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Intraocular Lens Formula Comparison of Flanged Intrascleral Intraocular Lens Fixation with Double Needle Technique
Daniel S Malach1, John Michael Guest1, Christopher Adam1
1Kresge Eye Institute/Wayne State University Department of Ophthalmology, Detroit, MI, USA.
Purpose:
To analyze visual outcomes and accuracy of intraocular lens (IOL) calculation formulas in predicting postoperative outcomes in patients undergoing flanged intrascleral IOL fixation.
Design:
Case Series.
Subjects:
Twenty-three patients who had undergone secondary IOL placement using flanged intrascleral fixation technique.
Methods:
Retrospective chart review.
Main Outcome Measures:
Corrected distance visual acuity (CDVA) and postoperative spherical equivalent based on manifest refraction.
Results:
Visual acuity improved from 20/577 to 20/58. Overall, the actual refraction was 0.06 D more myopic than predicted. Holladay 2, Sanders Retzlaff Kraff/Theoretical (SRK/T) and Barrett Universal II resulted in mild myopic surprise (-0.55, -0.18 and -0.20 D). Haigis and Hill-RBF (Radial Basis Function) resulted in mild hyperopic surprise (+0.28 and +0.28 D). Hoffer Q and Holladay 1 were the most accurate (-0.02D and -0.08 D).
Conclusion:
Flanged intrascleral IOL fixation improved vision even in patients with other posterior segment pathologies. The effective lens positioning is likely similar to in-the-bag positioning. Hoffer Q and Holladay 1 formulas with in-the-bag calculations were the most accurate.
