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Positioning of scleral-sutured posterior chamber IOLs affects power calculations
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FORT LAUDERDALE, Fla. — Because of the variability in lens positioning after implantation of scleral-sutured posterior chamber IOLs, one presenter suggested that the common practice of reducing IOL power by up to 1 D should not be done routinely in these cases.
Using spectral-domain optical coherence tomography anterior segment imaging postoperatively, Taylor F. Smith, MD, and colleagues measured the distance between the anterior IOL surface and iris plane in eyes with scleral-sutured posterior chamber IOLs (group 1, 28 eyes) and those with in-the-bag IOLs (group 2, 50 eyes). The study was presented as a poster at the Association for Research in Vision and Ophthalmology meeting.
The finding that the final position of the IOL is unpredictable was not unexpected, Dr. Smith told Ocular Surgery News.
"Previous studies show that it is hard to determine where the lens ends up," Dr. Smith said, adding that the variability in the scleral suture group was high.
Measuring at the two edges of the pupil margin in group 1, the average distance between the anterior IOL surface and the iris plane was 574.68/583.11 µm in the horizontal OCT image and 470.54/510.79 µm in the vertical image. In group 2, the measurements were 616.47/597.67 µm and 593.91/581.74 µm, with no statistically significant difference found in IOL positioning between the two groups.
"The exact location of postoperative IOL positioning cannot be predicted," the study authors said. "Therefore, reducing IOL power by up to 1 D, as is commonly employed with sulcus fixation, should not be routinely practiced in [scleral-sutured posterior chamber IOL] cases to avoid postoperative hyperopia. Significant visual improvement was observed in patients with scleral-sutured as well as in-the-bag-placed IOLs."
- Disclosure: Dr. Smith has no relevant financial disclosures.