Calculation of intraocular lens power after corneal cross-linking in keratoconus

Year 2018, Volume: 15 Issue: 2, 76 - 79, 14.08.2018

Ayhan Sağlık

Abstract

Background: Investigation of monofocal intraocular lens (IOL) measurement with Barret Formula after corneal collagen cross-linking (CXL) treatment in keratoconus.

Material and Methods: Thirty eyes of twenty-four progressive keratoconus patients were included in this retrospective study. Optic biometry measurements and axial length (AU) values were analyzed by optical low coherence reflectometer at preoperative and postoperative 12th month follow-up of patients with CXL due to keratoconus. The mean IOL measurements calculated by the Barret formula were used in the study. Repeated variance analysis was applied in the statistical evaluation.

Results: The mean age of the patients was 18.66 ± 0.77 years (12-27 years). The mean IOL measurement before CXL was 12.95 ± 0.95 diopter (D), and 12.65 ± 0.83 D at postoperative 12 months (p = 0.441). The AL value was 23.58 ± 0.12 mm before CXL and 23.63 ± 0.11 mm at postoperative 12th month (p =0.001). None of the patients had any complications that could lead to progression and visual loss after CXL.

Conclusions: Topographic and keratometric parameters are used as a guideline for follow-up after CXL treatment in keratoconus. For this reason, treatment results can be effect in IOL measurement parameters such as keratometry values and axial length. In our study, no significant difference was found the IOL measurement results, but the AL value was significantly increased after CXL.

Keywords

Axial length, Biometry, Cross-linking, Lens

Keratokonusta korneal cross-linking sonrasında intraoküler lens gücü hesaplaması

Abstract

Amaç: Keratokonusta korneal kollajen
cross-linking (CXL) tedavisi sonrası Barret formülü ile ölçülen monofokal göz
içi lens (İOL) dioptrisi değişiminin araştırılması.

 

Materyal ve Metod: Yirmi dört progresif
keratokonuslu hastanın 30 gözü bu retrospektif çalışmaya dahil edildi.
Progresif keratokonus nedeniyle CXL yapılan hastalardan, tedavi öncesi ve postoperatif
12. ayda optik biyometri analizleri optik düşük-kohorens reflektometre (Lenstar
LS 900) ile yapılan gözlerin Barret formülü ile hesaplanan ortalama İOL
ölçümleri ve aksiyel uzunluk (AU) değerleri hesaplandı. İstatistik için
tekrarlı varyans analizi kullanıldı.

 

Bulgular: Hastaların ortalama yaşı
18.66±0.77 yıl (12-27 yıl) idi. CXL öncesi ortalama İOL ölçümü 12.95±0.95 D
iken, postoperatif 12. ayda 12.65±0.83 D olarak ölçüldü (p=0.441). AU değeri
CXL öncesinde 23.58±0.12 mm iken, postoperatif 12.ayda 23.63±0.11mm olarak
ölçüldü (p=0.001). Hiçbir hastada CXL sonrasında, keratometrik progresyon ve görme
kaybına yol açabilecek komplikasyon saptanmadı.

 

Tartışma: Keratokonusta CXL tedavisi
sonrası takiplerde, topografik ve keratometrik parametreler yol gösterici
olarak kullanılmaktadır.  Bu nedenle
tedavi sonuçları, keratometrik değerler ve aksiyel uzunluk gibi İOL ölçümü
parametrelerinde etkili olabilmektedir. Çalışmamızda İOL ölçüm sonuçlarında
anlamlı farklılık saptanmazken, AU değeri CXL sonrasında anlamlı düzeyde
artmıştır.   

