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Corrected IOL Power Prediction for TRIPLE Procedures in Fuchs Dystrophy using Multiple Regression Analysis
Viestenz A., Seitz B., Langenbucher A.,
Friedrich-Alexander-Universität, Augenklinik (Erlangen)
Purpose: To develop a correcting term for IOL power prediction for penetrating keratoplasty combined with simultaneous extracapsular cataract extraction and posterior chamber lens implantation (triple procedure) in Fuchs' dystrophy considering the effect of corneal power (CP), axial length (AL), HAIGIS predicted IOL power (IOLP) and target refraction (TR) on deviation between achieved and intended refraction (DEV).
Methods: As part of a prospective clinical study triple procedures were performed in 42 eyes (32 female, 10 male) with Fuchs' dystrophy using donor/recipient diameters of 7.6/7.5 mm (excimer laser trephination from the epithelial side) and a double running diagonal suture. Only eyes with readable preoperative K-values were included in this study. Differences between intended and TR depending on the values of the theoretical-optical formula according to HAIGIS were analyzed using multiple regression in a linear ANOVA-model: DEV=a+b×CP+c×AL+d×IOLP+e×TR.
Results: Central keratometric diopters changed 2.8 ± 2.1 diopters in absolute value, but did not differ significantly between preoperative (42.8 ± 2.4 D) and postoperative (43.0 ± 3.4 D) mean value. Spherical equivalent after suture removal was 1.4 ± 2.8 D in contrast to the TR of -1.6 ± 1.7 D. A multiple regression formula was developed for correction of conventionally calculated IOL power. CP (b=-1.177, p=0.027), AL (c=-3.0291, p=0.005), IOLP (d=-2.974, p=0.007) and TR (e=-1.28, p=0.004) correlated significantly with DEV.
Conclusions: Proposed correcting multiple regression formula for IOL power prediction according to Haigis may help to improve the postoperative refractive outcome in patients with triple procedures.