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Optics of Transplanted Grafts: IOL Calculation in Grafted Patients

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Corneal Transplantation
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Abstract

Modern methods of intraocular lens (IOL) calculation have significantly reduced the risk of employing an improper IOL power. The development of theoretical formulas has improved the accuracy of predicting the effective lens position, while the use of laser partial coherence interferometry has increased the accuracy of axial length measurement. IOL calculation in grafted patients, however, is more challenging due to different and peculiar clinical situations. These situations fall into two main scenarios. The first comprises patients who are candidates to combined cataract extraction, IOL implantation, and corneal graft (the triple procedure). The second includes patients who have previously undergone corneal graft. In this second scenario, IOL calculation may be required for cataract extraction, piggyback IOL, and phakic IOL implantation.

This chapter examines the challenges inherent in each clinical situation and discusses the strategies that can be adopted to tackle these situations and optimize IOL power calculation.

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References

  1. Gorovoy MS. Descemet-stripping automated endothelial keratoplasty. Cornea. 2006;25:886–9.

    Article  PubMed  Google Scholar 

  2. Koenig SB, Covert DJ, Dupps WJ, Meisler DM. Visual acuity, refractive error, and endothelial cell density six months after descemet stripping and automated endothelial keratoplasty. Cornea. 2007;26:670–4.

    Article  PubMed  Google Scholar 

  3. Jun B, Kuo AN, Afshari NA, et al. Refractive change after descemet stripping automated endothelial keratoplasty surgery and its correlation with graft thickness and diameter. Cornea. 2009;28:19–23.

    Article  PubMed  Google Scholar 

  4. Holz HA, Meyer JJ, Espandar L, et al. Corneal profile analysis after Descemet stripping endothelial keratoplasty and its relationship to postoperative hyperopic shift. J Cataract Refract Surg. 2008;34:211–4.

    Article  PubMed  Google Scholar 

  5. Chen ES, Terry MA, Shamie N, et al. Stability of hyperopic refractive shift following descemet-stripping automated endothelial keratoplasty. J Cataract Refract Surg. 2009;35:113–20.

    Article  Google Scholar 

  6. Scorcia V, Matteoni S, Scorcia GB, et al. Pentacam assessment of posterior lamellar grafts to explain hyperopization after descemet’s stripping automated endothelial keratoplasty. Ophthalmology. 2009;116:1651–5.

    Article  PubMed  Google Scholar 

  7. Koenig SB, Covert DJ. Early results of small-incision descemet’s stripping and automated endothelial keratoplasty. Ophthalmology. 2007;114:221–6.

    Article  PubMed  Google Scholar 

  8. Yoo SH, Kymionis GD, Deobhakta AA, et al. One-year results and anterior segment optical coherence tomography findings of descemet stripping automated endothelial keratoplasty combined with phacoemulsification. Arch Ophthalmol. 2008;126:1052–5.

    Article  PubMed  Google Scholar 

  9. Rao SK, Leung CKS, Cheung CYL, et al. Descemet stripping endothelial keratoplasty: effect of the surgical procedure on corneal optics. Am J Ophthalmol. 2008;145:991–6.

    Article  PubMed  Google Scholar 

  10. de Sanctis U, Angeloni M, Zilio C, et al. Corneal power after DSAEK using microkeratome-prepared tissues. Opt Vis Sci. 2011;88:697–702.

    Article  Google Scholar 

  11. Covert DJ, Koenig SB. New triple procedure: descemet’s stripping and automated endothelial keratoplasty combined with phacoemulsification and intraocular lens implantation. Ophthalmology. 2007;114:1272–7.

    Article  PubMed  Google Scholar 

  12. Terry MA, Shamie N, Chen ES, et al. Endothelial keratoplasty for Fuchs’ dystrophy with cataract: complications and clinical results with the new triple procedure. Ophthalmology. 2009;116:631–9.

