Sherman W. Reeves, MD, MPH 1,3,4 ; Jacob A. Kozisek, OD 1,2 ; Noumia Cloutier-Gill, OD 1,2 ; David R. Hardten, MD 1,2,3,4 Accuracy of Scheimpflug Imaging.

Slides:

Advertisements

Similar presentations

Comparison of intraocular lens power calculation formulas with LENSTAR LS 900® Tsunekazu Hamada Hamada Eye Clinic, Osaka, Japan Disclosure statement of.

Advertisements

Accuracy of Predicted Refractive Error in Resident-Performed Cataract Surgery Using Partial Coherence Interferometry Nickolas P. Katsoulakis, M.D., Paul.

Swept Source Optical Coherence Tomography for Evaluation of Posterior Corneal Changes after Refractive Surgery Dr. Tommy Chung Yan Chan Dr. Vishal Jhanji.

A simple and accurate method of alignment for toric intraocular lens implantation using anterior segment optical coherence tomography (OCT). Kazuno Negishi,

Long-Term Follow-Up of Toric Intraocular Lens Implantation for Keratoconus Alejandro Navas, MD, MSc, Martha Jaimes, MD, Jesús Cabral, MD, Arturo Ramirez.

Development of an Apple iPhone IOL Calculator Application for Cataract Surgery Rony Gelman, MD 1, Richard E. Braunstein, MD 1 1 Department of Ophthalmology,

IOL power calculation following keratorefractive surgery

Anupama Kotha 1, Simar J. Singh 1, William B. Trattler 1,2, Carlos Buznego 1,2 The authors have no financial interest in the subject matter of this poster.

Minnesota Eye Consultantswww.mneye.com Outcomes of Presbyopic IOLs Parag Parekh, MD, MPA Mona Fahmy, OD David R. Hardten, MD, FACS ASCRS Poster ID:

INTRAOPERATIVE FLAP COMPLICATIONS IN LASIK SURGERY PERFORMED BY OPHTHALMOLOGY RESIDENTS IN TRAINING Arturo Gómez-Bastar MD Arturo Ramirez-MirandaMD Lorena.

IOL power calculation after refractive surgery A. Peyman, MD.

Placement of Toric Intraocular Lens and the Long-term Change in the Axis of Corneal Astigmatism after Sutureless Cataract Extraction by Phacoemulsification.

Bilateral phacoemulsification and intraocular lens (IOL) implantation for bilateral corneal ectasia after photorefractive keratectomy (PRK) Department.

Managing the Refractive “Surprise” After Toric IOL Placement Managing the Refractive “Surprise” After Toric IOL Placement Brad H Feldman, MD Derek DelMonte,

Repeatability of Anterior and Posterior Corneal Higher- Order Aberrations in 4 mm, 6 mm and 8 mm diameters measured by Pentacam System Jadwiga Wojtowicz.

Correction of Astigmatism with Toric IOL After Previous RK

Nizar S Abdelfattah, M.D.1, Marina Israel2, Nermin Osman, M.D.3,

JAIRO E. HOYOS, MD MELANIA CIGALES, MD Instituto Oftalmológico Hoyos Barcelona - SPAIN.

G. Jacob 1,2, C. Bouchard 2, S. Kancherla 1. Edward Hines, Jr. VA Hospital, Hines, IL, Department of Ophthalmology 1. Loyola University Medical Center,

Evaluation of Corneal Parameters and Spherical Aberration After DSAEK Measured with Pentacam System Orkun Muftuoglu, Pawan Prasher, R. Wayne Bowman, Steven.

Femto-Lasik after corneal transplantation

Phacoemulsification in eyes with previous anterior chamber phakic IOL surgery Walton Nosé, MD, PhD 1,2 Adriana dos Santos Forseto, MD 1 Mariana Ávila,

Hong Kong Eye Hospital Ms Frenchy Chiu Dr Victoria Wong IOL master

Biometric Accuracy in High Hypermetropes and Myopes

Evaluation of Zonal Equivalent Keratometry Readings After LASIK Timmy Kovoor, MD Orkun Muftuoglu, MD V.Vinod Mootha, MD Steven Verity, MD R. Wayne Bowman,

Photorefractive Keratectomy in Posterior Polymorphous Dystrophy [CONTROL ID: ] Edward W. Trudo 1, Kraig S. Bower 2, Charles D. Coe 2, Denise A. Sediq.

