Power prediction for one-piece and three-piece intraocular lens implantation after cataract surgery in patients with chronic angle-closure glaucoma: a prospective, randomized clinical trial

Acta Ophthalmol. 2012 Dec;90(8):e580-5. doi: 10.1111/j.1755-3768.2012.02499.x. Epub 2012 Sep 12.

Abstract

Purpose: To assess the accuracy of intraocular lens (IOL) power prediction for cataract surgery in chronic angle-closure glaucoma (CACG) patients with different IOLs' implantation.

Methods: This prospective randomized clinical trial included 45 eyes with CACG and 48 eyes with normal controls undergoing cataract surgery. In the CACG group, 23 eyes (51%) had three-piece IOL implantation and 22 eyes (49%) had one-piece IOL implantation. In the normal control group, 25 eyes (52%) had three-piece IOL implantation and 23 eyes (48%) had one-piece IOL implantation. Using the SRK/T formula, the mean difference between the predicted and actual postoperative spherical equivalent [mean absolute error (MAE)] was obtained and converted to natural logarithm (ln) for statistical analysis. The power of the implanted IOL was calculated to predict postoperative SE using three formulas: SRK II, Holladay II and Hoffer Q by post hoc analysis in each group. The predictive accuracy of each formula was analysed by comparing the lnMAE.

Results: In the one-piece IOL group, there was no difference in lnMAE between the CACG and normal control group (p = 0.314). In the three-piece IOL group, the lnMAE of the CACG group was larger than that of the normal control group (p < 0.001). The lnMAEs calculated by the SRK/T formula were more accurate than the Holladay II (p = 0.045) and Hoffer Q (p = 0.042) formula in the CACG one-piece IOL group.

Conclusions: Implantation of one-piece IOLs provides similar power prediction accuracy comparable to normal cataract patients; this result may be explained by the IOL haptic configuration or design.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms
  • Biometry
  • Cataract / complications*
  • Chronic Disease
  • Female
  • Glaucoma, Angle-Closure / complications*
  • Humans
  • Intraocular Pressure / physiology
  • Lens Implantation, Intraocular*
  • Lenses, Intraocular*
  • Male
  • Middle Aged
  • Optics and Photonics*
  • Phacoemulsification*
  • Prospective Studies
  • Prosthesis Design
  • Refraction, Ocular / physiology
  • Reproducibility of Results
  • Tonometry, Ocular
  • Visual Acuity / physiology