Posters

Phacoemulsification after radial keratotomy

Poster Details

First Author: N. Pasikova RUSSIAN FEDERATION

Co Author(s):    M. Bikbov   A. Bikbulatova                 

Abstract Details

Purpose:

To analyze the features of phacoemulsification in patients after radial keratotomy (RK), to develop recommendations preventing operative and postoperative complications.

Setting:

Ufa Eye Research Institute, Russia

Methods:

Phacoemulsification was performed on 50 eyes of 30 patients after RK by corneal or scleral tunnel access width of 2.2 mm. Number of keratotomy scars – from 6 to 18. The anterior corneal surface refractive power was determined by topographer «TMS-4», the axial length by «IOL Master», ultrasound biometer «OcuScan». IOL power calculation performed by Hoffer Q formula with topography data «TMS-4», choosing the average values of the refractive power of the cornea in two major meridians in the optical zone 3.0 mm. IOL power increased by adding 2.5-3.0 D to avoid hyperopic refractive error.

Results:

UCVA before operation was 0.18±0.07, BCVA 0.29±0.04. ECD was 1937,2±402,6 cells/mm2. We determined the «safety zone» width of intact cornea between the tunnel and keratotomy scars by original measuring instrument taking into account the reduction of the distance between corneal scars to the center of the cornea. We recommend the «safety zone» width more than 0.5 mm to prevent corneal scars crossing. Phacoemulsification on 38 eyes was made by corneal access, 12 eyes – by scleral. UCVA one year after surgery was on average 0.52±0.04 (p<0.05), BCVA – 0.85±0.02 (p<0.05). The achieved clinical refraction averaged -1.36±0.23 D. The ECD 1 month after phacoemulsification 1876.4±283.5 cells/mm2, the loss was 5.4%.

Conclusions:

Cornea refractive power measurement by modern scanning corneal topographer, axial length by non-contact laser interferometer, IOL power calculation by the formula Hoffer Q have allowed us to avoid hyperopic refractive error in the postoperative period. The «safety zone» compliance between the edges of the tunnel and keratotomy scars considering their convergence toward the center of the cornea prevented scar dehiscence during phacoemulsification. Endothelium protecting measures complex allowed to minimize cell loss.

Financial Disclosure:

NONE