Sonia Yoo, MD 1 Fernanda Piccoli, MD 1 Artur Schmitt, MD 1 Takeshi Ide, MD 1 Tsontcho Ianchulev, MD 2 Authors have no financial interest in this subject.

Endothelial Dystrophy Association with Hyperopia Glenn W. Thompson, M.D. Timothy P. Page, M.D. Authors have no financial interest.

Clinical outcomes of Epi-LASIK : 1-Year-Long Results of Flap ON/OFF with Mitomycin-C ON/OFF Gil-Joong Yoon (MD/PhD) 1 Seong-Taeck Kim (MD) 2 Jae-Woong.

LADARVision4000 Vs VISX CustomVue LADARVision4000 Vs VISX CustomVue CustomCornea CustomCornea A Comparison of Wavefront Guided Refractive Surgery outcomes.

Comparison of Central Corneal Thickness and Peripheral Corneal Thickness using Sheimpflug system, Optical Coherence Tomography and Ultrasound Pachymetry.

Mean Keratometry Measurement Post Penetrating Keratoplasty Jacky Yeung MSc MD, Stephanie Baxter MD FRCS(C) Department of Ophthalmology, Hotel Dieu Hospital,

Myoung Joon Kim, MD / Sara Yoon, MD Tracy Purcell, PhD / David J Schanzlin, MD L aser In Situ Keratomileusis versus Photorefractive Keratectomy for the.

Partial Coherence Interferometry Failure Rate in a Teaching Hospital Leslie A. Wei 1,2, BA, Nickolaus P. Katsoulakis 2, MD, Theodoros Filippopoulos 3,

The Effect of Corneal Anterior Surface Eccentricity on Astigmatism after Cataract Surgery Choul Yong Park MD 1 Sung Jun Lee MD 1 Prabjot Channa MD 2 Roy.

Factors which Influence Accommodative Amplitude in Crystalens HD Patients Uday Devgan, MD, FACS Devgan Eye Surgery, Los Angeles, CA FINANCIAL DISCLOSURES:

LONG TERM OUTCOMES OF RESTOR IOL IMPLANTATION Lori Dao, Orkun Muftuoglu, V. Vinod Mootha, Steven M. Verity, R. Wayne Bowman, H. Dwight Cavanagh, James.

Ocular functional optical zone following hyperopic LASIK/PRK: Analysis based on polychromatic retinal image quality Mitchell P. Weikert, MD Li Wang, MD,

Visual and IOP Outcomes after PRK in Pigment Dispersion Syndrome [Poster Number: P190] Kraig S. Bower, Denise A. Sediq, Charles D. Coe, Keith Wroblewski,

LogMAR-Analysis of multifocal intraocular lenses: Clinical performance A. Mannsfeld, I.-J. Limberger, A. Ehmer, M.P. Holzer, G. U.Auffarth International.

Financial Disclosure: Medical Director–Galilei R&D Consultant, Ziemer Group AG, Port, Switzerland Consultant & Territory Manager for.

Comparison of Central Corneal Thickness, Anterior Chamber Depth, and Central Corneal Power Measurements between Two Scheimpflug Imaging Systems Yuichi.

Wavefront-guided Ablation Retreatment in Myopic Eyes Engy M Mohamed MD, Orkun Muftuoglu MD, R.Wayne Bowman MD, V. Vinod Mootha MD, H. Dwight Cavanagh MD,PhD,

Comparison of visual function following piggyback implantation of Acrysof ReSTOR intraocular lenses with Tecnis multifocal ZM900 intraocular lenses. Rodrigo.

Long Term Results of Femtosecond Laser-Assisted Sutureless Anterior Lamellar Keratoplasty “FALK” Mohamed Abou Shousha, MD, Sonia H. Yoo, MD, William Feuer,

Investigation of Multifocal Toric IOLs to Compensate for Corneal Astigmatism and to Provide Near, Intermediate, and Distance Vision José L. Rincón, MD.

Minimizing Risk in Visian ICL Implantation.

Simulated Experiments on IOL Power Calculation Using Anterior Segment OCT Dong Hyun Jo, M.D., 1,2 Mee Kum Kim, M.D., 1,2 Won Ryang Wee, M.D. 1,2 1 Department.

Evaluating Post Laser Refractive Surgery Corneal Thickness Using Artemis-2 Very High Frequency Arc-Scanning Ultrasonography Versus Pentacam * † Sharon.

