Clinical observation of refractive outcome after surgery of idiopathic macular hole_Chinese Journal of Ocular Fundus Diseases

Authors：

Liu Boshi , Cui Weina , Niu Rui , Chen Qiong , Nie Zetong , Wei Jiaoting ,  Hu Bojie

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China;
Cui Weina, now is working on the Department of Ophthalmology, Tianjin Baodi Hospital, Tianjin 301800, China;
Liu Boshi and Cui Weina are contributed equally to the article;

Corresponding author：

Hu Bojie, Email: bhu07@tmu.edu.cn

Keywords：

Retinal perforations/surgery; Vitrectomy; Refraction, ocular

DOI：

10.3760/cma.j.cn511434-20200316-00116

Video：

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Objective To observe the changes in refractive status of eyes with idiopathic macular hole (IMH) after vitrectomy and phacoemulsification and IOL implantation (combined surgery).Methods A retrospective clinical study. From January 2016 to June 2019, 51patients (56 eyes) of IMH who underwent combined surgery at the Tianjin Medical University Eye Hospital. were included in the study. Among them, there were 17 males and 34 females with the average age of 66.79±4.33 years. All the affected eyes underwent BCVA, retinoscopy and axial length (AL) measurement. The IOL power was calculated according to the SRK-T formula and the refractive power (predicted value) was predicted. The average BCVA of the affected eye was 0.20±0.13. The average anterior chamber depth was 2.89±0.28 mm. The average △corneal astigmatism was 0.73±0.43 D, the average AL was 22.92±0.70 mm, the average predicted refractive power was 0.10±0.66 D. All the affected eyes underwent standard transciliary flat part three-channel 25G combined surgery. Six months after the operation, the actual value (actual value) of the diopter after the operation was measured with the same equipment and method before the operation. Paired t test was used to compare the difference between the predicted value and the actual value.Results Six months after the operation, the actual value of the refractive power was -0.19±0.64 D. Compared with the pre-operative refractive power, the difference was not statistically significant (t=1.665, P=0.102). The difference between the actual value and the predicted value was －0.33±0.81 D.Conclusions The refractive status of the IMH eye undergoes myopia drift after combined surgery. The preoperative IOL power budget can be appropriately reserved for +0.3 D hyperopia.

Citation： Liu Boshi, Cui Weina, Niu Rui, Chen Qiong, Nie Zetong, Wei Jiaoting, Hu Bojie. Clinical observation of refractive outcome after surgery of idiopathic macular hole. Chinese Journal of Ocular Fundus Diseases, 2020, 36(11): 880-883. doi: 10.3760/cma.j.cn511434-20200316-00116 Copy

