Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial
To compare surgically induced astigmatism (SIA) and refractive outcomes between two operation methods for late in-the-bag IOL dislocation. In this prospective, randomized, parallel-group clinical trial, 104 patients (eyes) were assigned to IOL repositioning by scleral suturing 1.5- to 2-mm posterior...
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| Veröffentlicht in: | Investigative ophthalmology & visual science 2017-09, Vol.58 (11), p.4747-4753 |
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| creator | Kristianslund, Olav Østern, Atle Einar Drolsum, Liv |
| description | To compare surgically induced astigmatism (SIA) and refractive outcomes between two operation methods for late in-the-bag IOL dislocation.
In this prospective, randomized, parallel-group clinical trial, 104 patients (eyes) were assigned to IOL repositioning by scleral suturing 1.5- to 2-mm posterior to limbus (n = 54) or IOL exchange with a retropupillar iris-claw IOL using a 5.5-mm scleral pocket incision (n = 50). The SIA was determined by vector analysis through conversion of corneal cylinders to Cartesian coordinates, and is presented as magnitude in diopters @ direction in degrees (D @ °). Follow-up was 6 months.
The SIA was 0.24 D @ 8° for IOL repositioning and 0.65 D @ 171° for IOL exchange, which was a nonsignificant group difference (X coordinate: P = 0.08; Y coordinate: P = 0.16). Mean SIA magnitude was 0.60 ± 0.50 D and 1.12 ± 0.85 D, respectively (P < 0.001). Mean postoperative spherical equivalent was -1.6 ± 1.6 D after IOL repositioning and -0.5 ± 1.0 D after IOL exchange (P < 0.001). For IOL repositioning, this represented a mean myopic shift of -0.7 ± 1.1 D compared with before the IOL dislocation (P < 0.001). For IOL exchange, it was within ±1 D of target refraction in 83% of the patients.
Surgically induced astigmatism was modest in both operation groups, albeit with a tendency of being more pronounced for IOL exchange. Repositioning surgery led to a myopic shift, whereas exchange surgery provided good refractive predictability. |
| doi_str_mv | 10.1167/iovs.17-22723 |
| format | Article |
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In this prospective, randomized, parallel-group clinical trial, 104 patients (eyes) were assigned to IOL repositioning by scleral suturing 1.5- to 2-mm posterior to limbus (n = 54) or IOL exchange with a retropupillar iris-claw IOL using a 5.5-mm scleral pocket incision (n = 50). The SIA was determined by vector analysis through conversion of corneal cylinders to Cartesian coordinates, and is presented as magnitude in diopters @ direction in degrees (D @ °). Follow-up was 6 months.
The SIA was 0.24 D @ 8° for IOL repositioning and 0.65 D @ 171° for IOL exchange, which was a nonsignificant group difference (X coordinate: P = 0.08; Y coordinate: P = 0.16). Mean SIA magnitude was 0.60 ± 0.50 D and 1.12 ± 0.85 D, respectively (P < 0.001). Mean postoperative spherical equivalent was -1.6 ± 1.6 D after IOL repositioning and -0.5 ± 1.0 D after IOL exchange (P < 0.001). For IOL repositioning, this represented a mean myopic shift of -0.7 ± 1.1 D compared with before the IOL dislocation (P < 0.001). For IOL exchange, it was within ±1 D of target refraction in 83% of the patients.
