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Sulcus-implanted IOL power should be based on axial length and predicted IOL power
The power of a sulcus-implanted IOL is particularly sensitive to measured axial length and predicted IOL power, according to a study.
“This study provides useful information in guiding decision making when adjusting the power of an IOL to be implanted in the ciliary sulcus to minimize an unexpected refractive shift,” the study authors said.
The retrospective case series included records of 679 eyes of 679 patients; 46 eyes experienced posterior capsule tears during cataract surgery. Thirty-six eyes were implanted with a foldable three-piece acrylic MA60AC IOL (Alcon). Mean patient age was 74.5 years.
IOL power was calculated preoperatively based on biometry measurements taken with the IOLMaster (Carl Zeiss Meditec). IOL power was reduced 0.5 D or 1 D from the power calculated by the SRK-T formula for in-the-bag implantation.
Study results showed that eyes in which IOL power was reduced by 1 D had 0.49 D of unexpected refractive error; eyes in which IOL power was reduced by 0.5 D had 1.01 D of unexpected refractive error.
Eyes in which IOL power was reduced by 1 D had a lower myopic shift than eyes in which power was reduced by 0.5 D.
Eyes with axial length of less than 22 mm had higher unexpected refractive error. Eyes with predicted IOL power greater than 25 D had higher postoperative refractive error.
Results suggested that for patients with predicted IOL power of 18 D to 25 D, power should be reduced by at least 1 D; for those with predicted power greater than 25 D, power should be reduced by 1.5 D to 2 D, the authors said.