-558.
DOI: https://doi.org/10.3341/jkos.2015.56.4.548 Published online April 15, 2015.

Refractive Change after Transscleral Fixation of Intraocular Lens.

Yong Sun Ahn, Yu Li Park, Hyun Seung Kim

Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea. sara514@catholic.ac.kr

인공수정체 공막 봉합고정술 후 굴절력의 변화

안용선⋅박율리⋅김현승

가톨릭대학교 의과대학 안과 및 시과학교실

Abstract

PURPOSE
To evaluate the anterior chamber depth (ACD), extent of intraocular lens (IOL) tilt, and decentration and refractive error after transscleral fixation of IOL. METHODS: We retrospectively reviewed the medical records of 17 cases with transscleral fixation of IOL (6 with aphakia, 5 with IOL dislocation, and 6 with lens subluxation). The acrylic IOL (MN60AC(R)) was fixated in 12 eyes and the polymethylmethacrylate IOL (CZ70BD(R)) was fixated in 5 eyes at 1.0 mm posterior from the limbus. We analyzed the ACD, extent of IOL tilt and decentration, manifest refraction, refractive error, higher order aberration, and corneal endothelium at 2 weeks, 1 month and 2 months postoperatively. RESULTS: The mean ACD was 3.36 +/- 0.11 mm, 3.30 +/- 0.12 mm, and 3.27 +/- 0.13 mm, the mean extent of IOL tilt was 4.61 +/- 0.12degrees, 4.65 +/- 0.14degrees, and 4.60 +/- 0.12degrees and the mean extent of IOL decentration was 0.43 +/- 0.01 mm, 0.45 +/- 0.01 mm, and 0.45 +/- 0.01 mm at 2 weeks, 1 month and 2 months postoperatively, respectively in eyes with transscleral fixation of IOL. The ACD was shallower and the extent of IOL tilt and decentration was greater than with IOL in-the-bag insertion patients. The mean refractive errors were -0.55 +/- 0.27 D, -0.63 +/- 0.24 D, and -0.69 +/- 0.19 D at the same period, respectively. CONCLUSIONS: Although postoperative refractive error is influenced by surgeon factors such as incision size, distance of fixation suture from limbus, and tightness of suture material, according to our results, an IOL 0.75 D more hyperopic than predicted should be selected in transscleral fixation of IOL at 1.0 mm posterior from the limbus. Additionally, each surgeon should assess their specific results and modify the lens calculations accordingly.

Key Words: Decentration;Intraocular lens;Refractive error;Tilt;Transscleral fixation