Keywords

aksiyel uzunluk, biyometri, cross-linking, lens

References

• 1. Rabinowitz YS. Keratoconus. Survey of ophthalmology 1998; 42(4):297-319.2. Martínez-Abad A, Piñero DP. New perspectives on the detection and progression of keratoconus. Journal of Cataract & Refractive Surgery 2017; 43(9):1213-1227.3. Wollensak G, Spörl E, Seiler T. Treatment of keratoconus by collagen cross linking. Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft 2003; 100(1):44-49.4. Wittig-Silva C, Chan E, Islam FM, Wu T, Whiting M, Snibson GR. A randomized, controlled trial of corneal collagen cross-linking in progressive keratoconus: three-year results. Ophthalmology 2014; 121(4):812-821.5. Randleman JB, Khandelwal SS, Hafezi F. Corneal cross-linking. survey of ophthalmology 2015; 60(6):509-523.6. Asgari S, Hashemi H. OPD scan III accuracy: Topographic and aberrometric indices after corneal cross-linking. Journal of Current Ophthalmology 2017.7. Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-A–induced collagen crosslinking for the treatment of keratoconus. American journal of ophthalmology 2003; 135(5):620-627.8. Raiskup F, Theuring A, Pillunat LE, Spoerl E. Corneal collagen crosslinking with riboflavin and ultraviolet-A light in progressive keratoconus: ten-year results. Journal of Cataract & Refractive Surgery 2015; 41(1):41-46.9. Koller T, Pajic B, Vinciguerra P, Seiler T. Flattening of the cornea after collagen crosslinking for keratoconus. Journal of Cataract & Refractive Surgery 2011; 37(8):1488-1492.10. Tamaoki A, Kojima T, Hasegawa A, Nakamura H, Tanaka K, Ichikawa K. Intraocular lens power calculation in cases with posterior keratoconus. Journal of Cataract & Refractive Surgery 2015; 41(10):2190-2195.11. Hashemi H, Seyedian MA, Miraftab M, Fotouhi A, Asgari S. Corneal collagen cross-linking with riboflavin and ultraviolet a irradiation for keratoconus: long-term results. Ophthalmology 2013; 120(8):1515-1520.12. Vinciguerra P, Albè E, Trazza S, Rosetta P, Vinciguerra R, Seiler T, Epstein D. Refractive, topographic, tomographic, and aberrometric analysis of keratoconic eyes undergoing corneal cross-linking. Ophthalmology 2009; 116(3):369-378.13. Caporossi A, Mazzotta C, Baiocchi S, Caporossi T. Long-term results of riboflavin ultraviolet a corneal collagen cross-linking for keratoconus in Italy: the Siena eye cross study. American journal of ophthalmology 2010; 149(4):585-593.14. Hersh PS, Greenstein SA, Fry KL. Corneal collagen crosslinking for keratoconus and corneal ectasia: one-year results. Journal of Cataract & Refractive Surgery 2011; 37(1):149-160.15. Koller T, Iseli HP, Hafezi F, Vinciguerra P, Seiler T. Scheimpflug imaging of corneas after collagen cross-linking. Cornea 2009; 28(5):510-515.16. Zotta PG, Diakonis VF, Kymionis GD, Grentzelos M, Moschou KA. Long-term outcomes of corneal cross-linking for keratoconus in pediatric patients. Journal of American Association for Pediatric Ophthalmology and Strabismus {JAAPOS} 2017; 21(5):397-401.17. Asri D, Touboul D, Fournié P, Malet F, Garra C, Gallois A, Malecaze F, Colin J. Corneal collagen crosslinking in progressive keratoconus: multicenter results from the French National Reference Center for Keratoconus. Journal of Cataract & Refractive Surgery 2011; 37(12):2137-2143.18. Mol IE, Van Dooren BT. Toric intraocular lenses for correction of astigmatism in keratoconus and after corneal surgery. Clinical Ophthalmology (Auckland, NZ) 2016; 10:1153.19. Savini G, Barboni P, Carbonelli M, Hoffer KJ. Accuracy of a dual Scheimpflug analyzer and a corneal topography system for intraocular lens power calculation in unoperated eyes. Journal of Cataract & Refractive Surgery 2011; 37(1):72-76.20. Wang M, Corpuz CCC. Effects of scleral cross-linking using genipin on the process of form-deprivation myopia in the guinea pig: a randomized controlled experimental study. BMC ophthalmology 2015; 15(1):89.