John P Berdahl M.D.* David R. Hardten M.D., F.A.C.S.* *No relevant financial disclosures.

Laser in Situ Keratomileusis Decentration With and Without Active Eye-Tracking System Mark Edmund Johnston MD FRCSC P 167: The author.

Sergio Kwitko, Diane Marinho, Samuel Rymer Ophthalmology Department - Hospital de Clínicas de Porto Alegre Federal University of Rio Grande do Sul - Porto.

Changes of Axial Length After LASIK Surgery: A 3-Year Follow-Up Study

Eun Chul Kim, M.D. , Man Soo Kim,M.D.

Postoperative Refraction and Patient Satisfaction after Bilateral Implantation of Presbyopia-Correcting Intraocular Lenses Robert Cionni, MD Financial.

Corneal Pachymetry in Prediction of Refraction After Cataract Surgery

Wavefront Optimized Retreatment after Prior Wavefront

Refractive outcomes of intraoperative wavefront aberrometry versus optical biometry alone for intraocular lens power calculation Zina Zhang MD1, Logan.

The authors have no financial interest.

Effect of Axial Length Measurement Method on Refractive Outcomes of Cataract Surgery: Real World Comparison of Partial Coherence Interferometry and Immersion.

Nienke Visser, Tos T.J.M. Berendschot, Rudy M.M.A. Nuijts

MP Weikert, M Shirayama, L Wang, DD Koch

Early Experience with Descemet’s Stripping Automated Endothelial Keratoplasty Combined with Phacoemulsification: Clinical and Refractive Outcome University.

Comparison of corneal powers obtained from four different devices

The authors have no financial interest to disclosure

Factors Potentially Affecting the Accuracy of Methods to Calculate Effective Refractive Power After Keratorefractive Surgery Helga P Sandoval, MD, MSCR,

Lasik decentration with the VISX ActiveTrak™ System

The authors have no financial interest

Visual Outcomes and Satisfaction with Toric IOL Versus Monofocal IOL

Michael Goodman, Alexandra Paul and Andrew Hsu

Presentation transcript:

Sherman W. Reeves, MD, MPH 1,3,4 ; Jacob A. Kozisek, OD 1,2 ; Noumia Cloutier-Gill, OD 1,2 ; David R. Hardten, MD 1,2,3,4 Accuracy of Scheimpflug Imaging Holladay Equivalent Keratometry Values for IOL Power Calculation in Post Laser Keratorefractive Surgery Eyes 1 Minnesota Eye Consultants, Minneapolis, Minnesota 2 Illinois College of Optometry, Chicago, Illinois 3 Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota 4 Department of Ophthalmology, Regions Medical Center, St. Paul, Minnesota **Financial disclosures: DRH – prior speaker for Oculus and Zeiss- Humphery; Minnesota Eye Consultants has received research funding from Bausch+Lomb for unrelated studies**

Minnesota Eye Consultantswww.mneye.com Background Traditional keratometry measurements, such as manual keratometry, inadequately measure corneal refractive power in eyes that have undergone prior laser keratorefactive surgery (LKS) such as laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). 1,2 Holladay Equivalent Keratometry Readings (EKR), available with the Pentacam Scheimpflug imaging system’s Holladay Report software package, are purported to provide accurate keratometry measurements in post LKS eyes. 3 Analysis of corneal power across a 4.5mm optical zone is the default measurement of the EKR software. A recent study suggested that EKR measurements at 4.5 mm zone may overestimate the true keratometric power in post LKS eyes. 4

Minnesota Eye Consultantswww.mneye.com Purpose To determine the accuracy of Pentacam Scheimpflug system Holladay Equivalent Keratometry Values for intraocular lens calculation prior to cataract extraction in eyes that have previously undergone excimer laser corneal refractive surgery.

Minnesota Eye Consultantswww.mneye.com Methods Design –Retrospective cohort –IRB approval granted by Chesapeake Research Review, Inc. Setting –Minnesota Eye Consultants (MEC), a private group practice with a large cataract and refractive surgery patient base. Subjects –Identified through a search of computerized billing database. –Eligibility: Eyes with prior hyperopic or myopic LASIK or PRK that subsequently underwent cataract surgery at MEC from Jan to Dec and with Pentacam measurements obtained preoperatively for cataract surgery. –Exclusions: Presence of visually significant ocular pathology unrelated to cataract. Eyes with intraoperative complications during cataract extraction.

