Validation Of A Sulcus Measurement Method Using Postoperative Analysis Of Intraocular Lens Size
Published 2024 - 42nd Congress of the ESCRS
Reference: FP05.03 | Type: Free paper | DOI: 10.82333/45gd-f939
Authors: Timo Eppig* 1 , Violetta Müller 2 , Manuel Seer 3 , Achim Langenbucher 4
1Institute of Experimental Ophthalmology,Saarland University,Homburg,Germany;Research & Development,AMIPLANT GmbH,Schnaittach,Germany, 2Augentagesklinik Oranienburg,Oranienburg,Germany;Institute of Experimental Ophthalmology,Saarland University,Homburg,Germany, 3Research & Development,AMIPLANT GmbH,Schnaittach,Germany, 4Institute of Experimental Ophthalmology,Saarland University,Homburg,Germany
Purpose
To develop and validate a non-contact optical method for measuring the dimensions of the ciliary sulcus by postoperative images for the preoperative calculation of a dual-optic presbyopia correcting intraocular lens (IOL).
Setting
Department of Experimental Ophthalmology, Saarland University and AMIPLANT GmbH
Methods
We analyzed 12 eyes of 9 patients that had undergone cataract surgery with implantation of a Lumina presbyopia correcting IOL. We used anterior segment optical coherence tomography (CASIA2, Tomey Corp., Nagoya, Japan) to determine the required size of a presbyopia correcting intraocular lens for placement into the ciliary sulcus. Preoperative images were used to determine the size of the Lumina IOL. The lens was manufactured with smaller tolerances for the overall diameter than those required by ISO 11979-3. Lenses were implanted into the ciliary sulcus and we measured the size of the posterior part of the implant with the same method and compared it to the manufacturing records. Manucturing data was correlated to the measured values.
Results
A modification of scan parameters improved the visibility of ciliary anatomy in the anterior segment scan. This allowed to determine the ciliary sulcus directly in the OCT image. The power of the implant was 21.23 ± 1.67 [18.5 – 23.59] D. The preoperative posterior diameter of the IOL was 11.02 ± 0.28 [10.46 – 11.51] mm and the measured postoperative size was 10.95 ± 0.32 [10.41 – 11.49] mm. The center thickness according to manufacturer data was 1.65 ± 0.13 mm and postoperative measurement after correction for optical path length was 1.69 ± 0.12 mm. The spacebetween the two optic parts was 0.32 ± 0.03 (design: 0.36 mm). The slope of linear fit was 0.994 (R²=0.99) for IOL size, and 1.028 (R²=0.99) for IOL center thickness.
Conclusions
There are various influencing factors, such as refractive index of IOL material, swelling of the hydrophilic IOL material, manufacturing tolerances, visibility of the IOL in the OCT image, and the resolution of the OCT image. Taking these into consideration the results show that the method is reliable for pre- and postoperative assessment of the ciliary sulcus dimensions and less burdensome for the patient compared to ultrasound imaging.