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Changes in Chord Mu (µ) Length Before and After Cataract Surgery

Year 2024, Volume: 13 Issue: 2, 254 - 258, 28.08.2024
https://doi.org/10.53424/balikesirsbd.1386027

Abstract

Aim: Comparison of chord  length, a potential marker that may gain importance especially in multifocal lens implantation, before and after phacoemulsification surgery and intraocular lens (IOL) implantation in patients with cataracts.
Methods: This retrospective study included 33 eyes of 33 patients who underwent phacoemulsification surgery between December 2022 and February 2023. Corneal topography (Pentacam HR, Oculus, Wetzlar, optikgerate GmbH) was performed on each patient before and after surgery. The values obtained before and at least 3 months after surgery were compared using the Student-t test. Results: There were 18 (54.5%) males and 15 (45.5%) females among the 33 patients who participated in the study. The average age was 67.27 ± 10.93 years. The postoperative mean chord μ lenght was significantly lower than the preoperative mean chord μ lenght (p=0.002). Additionally, the mean postoperative pupil size was significantly lower than the mean preoperative pupil size (p=0.000). There is a weak positive relationship between the change in chord μ length and the change in pupil size, but this relationship is not statistically significant (p>0.05). No statistically significant relationship was found between any of the other binary variables. Conclusion: Centralization is crucial in refractive surgery and multifocal IOL implantation to prevent high-order aberrations and photic phenomena. Therefore, it seems useful for surgeons to be familiar with chord μ measurements, especially regarding surgical preparation. It should be considered that changes in chord mu values may influence the development of photic phenomena. A decrease in chord mu after phacoemulsification may assist the surgeon in the preoperative decision-making process in patients at risk of photic phenomena or in patients with borderline values.

