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Refractive outcomes and accuracy of IOL power calculation with the SRK/T formula for sutured, scleral-fixated Akreos AO60 intraocular lenses

  • Retinal Disorders
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Abstract

Background

Scleral fixation of intraocular lenses has become a popular procedure for treating aphakia in the absence of capsular support. However, the lens formulas used to predict refractive outcomes were designed for in-the-bag lens placement. This study evaluates the accuracy of the SRK/T formula in predicting a target postoperative refraction when suturing a scleral-fixated intraocular lens (IOL) implant 3 mm posterior to the limbus.

Methods

This is a retrospective, case series including 20 eyes of 20 patients who underwent scleral fixation of Akreos AO60 IOLs (Bausch & Lomb, Rochester, NY) by a single surgeon at the OSU Wexner Medical Center. Preoperative measurements were performed with optical biometry, and IOL power was calculated with the SRK/T formula. Following surgery, the actual refractive spherical equivalent (SE) was performed and compared with the preoperative prediction. Prediction error (PE), defined as the deviation of actual postoperative SE refraction in diopters (D) from preoperative predicted SE refraction, was the primary outcome measure.

Results

The mean attempted (predicted) SE was − 1.12 D (± 0.87). Mean achieved SE was − 0.96 D (± 1.04). Mean PE (actual postoperative SE versus predicted preoperative SE) was 0.16 D (± 0.69). A total of 9 eyes (45%) were within ± 0.5 D of the predicted SE, 16 eyes (80%) were within ± 1.0 D, and all 20 eyes (100%) were within ± 1.5 D.

Conclusion

IOL power calculation using the SRK/T formula with optical biometry demonstrates reliable postoperative refractive outcomes in patients undergoing scleral fixation of an IOL (Akreos AO60). Further studies are needed to refine the predictive value of the SRK/T and other formulas for application in scleral fixation of IOLs.

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Authors and Affiliations

  1. Department of Ophthalmology, The Ohio State University, 915 Olentangy River Road Suite 5000, Columbus, OH, 43212, USA

    Matthew P. Ohr

  2. Department of Ophthalmology, Duke University, Durham, NC, USA

    C. Ellis Wisely

Authors
  1. Matthew P. Ohr
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  2. C. Ellis Wisely
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Correspondence to Matthew P. Ohr.

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Conflict of interest

(Any in the last 36 months) M.P.O. Consultant fees: Alimera and Bausch & Lomb (the manufacturer of the lens used in this study). Personal Fees: Alimera, Bausch & Lomb, and Gilead. Stockholder: Alimera and Spark Therapeutics. Research Grants: Allergan, AstraZeneca, Merck, Ophthea, Ophthotech, Regeneron, Roche.

Illustration of the use of an acrylic four-point closed-loop haptic Akreos AO60 IOL (Bausch & Lomb, Rochester, NY) using CV-8 (USP 7.0) Gore-Tex (W.L. Gore & Associates, Newark, DE) microporous, non-absorbable monofilament suture. A combined pars plana vitrectomy and ab externo scleral fixation are demonstrated.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was waived by the IRB due to the retrospective nature of the study.

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Ohr, M.P., Wisely, C.E. Refractive outcomes and accuracy of IOL power calculation with the SRK/T formula for sutured, scleral-fixated Akreos AO60 intraocular lenses. Graefes Arch Clin Exp Ophthalmol 258, 2125–2129 (2020). https://doi.org/10.1007/s00417-020-04721-9

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  • DOI: https://doi.org/10.1007/s00417-020-04721-9

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