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Axial length plays role in myopic shift of foldable acrylic IOLs after sulcus fixation
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Surgeons should consider axial length when determining IOL power for sulcus fixation because it can play a role in myopic shift, a study found.
“We found no significant differences for other preoperative variables, with the exception of age,” the study authors said. “However, in our study, younger patients had a longer [axial length]. Thus, older patients showed a greater myopic shift, not because of age, but because of their shorter [axial length].”
The retrospective study analyzed 91 eyes of 91 consecutive patients who underwent primary implantation of sulcus-fixated foldable acrylic IOLs; 18 patients received the AcrySof MA60BM multi-piece IOL (Alcon), 54 patients received the Sensar AR40e multi-piece IOL (Abbott Medical Optics), six patients received the BioVue single-piece IOL (Ophthalmic Innovations), and 13 patients received the AcrySof SA60AT single-piece IOL (Alcon).
A significant negative correlation was found between myopic shift and axial length (P = .033).
The eyes were then separated into four groups; five eyes with axial length that was less than 22 mm were considered short, 68 eyes with an axial length that was 22 mm or greater and less than 24.5 mm were considered normal, 10 eyes with an axial length that was 24.5 mm or greater and less than 26 mm were considered long, and eight eyes with an axial length that was greater than 26 mm were considered very long. Mean myopic shift decreased as axial length increased (P = .001).
“The [axial length] should be considered when adjusting the IOL power for sulcus fixation so as not to overestimate or underestimate postoperative myopic shift in eyes with a short or long [axial length], respectively,” the authors said.
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