References

  • Arba Mosquera, S., Verma, S., & McAlinden, C. (2015). Centration axis in refractive surgery. Eye Vis (Lond), 2, 4. https://doi.org/10.1186/s40662-015-0014-6.
  • Chang, D. H., & Waring, G. O. t. (2014). The subject-fixated coaxially sighted corneal light reflex: a clinical marker for centration of refractive treatments and devices. Am J Ophthalmol, 158(5), 863-874. https://doi.org/10.1016/j.a jo.2014.06.028.
  • de Vries, N. E., Webers, C. A., Touwslager, W. R., Bauer, N. J., de Brabander, J., Berendschot, T. T., & Nuijts, R. M. (2011). Dissatisfaction after implantation of multifocal intraocular lenses. J Cataract Refract Surg, 37(5), 859-865. https://doi.org/10.1016/j.jcrs.2010.11.032.
  • Dick, H. B., Aliyeva, S., Tehrani, M. (2005). Change in pupil size after implantation of an iris-fixated toric phakic intraocular lens. J Cataract Refract Surg, 31(2), 302-307. https://doi.org/10.1016/j.jcrs.2004.04.040.
  • Fernández, J., Rodríguez-Vallejo, M., Martínez, J., Tauste, A., & Piñero, D. P. (2018). Biometric Factors Associated with the Visual Performance of a High Addition Multifocal Intraocular Lens. Curr Eye Res, 43(8), 998-1005. https:// doi.org/10.1080/02713683.2018.1478981.
  • Holladay, J. T. (2019). Apparent chord mu and actual chord mu and their clinical value. J Cataract Refract Surg, 45(8), 1198-1199. https://doi.org/10.1016/j.jcrs.2019.03.029.
  • Holladay, J. T., Calogero, D., Hilmantel, G., Glasser, A., MacRae, S., Masket, S., Stark, W., Tarver, M. E., Nguyen, T., & Eydelman, M. (2017). Special Report: American Academy of Ophthalmology Task Force Summary Statement for Measurement of Tilt, Decentration, and Chord Length. Ophthalmology, 124(1), 144-146. https://doi.org/10.1016/j.ophtha.2016.09.030.
  • Jiang, J. Y., Hodge, C., & Lawless, M. (2020). Understanding chord mu through a large population-based study. Clin Exp Ophthalmol, 48(7), 998-1001. https://doi.org/10.1 111/ceo.13800.
  • Karhanová, M., Marešová, K., Pluháček, F., Mlčák, P., Vláčil, O. & Sín M. (2013). The importance of angle kappa for centration of multifocal intraocular lenses. Cesk Slov Oftalmol, 69(2), 64-68.
  • Keuch, R.J., Bleckmann, H. (2002). Pupil diameter changes and reaction after posterior chamber phakic intraocular lens implantation. J Cataract Refract Surg, 28(12), 2170-2172. https://doi.org/10.1016/s0886-3350(02)01355-x
  • Mandell, R. B. (1995). Locating the corneal sighting center from videokeratography. J Refract Surg, 11(4), 253-259. https://doi.org/10.3928/1081-597x-19950701-09.
  • Moshirfar, M., Hoggan, R. N., & Muthappan, V. (2013). Angle Kappa and its importance in refractive surgery. Oman J Ophthalmol, 6(3), 151-158. https://doi.org/10.4103/0974-620x.122268.
  • Narang, P., Holladay, J., Agarwal, A., Jaganathasamy, N., Kumar, D. A., & Sivagnanam, S. (2019). Application of Purkinje images for pinhole pupilloplasty and relevance to chord length mu. J Cataract Refract Surg, 45(6), 745-751. https://doi.org/10.1016/j.jcrs.2019.02.037.
  • Park, C. Y., Oh, S. Y., & Chuck, R. S. (2012). Measurement of angle kappa and centration in refractive surgery. Curr Opin Ophthalmol, 23(4), 269-275. https://doi.org/10.109 7/ICU.0b013e3283543c41.
  • Prakash, G., Prakash, D. R., Agarwal, A., Kumar, D. A., Agarwal, A., & Jacob, S. (2011). Predictive factor and kappa angle analysis for visual satisfactions in patients with multifocal IOL implantation. Eye (Lond), 25(9), 1187-1193. https://doi.org/10.1038/eye.2011.150.
  • Rodríguez-Vallejo, M., Piñero, D. P., & Fernández, J. (2019). Avoiding misinterpretations of Kappa angle for clinical research studies with Pentacam. J Optom, 12(2), 71-73. https://doi.org/10.1016/j.optom.2018.03.003.
  • Schwiegerling, J. T. (2013). Eye axes and their relevance to alignment of corneal refractive procedures. J Refract Surg, 29(8), 515-516. https://doi.org/10.3928/1081597x-20130719-01.
  • Simsek A, Toptan M. (2023). The evaluation of pupil diameter by using Sirius before and after phacoemulsification in healthy, diabetic and hypertension patients. Medicine (Baltimore), 102(16), e33223. https://doi.org/10.1097 /MD.0000000000033223
  • Şener, H., Polat, O. A., & Çetinkaya, Z. (2022). Fakoemülsifikasyon Cerrahisi Sonrasında Korneal Topografide Chord Mu (μ) Değerinin Değişiminin Değerlendirilmesi. MN Opthalmology/MN Oftalmoloji, 29(4).
  • Wang, R., Long, T., Gu, X., & Ma, T. (2020). Changes in angle kappa and angle alpha before and after cataract surgery. J Cataract Refract Surg, 46(3), 365-371. https://doi.org/ 10.1097/j.jcrs.0000000000000063.
  • Yang, Y., Thompson, K., & Burns, S. A. (2002). Pupil location under mesopic, photopic, and pharmacologically dilated conditions. Invest Ophthalmol Vis Sci, 43(7), 2508-2512.

Katarakt Cerrahisi Öncesi ve Sonrası Chord Mu (µ) Uzunluğundaki Değişim

Year 2024, Volume: 13 Issue: 2, 254 - 258, 28.08.2024
https://doi.org/10.53424/balikesirsbd.1386027