Surgically induced astigmatism was modest in both operation groups, albeit with a tendency of being more pronounced for IOL exchange. Repositioning surgery led to a myopic shift, whereas exchange surgery provided good refractive predictability.</description><identifier>ISSN: 1552-5783</identifier><identifier>ISSN: 0146-0404</identifier><identifier>EISSN: 1552-5783</identifier><identifier>DOI: 10.1167/iovs.17-22723</identifier><identifier>PMID: 28973318</identifier><language>eng</language><publisher>United States: Lippincott-Raven Publishers</publisher><subject>Aged ; Aged, 80 and over ; Astigmatism - etiology ; Astigmatism - physiopathology ; Female ; Humans ; Lens Implantation, Intraocular - adverse effects ; Lens Implantation, Intraocular - methods ; Lenses, Intraocular ; Male ; Middle Aged ; Myopia - etiology ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Prospective Studies ; Prosthesis Failure ; Refraction, Ocular - physiology ; Reoperation - methods ; Retrospective Studies ; Visual Acuity</subject><ispartof>Investigative ophthalmology & visual science, 2017-09, Vol.58 (11), p.4747-4753</ispartof><rights>info:eu-repo/semantics/openAccess</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-d44b66dffed493a8c7c7677b28e0bfa1167d8616c4bec34b4ca82b73b1053f53</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,864,885,26567,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28973318$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kristianslund, Olav</creatorcontrib><creatorcontrib>Østern, Atle Einar</creatorcontrib><creatorcontrib>Drolsum, Liv</creatorcontrib><title>Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial</title><title>Investigative ophthalmology & visual science</title><addtitle>Invest Ophthalmol Vis Sci</addtitle><description>To compare surgically induced astigmatism (SIA) and refractive outcomes between two operation methods for late in-the-bag IOL dislocation.
In this prospective, randomized, parallel-group clinical trial, 104 patients (eyes) were assigned to IOL repositioning by scleral suturing 1.5- to 2-mm posterior to limbus (n = 54) or IOL exchange with a retropupillar iris-claw IOL using a 5.5-mm scleral pocket incision (n = 50). The SIA was determined by vector analysis through conversion of corneal cylinders to Cartesian coordinates, and is presented as magnitude in diopters @ direction in degrees (D @ °). Follow-up was 6 months.
The SIA was 0.24 D @ 8° for IOL repositioning and 0.65 D @ 171° for IOL exchange, which was a nonsignificant group difference (X coordinate: P = 0.08; Y coordinate: P = 0.16). Mean SIA magnitude was 0.60 ± 0.50 D and 1.12 ± 0.85 D, respectively (P < 0.001). Mean postoperative spherical equivalent was -1.6 ± 1.6 D after IOL repositioning and -0.5 ± 1.0 D after IOL exchange (P < 0.001). For IOL repositioning, this represented a mean myopic shift of -0.7 ± 1.1 D compared with before the IOL dislocation (P < 0.001). For IOL exchange, it was within ±1 D of target refraction in 83% of the patients.
Surgically induced astigmatism was modest in both operation groups, albeit with a tendency of being more pronounced for IOL exchange. Repositioning surgery led to a myopic shift, whereas exchange surgery provided good refractive predictability.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Astigmatism - etiology</subject><subject>Astigmatism - physiopathology</subject><subject>Female</subject><subject>Humans</subject><subject>Lens Implantation, Intraocular - adverse effects</subject><subject>Lens Implantation, Intraocular - methods</subject><subject>Lenses, Intraocular</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myopia - etiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - surgery</subject><subject>Prospective Studies</subject><subject>Prosthesis Failure</subject><subject>Refraction, Ocular - physiology</subject><subject>Reoperation - methods</subject><subject>Retrospective Studies</subject><subject>Visual Acuity</subject><issn>1552-5783</issn><issn>0146-0404</issn><issn>1552-5783</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>3HK</sourceid><recordid>eNpNkctLxDAQh4Movo9eNUcv1TzaJOttXZ-wIOjeQ5pO10jbaJIK619v1heeZmA-Pmbmh9ARJWeUCnnu_Hs8o7JgTDK-gXZpVbGikopv_ut30F6ML4QwShnZRjtMTSTnVO2ij2lMbtmb5GKPzdDgR2iDscm9A34Yk_U94GmbIOC5SYDvh2LxDMWlWeY2BePt2Jk8gyHiKxc7b7PJD_hpDEsIqws8xY_Z6nv3AQ2edW5w1nR4EZzpDtBWa7oIhz91Hy1urhezu2L-cHs_m84LyyuRiqYsayGatoWmnHCjrLRSSFkzBaRuzfoJjRJU2LIGy8u6tEaxWvKakoq3Fd9HJ99aG1y-ddCDD0ZToiqmBSVcZeL0m3gN_m2EmHTvooWuMwP4MWo6KSWZiJLJjBa_Mh9jgFa_BtebsMpCvV5Fr_PQVOqvPDJ__KMe6x6aP_o3AP4JQceGRQ</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Kristianslund, Olav</creator><creator>Østern, Atle