Minnesota Eye Consultantswww.mneye.com Methods Chart Review –Clinical data collected Preoperative –Axial length –Manual keratometry values –Pentacam EKR values »Extrapolated at 4.5mm, 3.0mm and 2.0mm optical zones Power and model of intraocular lens implanted Postoperative –Stable spherical equivalent refractive error obtained between 2 to 12 weeks after cataract extraction.

Minnesota Eye Consultantswww.mneye.com Methods Analysis –The back-calculated keratometry value (BackCalc K) was generated for each patient with the Holladay IOL Consultant program, Version a (Holladay Consulting, Inc. Bellaire, TX), using the postoperative refraction, axial length, lens power and lens constant of the lens implanted. The BackCalc K represents the “ideal” keratometry value for an eye which, if entered into the IOL calculation formula preoperatively, would have generated and emmetropic spherical equivalent postoperative refractive outcome. 5 –Manual keratometry and Pentacam EKRs at the 4.5mm, 3.0mm, and 2.0mm zones obtained immediately prior to cataract extraction were then compared to the BackCalc K values for each patient. –Paired t-tests were use to compare the BackCalc K to manual and EKR Ks –Subset analysis was performed on eyes status post myopic laser with a monofocal IOL implanted. Wilcoxan rank-sum testing was used for subset comparisons due to small group numbers.

Minnesota Eye Consultantswww.mneye.com Results Population –30 eyes of 25 patients met the inclusion & exclusion criteria –29 eyes status post Lasik 23 eyes post myopic LASIK 6 eyes post hyperopic LASIK –1 eye status post PRK Unknown prior refractive error –IOL models implanted included Tecnis Z9002 and Z9003 AR40e Clariflex Crystalens AT-45, 5.0 and HD ReZoom –16 eyes status post myopic LASIK with a monofocal IOL implanted

Minnesota Eye Consultantswww.mneye.com Results MeasureMean (D) SD (D) BackCalc K Manual K EKR 4.5mm EKR 3.0mm EKR 2.0mm MeasureMean (D) SD (D) BackCalc K Manual K EKR 4.5mm EKR 3.0mm EKR 2.0mm ALL Eyes (n = 30) Subset: Eyes s/p myopic lasik with monofocal IOL (n = 16)

Minnesota Eye Consultantswww.mneye.com Results – ALL Eyes (n=30)

Minnesota Eye Consultantswww.mneye.com Results – Myopic LASIK/ Monofocal IOL Subset (n=16) Difference between means = ± 1.83 (p<0.001)

Minnesota Eye Consultantswww.mneye.com Pentacam Equivalent Keratometry Readings in the 4.5mm zone overestimate the keratometry value in post LASIK and PRK eyes undergoing cataract extraction when compared to an ideal K based on post surgical outcomes data. Shrinking the EKR optical zone produced flatter EKRs, which at the 3.0mm and 2.0mm zones were statistically indistinguishable from the ideal K when all eyes in the study were considered. A 2.0mm EKR gave a more accurate estimate of the actual keratometry than larger zones in the subset of eyes status post myopic LASIK and with a monofocal IOL implanted. Use of the Pentacam EKR measurements in the 2.0mm and/or 3.0mm zones may provide improved accuracy of Pentacam Equivalent K measurements in these eyes. Conclusions

Minnesota Eye Consultantswww.mneye.com References 1.Maeda N, Klyce SD, Smolek MK, McDonald MB. Disparity between keratometry-style readings and corneal power within the pupil after refractive surgery for myopia. Cornea 1997;16: Hamilton DR, Hardten DR. Cataract surgery in patients with prior refractive surgery. Curr Opin Ophthalmol. 2003;14: Holladay JT, Hill WE, Steinmueller A. Corneal power measurements using Scheimpflug imaging in eyes with prior corneal refractive surgery. J Refract Surg 2009; 25:862– Tang Q, MD, Hoffer KJ, Olson MD, Miller KM. Accuracy of Scheimpflug Holladay equivalent keratometry readings after corneal refractive surgery. J Cataract Refract Surg 2009; 35:1198– Randleman JB, Loupe DN, Song D, Waring GO, Stulting RD. Intraocular Lens Power Calculations After Laser In Situ Keratomileusis. Cornea 2002; 21(8): 751–755.