Abstract

Amaç: Kataraktlı hastalarda fakoemülsifikasyon cerrahisi ve göz içi lens (GİL) implantasyonundan önce ve sonra, özellikle çok odaklı lens implantasyonunda önem kazanabilecek potansiyel bir belirteç olan chord  uzunluğunun karşılaştırılması. Gereç ve yöntem: Retrospektif olarak yürütülen bu çalışmada Aralık 2022- Şubat 2023 tarihleri arasında fakoemülsifikasyon cerrahisi yapılan 33 hastanın 33 gözü çalışmaya dahil edilmiştir. Her olguya ameliyat öncesinde ve sonrasında kornea topografisi testi (Pentacam HR, Oculus, Wetzlar, optikgerate GmbH) uygulanmıştır. Ameliyat öncesi ve en az 3 ay sonrası elde edilen değerler Student-t testi ile karşılatırılmıştır. Bulgular: Çalışmaya dahil edilen 33 hastanın %54.5’i erkek (n=18) ve %45.5’i kadın (n=15) idi. Yaş ortalaması 67.27 ± 10.93 yıl olarak hesaplandı. Ameliyat sonrası chord  ortalaması ameliyat öncesi chord  ortalamasına göre istatistiksel olarak anlamlı bir şekilde daha düşük bulunmuştur (p=0.002). Ameliyat sonrası pupil büyüklüğü ortalaması ameliyat öncesi ortalamasına göre istatistiksel olarak anlamlı bir şekilde daha düşük bulunmuştur (p=0.000). Chord  uzunluğundaki değişim ile pupil büyüklüğündeki değişim arasında zayıf pozitif bir ilişki olup bu ilişki istatistiksel anlamlılığa ulaşmamaktadır (p>0.05). Diğer ikili değişkenlerin hiçbiri arasında istatistiksel olarak anlamlı bir ilişki tespit edilememiştir. Sonuç: Doğru santralizasyon, hem refraktif cerrahide hem de multifokal GİL implantasyonunda, yüksek dereceli aberasyonları ve fotik fenomenlerin oluşmasını önlemek için önemlidir. Bu nedenle cerrahların, özellikle cerrahi hazırlık ile ilgili olarak, chord μ ölçümlerine aşina olmaları faydalı görünmektedir. Chord mu değerlerindeki değişikliklerin fotik fenomenlerin oluşumuna etki edebileceği gözönünde bulundurulmalıdır. Fakoemülsifikasyon sonrası chord mu değerlerinin azalıyor olması fotik fenomen oluşumu riski olan veya sınır değerdeki hastalarda preoperative karar verme sürecinde cerraha yardımcı olabilir.