    Article  PubMed  Google Scholar 

  13. de Sanctis U, Damiani F, Brusasco L, Grignolo FM. Refractive error after cataract surgery combined with descemet stripping automated endothelial keratoplasty. Am J Ophthalmol. 2013;156:254–9.

    Article  PubMed  Google Scholar 

  14. Bonfadini G, Ladas JD, Moreira H, et al. Optimization of intraocular lens constant improves refractive outcomes in combined endothelial keratoplasty and cataract surgery. Ophthalmology. 2013;120:234–9.

    Article  PubMed  Google Scholar 

  15. McEwan JR, Massengill RK, Friedel SD. Effect of keratometer and axial length measurement errors on primary implant power calculations. J Cataract Refract Surg. 1990;16:61–70.

    Article  CAS  PubMed  Google Scholar 

  16. Hahn U, Krummenauer K, Kolbl B, et al. Determination of valid benchmarks for outcome indicators in cataract surgery. A multicenter, prospective cohort trial. Ophthalmology. 2011;118:2105–12.

    Article  PubMed  Google Scholar 

  17. Lundstrom M, Barry P, Leite E, et al. 1998 European cataract outcome study report from the European Cataract Outcome Study Group. J Cataract Refract Surg. 2001;27:1176–84.

    Article  CAS  PubMed  Google Scholar 

  18. Lundstrom M, Stenevi U, Thorburn W. The Swedish National Cataract Register: a 9-year review. Acta Ophthalmol Scand. 2002;80:248–57.

    Article  PubMed  Google Scholar 

  19. Murphy C, Tuft SJ, Minassian DC. Refractive error and visual outcome after cataract extraction. J Cataract Refract Surg. 2002;28:62–6.

    Article  PubMed  Google Scholar 

  20. Zaidi FH, Corbett MC, Burton BJL, Bloom PA. Raising the benchmark for the 21st century—the 1000 cataract operations audit and survey: outcomes, consultant supervised training and sourcing NHS choice. Br J Ophthalmol. 2007;91:731–6.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Kugelberg M, Lundstrom M. Factors related to the degree of success in achieving target refraction in cataract surgery Swedish National Cataract Register study. J Cataract Refract Surg. 2008;34:1935–9.

    Article  PubMed  Google Scholar 

  22. Ham L, Dapena I, Moutsouris K, et al. Refractive change and stability after Descemet membrane endothelial keratoplasty. Effect of corneal dehydration-induced hyperopic shift on intraocular lens power calculation. J Cataract Refract Surg. 2011;37:1455–64.

    Article  PubMed  Google Scholar 

  23. Laaser K, Bachman BO, Horn FK, et al. Descemet membrane endothelial keratoplasty combined with phacoemulsification and intraocular lens implantation: advanced triple procedure. Am J Ophthalmol. 2012;154:47–55.

    Article  CAS  PubMed  Google Scholar 

  24. Flowers CW, Mc Leod SD, McDonnel PJ, et al. Evaluation of intraocular lens power calculation formulas in the triple procedure. J Cataract Refract Surg. 1996;22:116–22.

    Article  CAS  PubMed  Google Scholar 

  25. Katz HR, Forster RK. Intraocular lens calculations in combined penetrating keratoplasty, cataract extraction and intraocular lens implantation. Ophthalmology. 1985;92:1203–7.

    Article  CAS  PubMed  Google Scholar 

  26. Davis EA, Azar DT, Jakobs FM, Stark WJ. Refractive and keratometric results after the triple procedure: experience with early and late suture removal. Ophthalmology. 1998;105:624–30.

    Article  CAS  PubMed  Google Scholar 

  27. Javadi MA, Feizi S, Moein HR. Simultaneous penetrating keratoplasty and cataract surgery. J Ophthalmic Vis Res. 2013;8:39–46.

    PubMed Central  PubMed  Google Scholar 

  28. Geggel HS. Intraocular lens implantation after penetrating keratoplasty: improved unaided visual acuity, astigmatism, and safety in patients with combined corneal disease and cataract. Ophthalmology. 1990;97:1460–7.

