Córdova CJL, Loayza GW, Valera CDA, Alvarado VR, Herrera QJ

Language: Spanish
References: 10
Page: 1-10
PDF size: 290.66 Kb.

ABSTRACT

An unexpected refractive outcome after cataract surgery may have multiple causes, whether preoperative, operative or postoperative. The most important ones have been described as errors in the preoperative biometric calculation and also the less probable or infrequent ones such as: inadequate selection of IOL power, lack of precision in the manufacture of IOLs, surgical intervention in the wrong patient or in the wrong eye and the use of a soft contact lens at the time of the biometry test. We present the case of a patient who underwent cataract surgery by phacoemulsification with a monofocal foldable intraocular lens (IOL) implantation in the capsular bag, who 30 days after the operation presented a total or refractive astigmatism of - 1.00 diopters (D) x 110°. Sometime later, 90 days after surgery, he returned due to decreased visual acuity with a refractive astigmatism of -5.50 D x 165° which was not related to the corneal astigmatism measured by keratometry and topography (-0.94 D x 82°). The eye had clear mediums and showed no reports of immediate and gradual postoperative complications. In this case we found a mechanism of IOL tilt caused by a poorly deployed haptic at the time of IOL insertion that was not evident at the time of surgery associated with IOL displacement caused by fibrosis and pupillary contraction, which generated a late astigmatic effect. This was corroborated by ultrasound with ultrabiomicroscopy and surgical repositioning of the IOL, which allowed the case to be solved.

REFERENCES

1. Hormigó Puertas IF, Ventí Robirosa ZA, Cárdenas Díaz T, Méndez Duques de Estrada AM, Pérez Candelaria E, Montero Díaz E. Sorpresa refractiva por rotulación inadecuada. Rev Cubana Oftalmol. 2010[acceso 20/02/2021];23(Suppl 2):869-76. Disponible en: http://scieloprueba.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21762010000400019&lng=es1.

2. Abdelghany AA, Alio JL. Surgical options for correction of refractive error following cataract surgery. Eye Vis (Lond). 2014;1:2. DOI: 10.1186/s40662-014-0002-2.

3. Gaurisankar ZS, van Rijn GA, Lima JEE, Ilgenfritz AP, Cheng Y, Haasnoot GW, et al. Correlations between ocular biometrics and refractive error: A systematic review and meta-analysis. Acta Ophthalmol. 2019;97(8):735-43. DOI: 10.1111/aos.14208.

4. Jeong J, Song H, Lee JK, Chuck RS, Kwon JW. The effect of ocular biometric factors on the accuracy of various IOL power calculation formulas. BMC Ophthalmol. 2017 May 2;17(1):62. DOI: 10.1186/s12886-017-0454-y.

5. Momeni-Moghaddam H, Maddah N, Wolffsohn JS, Etezad-Razavi M, Zarei-Ghanavati S, Akhavan Rezayat A, et al. The Effect of Cycloplegia on the Ocular Biometric and Anterior Segment Parameters: A Cross-Sectional Study. Ophthalmol Ther. 2019 Sep;8(3):387-395. DOI: 10.1007/s40123-019-0187-5.

6. Epitropoulos AT, Matossian C, Berdy GJ, Malhotra RP, Potvin R. Effect of tear osmolarity on repeatability of keratometry for cataract surgery planning. J Cataract Refract Surg. 2015 Aug;41(8):1672-7. DOI: 10.1016/j.jcrs.2015.01.016.

7. Kelly SP, Jalil A. Wrong intraocular lens implant; learning from reported patient safety incidents. Eye (Lond). 2011 Jun;25(6):730-4. DOI: 10.1038/eye.2011.22.

8. Prado-Serrano A, Nava-Hernández N. Cálculo del poder dióptrico de lentes intraoculares ¿Cómo evitar la sorpresa refractiva? Revista Mexicana de Oftalmología. 2009[acceso 20/02/2021];83:272-80. Disponible en: https://www.medigraphic.com/pdfs/revmexoft/rmo-2009/rmo095e.pdf8.

9. García Y, Torriente V, Legon Z, Triana I. Cálculo del poder de la lente intraocular mediante biometría ultrasónica. Revista Cubana de Oftalmología. 2013[acceso 20/02/2021];399-409. Disponible en: http://scielo.sld.cu/pdf/oft/v26n3/oft06313.pdf9.

10. LaHood B, Goggin M. Measurement of Posterior Corneal Astigmatism by the IOLMaster 700. Journal of Refractive Surgery. 2018[acceso 20/02/2021];34(5):331-6. Disponible en: https://doi.org/10.3928/1081597X-20180214-0210.