Einar</creator><creator>Drolsum, Liv</creator><general>Lippincott-Raven Publishers</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>3HK</scope></search><sort><creationdate>20170901</creationdate><title>Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial</title><author>Kristianslund, Olav ; Østern, Atle Einar ; Drolsum, Liv</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-d44b66dffed493a8c7c7677b28e0bfa1167d8616c4bec34b4ca82b73b1053f53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Astigmatism - etiology</topic><topic>Astigmatism - physiopathology</topic><topic>Female</topic><topic>Humans</topic><topic>Lens Implantation, Intraocular - adverse effects</topic><topic>Lens Implantation, Intraocular - methods</topic><topic>Lenses, Intraocular</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myopia - etiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - surgery</topic><topic>Prospective Studies</topic><topic>Prosthesis Failure</topic><topic>Refraction, Ocular - physiology</topic><topic>Reoperation - methods</topic><topic>Retrospective Studies</topic><topic>Visual Acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kristianslund, Olav</creatorcontrib><creatorcontrib>Østern, Atle Einar</creatorcontrib><creatorcontrib>Drolsum, Liv</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>NORA - Norwegian Open Research Archives</collection><jtitle>Investigative ophthalmology & visual science</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kristianslund, Olav</au><au>Østern, Atle Einar</au><au>Drolsum, Liv</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial</atitle><jtitle>Investigative ophthalmology & visual science</jtitle><addtitle>Invest Ophthalmol Vis Sci</addtitle><date>2017-09-01</date><risdate>2017</risdate><volume>58</volume><issue>11</issue><spage>4747</spage><epage>4753</epage><pages>4747-4753</pages><issn>1552-5783</issn><issn>0146-0404</issn><eissn>1552-5783</eissn><abstract>To compare surgically induced astigmatism (SIA) and refractive outcomes between two operation methods for late in-the-bag IOL dislocation.
In this prospective, randomized, parallel-group clinical trial, 104 patients (eyes) were assigned to IOL repositioning by scleral suturing 1.5- to 2-mm posterior to limbus (n = 54) or IOL exchange with a retropupillar iris-claw IOL using a 5.5-mm scleral pocket incision (n = 50). The SIA was determined by vector analysis through conversion of corneal cylinders to Cartesian coordinates, and is presented as magnitude in diopters @ direction in degrees (D @ °). Follow-up was 6 months.
The SIA was 0.24 D @ 8° for IOL repositioning and 0.65 D @ 171° for IOL exchange, which was a nonsignificant group difference (X coordinate: P = 0.08; Y coordinate: P = 0.16). Mean SIA magnitude was 0.60 ± 0.50 D and 1.12 ± 0.85 D, respectively (P < 0.001). Mean postoperative spherical equivalent was -1.6 ± 1.6 D after IOL repositioning and -0.5 ± 1.0 D after IOL exchange (P < 0.001). For IOL repositioning, this represented a mean myopic shift of -0.7 ± 1.1 D compared with before the IOL dislocation (P < 0.001). For IOL exchange, it was within ±1 D of target refraction in 83% of the patients.
Surgically induced astigmatism was modest in both operation groups, albeit with a tendency of being more pronounced for IOL exchange. Repositioning surgery led to a myopic shift, whereas exchange surgery provided good refractive predictability.</abstract><cop>United States</cop><pub>Lippincott-Raven Publishers</pub><pmid>28973318</pmid><doi>10.1167/iovs.17-22723</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Astigmatism - etiology Astigmatism - physiopathology Female Humans Lens Implantation, Intraocular - adverse effects Lens Implantation, Intraocular - methods Lenses, Intraocular Male Middle Aged Myopia - etiology Postoperative Complications - etiology Postoperative Complications - surgery Prospective Studies Prosthesis Failure Refraction, Ocular - physiology Reoperation - methods Retrospective Studies Visual Acuity |
| title | Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial |
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