ESCRS - FP04.01 - The Influence Of Lens Position, Vault Prediction, And Posterior Cornea On Phakic Posterior Chamber Intraocular Lens Power

The Influence Of Lens Position, Vault Prediction, And Posterior Cornea On Phakic Posterior Chamber Intraocular Lens Power

Published 2024 - 42nd Congress of the ESCRS

Reference: FP04.01 | Type: Free paper | DOI: 10.82333/c4re-6j48

Authors: Jascha Wendelstein* 1 , Achim Langenbucher 2 , Giacomo Savini 3 , Theo Seiler 4 , Tun Kuan Yeo 5 , Burkhard Dick 6 , Sarah Hinterberger 7 , Suphi Taneri 8

1IROC,Zürich,Switzerland;Johannes Kepler University,Linz,Austria;Kepler University Hospital,Linz,Austria, 2Saarland University,Homburg,Germany, 3Biettei Fondation,Rome,Italy, 4IROC,Zürich,Switzerland;Universitätsklinik Düsseldorf,Düsseldorf,Germany;Inselpital,Bern,Switzerland, 5Tan Tock Seng Hospital,Singapore,Singapore, 6University of Bochum,Bochum,Germany, 7Kepler University Hospital,Linz,Austria;Johannes Kepler University,Linz,Austria, 8University of Bochum,Bochum,Germany;St. Francis Hospital,Münster,Germany

Purpose

Achieving precise refractive outcomes in phakic posterior chamber intraocular lens (pIOL) implantation is crucial for patient satisfaction. This study investigates factors affecting pIOL power calculations, focusing on myopic eyes, and evaluates the potential benefits of advanced predictive models.

Setting

Retrospective, single-center study in Münster, Germany

Methods

Various variations with different effective lens position (ELP) algorithms were analyzed. The algorithms included a fixed constant model, and a multiple linear regression model and were tested with and without incorporation of the posterior corneal curvature (Rcp). Furthermore, the impact of inserting the postoperative vault, the space between the pIOL and the crystalline lens, into the ELP algorithm was examined, and a simple vault prediction model was assessed.

Results

Integrating Rcp and the measured vault into pIOL calculations did not significantly improve accuracy. Transitioning from constant model approaches to ELP concepts based on linear regression models significantly improved pIOL power calculations. Linear regression models outperformed constant models, enhancing refractive outcomes for both ICL and IPCL pIOL platforms.

Conclusions

This study underscores the utility of implementing ELP concepts based on linear regression models into pIOL power calculation. Linear regression based ELP models offered substantial advantages for achieving desired refractive outcomes, especially in lower to medium power pIOL models. For pIOL power calculations in both pIOL platforms we tested with preoperative measurements from a Scheimpflug device, we found improved results with the LION 1ICL formula and LION 1IPCL formula. Further research is needed to explore the applicability of these findings to a broader range of pIOL designs and measurement devices.