1.	Demetriades AM, Gottsch JD, Thomsen R, et al. Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology[J]. Am J Ophthalmol, 2003, 135(3): 291-296. DOI: 10.1016/s0002-9394(02)01972-4.
2.	Smiddy WE, Mady M, Anagnoste S. Acrylic intraocular lens placement in conjunction with pars plana vitrectomy[J]. Am J Ophthalmol, 2001, 131(6): 748-750. DOI: 10.1016/s0002-9394(01)00835-2.
3.	Scharwey K, Pavlovic S, Jacobi KW. Combined clear corneal phacoemulsification, vitreoretinal surgery, and intraocular lens implantation[J]. J Cataract Refract Surg, 1999, 25(5): 693-698. DOI: 10.1016/s0886-3350(99)00022-x.
4.	Shi L, Chang JS, Suh LH, et al. Differences of refractive outcomes between phacoemulsification for cataract alone and combined phacoemulsification and vitrectomy for epiretinal membrane[J]. Retina, 2019, 39(7): 1410-1415. DOI: 10.1097/IAE.0000000000002153.
5.	宋爽, 谷潇雅, 卢颖毅, 等. 特发性黄斑裂孔患眼玻璃体切割手术后视力及裂孔闭合的影响因素分析[J]. 中华眼底病杂志, 2017, 33(4): 346-349. DOI: 10.3760/cma.j.issn.1005-1015.2017.04.005.Song S, Gu XY, Lu YY, et al. Analysis of factors associated with vision and hole closure for idiopathic macular hole after vitrectomy surgery[J]. Chin J Ocul Fundus Dis, 2017, 33(4): 346-349. DOI: 10.3760/cma.j.issn.1005-1015.2017.04.005.
6.	Nishigaki S, Inaba I, Minami H, et al. The postoperative change of depth of anterior chamber, refraction and anterior capsulorhexis size after intraocular lens implantation[J]. Nippon Ganka Gakkai Zasshi, 1996, 100(2): 156-158.
7.	Patel D, Rahman R, Kumarasamy M. Accuracy of intraocular lens power estimation in eyes having phacovitrectomy for macular holes[J]. J Cataract Refract Surg, 2007, 33(10): 1760-1762. DOI: 10.1016/j.jcrs.2007.05.031.
8.	Suzuki Y, Sakuraba T, Mizutani H, et al. Postoperative refractive error after simultaneous vitrectomy and cataract surgery[J]. Ophthalmic Surg Lasers, 2000, 31(4): 271-275.
9.	Shioya M, Ogino N, Shinjo U. Change in postoperative refractive error when vitrectomy is added to intraocular lens implantation[J]. J Cataract Refract Surg, 1997, 23(8): 1217-1220. DOI: 10.1016/s0886-3350(97)80319-7.
10.	Manvikar SR, Allen D, Steel DH. Optical biometry in combined phacovitrectomy[J]. J Cataract Refract Surg, 2009, 35(1): 64-69. DOI: 10.1016/j.jcrs.2008.09.020.
11.	Falkner-Radler CI, Benesch T, Binder S. Accuracy of preoperative biometry in vitrectomy combined with cataract surgery for patients with epiretinal membranes and macular holes: results of a prospective controlled clinical trial[J]. J Cataract Refract Surg, 2008, 34(10): 1754-1760. DOI: 10.1016/j.jcrs.2008.06.021.
12.	Kim M, Kim HE, Lee DH, et al. Intraocular lens power estimation in combined phacoemulsification and pars plana vitrectomy in eyes with epiretinal membranes: a case-control study[J]. Yonsei Med J, 2015, 56(3): 805-811. DOI: 10.3349/ymj.2015.56.3.805.
13.	Schweitzer KD, García R. Myopic shift after combined phacoemulsification and vitrectomy with gas tamponade[J]. Can J Ophthalmol, 2008, 43(5): 581-583. DOI: 10.3129/i08-135.
14.	Ehmann D, García R. Investigating a possible cause of the myopic shift after combined cataract extraction, intraocular lens implantation, and vitrectomy for treatment of a macular hole[J]. Can J Ophthalmol, 2009, 44(5): 594-597. DOI: 10.3129/i09-089.
15.	孙靖, 梁四妥, 张红. 光相干生物测量仪与接触式A型超声测量黄斑水肿患者眼轴长度比较[J]. 中华眼底病杂志, 2012, 28(4): 359-362. DOI: 10.3760/cma.j.issn.1005-1015.2012.04.011.Sun J, Liang ST, Zhang H. Comparison of axial length measurements of IOLMaster and contact A-scan in eyes with macular edema[J]. Chin J Ocul Fundus Dis, 2012, 28(4): 359-362. DOI: 10.3760/cma.j.issn.1005-1015.2012.04.011.
16.	王焕霞, 姜涛, 王哲, 等. 高度近视孔源性视网膜脱离行玻璃体切割联合晶状体手术后屈光状态的变化[J]. 眼科新进展, 2018, 38(1): 73-76. DOI: 10.13389/j.cnki.rao.2018.0016.Wang HX, Jiang T, Wang Z, et al. Changes in refractive status in high-myopic patients with rhegmatogenous retinal detachment after vitrectomy combined with cataract surger[J]. Rec Adv Ophthalmol, 2018, 38(1): 73-76. DOI: 10.13389/j.cnki.rao.2018.0016.
17.	Hamoudi H, La Cour M. Refractive changes after vitrectomy and phacovitrectomy for macular hole and epiretinal membrane[J]. J Cataract Refract Surg, 2013, 39(6): 942-947. DOI: 10.1016/j.jcrs.2013.04.012.
18.	Sardar DK, Swanland GY, Yow RM, et al. Optical properties of ocular tissues in the near infrared region[J]. Lasers Med Sci, 2007, 22(1): 46-52. DOI: 10.1007/s10103-006-0421-y.
19.	Lee NY, Park SH, Joo CK. Refractive outcomes of phacoemulsification and intraocular lens implantation after pars plana vitrectomy[J]. Retina, 2009, 29(4): 487-491. DOI: 10.1097/IAE.0b013e318195caee.
20.	Fajgenbaum MAP, Robins J, Williamson TH. Refractive outcomes using the lenstar optical low coherence reflectometry biometer in phacovitrectomy for epiretrinal membranes and macular holes[J]. Open J ophthalmol, 2017, 7(3): 216-224. DOI: 10.4236/ojoph.2017.73029.