References

  • Arba Mosquera, S., Verma, S., & McAlinden, C. (2015). Centration axis in refractive surgery. Eye Vis (Lond), 2, 4. https://doi.org/10.1186/s40662-015-0014-6.
  • Chang, D. H., & Waring, G. O. t. (2014). The subject-fixated coaxially sighted corneal light reflex: a clinical marker for centration of refractive treatments and devices. Am J Ophthalmol, 158(5), 863-874. https://doi.org/10.1016/j.a jo.2014.06.028.
  • de Vries, N. E., Webers, C. A., Touwslager, W. R., Bauer, N. J., de Brabander, J., Berendschot, T. T., & Nuijts, R. M. (2011). Dissatisfaction after implantation of multifocal intraocular lenses. J Cataract Refract Surg, 37(5), 859-865. https://doi.org/10.1016/j.jcrs.2010.11.032.
  • Dick, H. B., Aliyeva, S., Tehrani, M. (2005). Change in pupil size after implantation of an iris-fixated toric phakic intraocular lens. J Cataract Refract Surg, 31(2), 302-307. https://doi.org/10.1016/j.jcrs.2004.04.040.
  • Fernández, J., Rodríguez-Vallejo, M., Martínez, J., Tauste, A., & Piñero, D. P. (2018). Biometric Factors Associated with the Visual Performance of a High Addition Multifocal Intraocular Lens. Curr Eye Res, 43(8), 998-1005. https:// doi.org/10.1080/02713683.2018.1478981.
  • Holladay, J. T. (2019). Apparent chord mu and actual chord mu and their clinical value. J Cataract Refract Surg, 45(8), 1198-1199. https://doi.org/10.1016/j.jcrs.2019.03.029.
  • Holladay, J. T., Calogero, D., Hilmantel, G., Glasser, A., MacRae, S., Masket, S., Stark, W., Tarver, M. E., Nguyen, T., & Eydelman, M. (2017). Special Report: American Academy of Ophthalmology Task Force Summary Statement for Measurement of Tilt, Decentration, and Chord Length. Ophthalmology, 124(1), 144-146. https://doi.org/10.1016/j.ophtha.2016.09.030.
  • Jiang, J. Y., Hodge, C., & Lawless, M. (2020). Understanding chord mu through a large population-based study. Clin Exp Ophthalmol, 48(7), 998-1001. https://doi.org/10.1 111/ceo.13800.
  • Karhanová, M., Marešová, K., Pluháček, F., Mlčák, P., Vláčil, O. & Sín M. (2013). The importance of angle kappa for centration of multifocal intraocular lenses. Cesk Slov Oftalmol, 69(2), 64-68.
  • Keuch, R.J., Bleckmann, H. (2002). Pupil diameter changes and reaction after posterior chamber phakic intraocular lens implantation. J Cataract Refract Surg, 28(12), 2170-2172. https://doi.org/10.1016/s0886-3350(02)01355-x
  • Mandell, R. B. (1995). Locating the corneal sighting center from videokeratography. J Refract Surg, 11(4), 253-259. https://doi.org/10.3928/1081-597x-19950701-09.
  • Moshirfar, M., Hoggan, R. N., & Muthappan, V. (2013). Angle Kappa and its importance in refractive surgery. Oman J Ophthalmol, 6(3), 151-158. https://doi.org/10.4103/0974-620x.122268.
  • Narang, P., Holladay, J., Agarwal, A., Jaganathasamy, N., Kumar, D. A., & Sivagnanam, S. (2019). Application of Purkinje images for pinhole pupilloplasty and relevance to chord length mu. J Cataract Refract Surg, 45(6), 745-751. https://doi.org/10.1016/j.jcrs.2019.02.037.
  • Park, C. Y., Oh, S. Y., & Chuck, R. S. (2012). Measurement of angle kappa and centration in refractive surgery. Curr Opin Ophthalmol, 23(4), 269-275. https://doi.org/10.109 7/ICU.0b013e3283543c41.
  • Prakash, G., Prakash, D. R., Agarwal, A., Kumar, D. A., Agarwal, A., & Jacob, S. (2011). Predictive factor and kappa angle analysis for visual satisfactions in patients with multifocal IOL implantation. Eye (Lond), 25(9), 1187-1193. https://doi.org/10.1038/eye.2011.150.
  • Rodríguez-Vallejo, M., Piñero, D. P., & Fernández, J. (2019). Avoiding misinterpretations of Kappa angle for clinical research studies with Pentacam. J Optom, 12(2), 71-73. https://doi.org/10.1016/j.optom.2018.03.003.
  • Schwiegerling, J. T. (2013). Eye axes and their relevance to alignment of corneal refractive procedures. J Refract Surg, 29(8), 515-516. https://doi.org/10.3928/1081597x-20130719-01.
  • Simsek A, Toptan M. (2023). The evaluation of pupil diameter by using Sirius before and after phacoemulsification in healthy, diabetic and hypertension patients. Medicine (Baltimore), 102(16), e33223. https://doi.org/10.1097 /MD.0000000000033223
  • Şener, H., Polat, O. A., & Çetinkaya, Z. (2022). Fakoemülsifikasyon Cerrahisi Sonrasında Korneal Topografide Chord Mu (μ) Değerinin Değişiminin Değerlendirilmesi. MN Opthalmology/MN Oftalmoloji, 29(4).
  • Wang, R., Long, T., Gu, X., & Ma, T. (2020). Changes in angle kappa and angle alpha before and after cataract surgery. J Cataract Refract Surg, 46(3), 365-371. https://doi.org/ 10.1097/j.jcrs.0000000000000063.
  • Yang, Y., Thompson, K., & Burns, S. A. (2002). Pupil location under mesopic, photopic, and pharmacologically dilated conditions. Invest Ophthalmol Vis Sci, 43(7), 2508-2512.
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Details

Primary Language English
Subjects Surgery (Other)
Journal Section Articles
Authors

Ali Küçüködük 0000-0001-8024-4758

Hüseyin Türe 0000-0001-6534-6174

Publication Date August 28, 2024
Submission Date November 4, 2023
Acceptance Date January 18, 2024
Published in Issue Year 2024 Volume: 13 Issue: 2

Cite

APA Küçüködük, A., & Türe, H. (2024). Changes in Chord Mu (µ) Length Before and After Cataract Surgery. Balıkesir Sağlık Bilimleri Dergisi, 13(2), 254-258. https://doi.org/10.53424/balikesirsbd.1386027

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