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Adjust IOL power for sulcus fixation
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For sulcus fixation in eyes of normal length, IOL power should be reduced 1 D from the power calculated for in-the-bag placement, according to a Japanese study.
Chikako Suto, MD, and colleagues at Tokyo Women’s Medical University retrospectively evaluated postop refraction, virtual postop refraction with incremental increases in IOL power, and effective lens position in 30 eyes with normal axial lengths. These results were prospectively compared to 16 eyes requiring IOL fixation in the sulcus.
A significant mean myopic shift of 0.78 ± 0.47 D from the predicted refraction was seen when lenses were fixated in the sulcus (P < .0001). Also, virtual IOL power averaged 1.11 D higher than the power of the IOL fixated in the sulcus.
With sulcus fixation, estimated lens position was 0.75 mm shorter than in-the-bag fixation on A-mode measurement, and 0.62 mm shorter using back calculation from the theoretical formula.
Only a small mean refractive error of –0.06 D was seen when the planned IOL power was reduced by 1 D and the IOL was implanted in the sulcus, the authors said.
The study is published in the Journal of Cataract and Refractive Surgery.