Refractive Accuracy Of Iol Formulas And Postoperative Corneal Changes In Fuchs Endothelial Dystrophy
Published 2025 - 43rd Congress of the ESCRS
Reference: PO451 | Type: Free paper | DOI: 10.82333/3jrk-j744
Authors: Ioannis Michail Klapsidis 1 , Lampros Pantsios 1 , Maria Stoila* 1 , Georgios Tzamichas 2 , Ioannis Tzamichas 1
1Department of Ophthalmology,Hippocrateio General Hospital of Thessaloniki,Thessaloniki,Greece, 2Anatolia College of Thessaloniki,Thessaloniki,Greece
Purpose
To evaluate the refractive accuracy of intraocular lens (IOL) power calculation formulas and the postoperative changes in corneal tomography and densitometry in patients with Fuchs endothelial dystrophy (FECD) undergoing cataract surgery.
Setting
This study was conducted at the Ankara Bilkent City Hospital, Department of Ophthalmology
Methods
A total of 28 eyes (mean age: 69.5±9.7 years;21 females,7 males) were included in the study.Preoperative and postoperative (up to 3 months) measurements included best-corrected visual acuity (BCVA),central corneal thickness (CCT), endothelial cell density (ECD),spherical equivalent refractive error,corneal densitometry (Pentacam, Oculus) and target refraction.Preoperative biometry was performed using the LensStar and IOL power was calculated to achieve a myopic target of approximately –0.70 D.Phacoemulsification was performed using the soft-shell technique with meticulous instrumentation to protect the corneal endothelium. Statistical analyses were performed with significance set at p<0.05.
Results
Postoperative best-corrected visual acuity (BCVA) showed significant improvement, increasing from 0.7±0.31 logMAR preoperatively to 0.12±0.15 logMAR (p<0.05). Central corneal thickness (CCT) increased slightly from 555±45 µm to 558±53 µm (p<0.05). Endothelial cell density (ECD) decreased from 2177±677 cells/mm² to 1917±883 cells/mm² (p<0.05). The mean refractive shift was 0.09±0.5 D, with a range from –0.97 to +1.26 D. Although central corneal densitometry increased from 25.7±8.7 units to 28.5±11.5 units, this change was not statistically significant (p=0.23)
Conclusions
Targeting a mild myopic refraction in FECD patients is a strategic approach, considering the potential need for future Descemet membrane endothelial keratoplasty (DMEK). The refractive outcomes closely aligned with the intended targets, demonstrating the reliability of IOL calculation methods in FECD eyes. In mild to moderate cases without significant corneal edema, IOL formulas provide reliable predictions despite topographic variations. Additionally, stable corneal densitometry values postoperatively indicate preserved corneal transparency and support favorable visual outcomes