    Article  CAS  PubMed  Google Scholar 

  29. Vail A. Conclusions of the corneal transplant follow-up study. Br J Ophthalmol. 1997;81:631–6.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  30. Frohn A, Dick HB, Thiel HJ. Implantation of a toric polymethylmethacrylate intraocular lens to correct high astigmatism. J Cataract Refract Surg. 1999;25:1675–8.

    Article  CAS  PubMed  Google Scholar 

  31. Tehrani M, Stoffelns B, Dick HB. Implantation of a custom intraocular lens with a 30-diopter torus for the correction of high astigmatism after penetrating keratoplasty. J Cataract Refract Surg. 2003;29:244–7.

    Google Scholar 

  32. Visser N, Bauer NJC, Nuijts RMMA. Toric intraocular lenses: historical overview, patient selection, IOL calculation, surgical techniques, clinical outcomes, and complications. J Cataract Refract Surg. 2013;39:624–37.

    Article  PubMed  Google Scholar 

  33. Kersey JP, O’Donnell A, Illingworth CD. Cataract surgery with toric intraocular lenses can optimize uncorrected postoperative visual acuity in patients with marked corneal astigmatism. Cornea. 2007;26:133–5.

    Article  PubMed  Google Scholar 

  34. Stewart CM, McAlister JC. Comparison of grafted and nongrafted patients with corneal astigmatism undergoing cataract extraction with a toric intraocular lens implant. Clin Experiment Ophthalmol. 2010;38:747–57.

    Article  PubMed  Google Scholar 

  35. De Sanctis U, Eandi C, Grignolo F. Phacoemulsification and customized toric intraocular lens implantation in eyes with cataract and high astigmatism after penetrating keratoplasty. J Cataract Refract Surg. 2011;37:781–5.

    Article  PubMed  Google Scholar 

  36. Gupta N, Ram J, Chaudhary M. AcrySof toric intraocular lens for post-keratoplasty astigmatism. Indian J Ophthalmol. 2012;60:213–5.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Srinivasan S, Ting DS, Lyall DA. Implantation of a customized toric intraocular lens for correction of post-keratoplasty astigmatism. Eye. 2013;27:531–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. Wade M, Steinert RF, Garg S, et al. Results of toric intraocular lenses for post-penetrating keratoplasty astigmatism. Ophthalmology. 2014;121:771–7.

    Article  PubMed  Google Scholar 

  39. Goggin M, Moore S, Esterman A. Outcome of toric intraocular lens implantation after adjusting for anterior chamber depth and intraocular lens sphere equivalent power effects. Arch Ophthalmol. 2011;129:998–1003.

    Article  PubMed  Google Scholar 

  40. Novis C. Astigmatism and the toric intraocular lens and other vertex distance effects. Surv Ophthalmol. 1997;42:268–70.

    Article  CAS  PubMed  Google Scholar 

  41. Holladay JT. Refractive power calculations for intraocular lenses in the phakic eye. Am J Ophthalmol. 1993;116:63–6.

    Article  CAS  PubMed  Google Scholar 

  42. Gills JP, Cherchio M. Phacoemulsification in high hyperopic cataract patients. In: Lu LW, Fine IH, editors. Phacoemulsification in difficult and challenging cases. New York: Thieme Medical Publishers; 1999. p. 21–31.

    Google Scholar 

  43. Habot-Wilner Z, Sachs D, Cahane M, et al. Refractive results with secondary piggy-back implantation to correct pseudophakic refractive errors. J Cataract Refract Surg. 2005;31:2101–3.

    Article  PubMed  Google Scholar 

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Correspondence to Ugo De Sanctis MD, PhD .

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De Sanctis, U. (2016). Optics of Transplanted Grafts: IOL Calculation in Grafted Patients. In: Hjortdal, J. (eds) Corneal Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-24052-7_13

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  • DOI: https://doi.org/10.1007/978-3-319-24052-7_13

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  • Publisher Name: Springer, Cham

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