Delta Journal of Ophthalmology (Jan 2022)

Accuracy of intraocular lens power calculation using Scheimpflug tomography and OKULIX ray-tracing software in paracentral corneal scarring not interfering with postoperative refraction

  • Karim M Nabil

DOI
https://doi.org/10.1353/djo_79_21
Journal volume & issue
Vol. 23, no. 3
pp. 168 – 176

Abstract

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Purpose The aim of this study was to evaluate the accuracy of intraocular lens (IOL) power calculation using Scheimpflug tomography and OKULIX ray-tracing software in cases of paracentral corneal scarring. Patients and methods The study was conducted on 40 consecutive eyes: 20 with corneal scarring and coexisting cataract and 20 controls with clear cornea, for whom uneventful phacoemulsification and IOL implantation was performed. Preoperatively, Scheimpflug tomography and OKULIX ray-tracing software and third-generation IOL power calculation formulas were used for IOL power calculation. Accuracy of IOL power calculation was evaluated by subtracting the expected and achieved spherical refraction, 3 months postoperatively and was recorded as the mean absolute error (MAE). The distance uncorrected visual acuity for each eye was measured preoperatively and 3 months postoperatively; the visual acuity was scored and converted to the logarithm of the minimum angle of resolution (LogMar) for statistical analysis. Results In cases of corneal scarring, all eyes (100%) yielded a postoperative spherical refraction which differed by less than 1 D from the predicted. In 16 (80%) eyes, the postoperative spherical refraction was within 0.50 D from the expected. The MAE was 0.2 D in cases of corneal scarring, which did not differ significantly from the controls (MAE=0.1 D), P=0.142. In corneal scarring cases, the distance uncorrected visual acuity showed significant improvement from 1.3 LogMar (Snellen’s equivalent 20/400), preoperatively, to 0.5 LogMar (Snellen’s equivalent 20/60), 3 months postoperatively. Conclusion Scheimpflug tomography combined with OKULIX ray-tracing software for the calculation of IOL power provided accurate results in cases of corneal scarring.

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