1. Demetriades AM, Gottsch JD, Thomsen R, et al. Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology[J]. Am J Ophthalmol, 2003, 135(3): 291-296. DOI: 10.1016/s0002-9394(02)01972-4.
2. Smiddy WE, Mady M, Anagnoste S. Acrylic intraocular lens placement in conjunction with pars plana vitrectomy[J]. Am J Ophthalmol, 2001, 131(6): 748-750. DOI: 10.1016/s0002-9394(01)00835-2.
3. Scharwey K, Pavlovic S, Jacobi KW. Combined clear corneal phacoemulsification, vitreoretinal surgery, and intraocular lens implantation[J]. J Cataract Refract Surg, 1999, 25(5): 693-698. DOI: 10.1016/s0886-3350(99)00022-x.
4. Shi L, Chang JS, Suh LH, et al. Differences of refractive outcomes between phacoemulsification for cataract alone and combined phacoemulsification and vitrectomy for epiretinal membrane[J]. Retina, 2019, 39(7): 1410-1415. DOI: 10.1097/IAE.0000000000002153.
5. 宋爽, 谷潇雅, 卢颖毅, 等. 特发性黄斑裂孔患眼玻璃体切割手术后视力及裂孔闭合的影响因素分析[J]. 中华眼底病杂志, 2017, 33(4): 346-349. DOI: 10.3760/cma.j.issn.1005-1015.2017.04.005.Song S, Gu XY, Lu YY, et al. Analysis of factors associated with vision and hole closure for idiopathic macular hole after vitrectomy surgery[J]. Chin J Ocul Fundus Dis, 2017, 33(4): 346-349. DOI: 10.3760/cma.j.issn.1005-1015.2017.04.005.
6. Nishigaki S, Inaba I, Minami H, et al. The postoperative change of depth of anterior chamber, refraction and anterior capsulorhexis size after intraocular lens implantation[J]. Nippon Ganka Gakkai Zasshi, 1996, 100(2): 156-158.
7. Patel D, Rahman R, Kumarasamy M. Accuracy of intraocular lens power estimation in eyes having phacovitrectomy for macular holes[J]. J Cataract Refract Surg, 2007, 33(10): 1760-1762. DOI: 10.1016/j.jcrs.2007.05.031.
8. Suzuki Y, Sakuraba T, Mizutani H, et al. Postoperative refractive error after simultaneous vitrectomy and cataract surgery[J]. Ophthalmic Surg Lasers, 2000, 31(4): 271-275.
9. Shioya M, Ogino N, Shinjo U. Change in postoperative refractive error when vitrectomy is added to intraocular lens implantation[J]. J Cataract Refract Surg, 1997, 23(8): 1217-1220. DOI: 10.1016/s0886-3350(97)80319-7.
10. Manvikar SR, Allen D, Steel DH. Optical biometry in combined phacovitrectomy[J]. J Cataract Refract Surg, 2009, 35(1): 64-69. DOI: 10.1016/j.jcrs.2008.09.020.
11. Falkner-Radler CI, Benesch T, Binder S. Accuracy of preoperative biometry in vitrectomy combined with cataract surgery for patients with epiretinal membranes and macular holes: results of a prospective controlled clinical trial[J]. J Cataract Refract Surg, 2008, 34(10): 1754-1760. DOI: 10.1016/j.jcrs.2008.06.021.
12. Kim M, Kim HE, Lee DH, et al. Intraocular lens power estimation in combined phacoemulsification and pars plana vitrectomy in eyes with epiretinal membranes: a case-control study[J]. Yonsei Med J, 2015, 56(3): 805-811. DOI: 10.3349/ymj.2015.56.3.805.
13. Schweitzer KD, García R. Myopic shift after combined phacoemulsification and vitrectomy with gas tamponade[J]. Can J Ophthalmol, 2008, 43(5): 581-583. DOI: 10.3129/i08-135.
14. Ehmann D, García R. Investigating a possible cause of the myopic shift after combined cataract extraction, intraocular lens implantation, and vitrectomy for treatment of a macular hole[J]. Can J Ophthalmol, 2009, 44(5): 594-597. DOI: 10.3129/i09-089.
15. 孙靖, 梁四妥, 张红. 光相干生物测量仪与接触式A型超声测量黄斑水肿患者眼轴长度比较[J]. 中华眼底病杂志, 2012, 28(4): 359-362. DOI: 10.3760/cma.j.issn.1005-1015.2012.04.011.Sun J, Liang ST, Zhang H. Comparison of axial length measurements of IOLMaster and contact A-scan in eyes with macular edema[J]. Chin J Ocul Fundus Dis, 2012, 28(4): 359-362. DOI: 10.3760/cma.j.issn.1005-1015.2012.04.011.
16. 王焕霞, 姜涛, 王哲, 等. 高度近视孔源性视网膜脱离行玻璃体切割联合晶状体手术后屈光状态的变化[J]. 眼科新进展, 2018, 38(1): 73-76. DOI: 10.13389/j.cnki.rao.2018.0016.Wang HX, Jiang T, Wang Z, et al. Changes in refractive status in high-myopic patients with rhegmatogenous retinal detachment after vitrectomy combined with cataract surger[J]. Rec Adv Ophthalmol, 2018, 38(1): 73-76. DOI: 10.13389/j.cnki.rao.2018.0016.
17. Hamoudi H, La Cour M. Refractive changes after vitrectomy and phacovitrectomy for macular hole and epiretinal membrane[J]. J Cataract Refract Surg, 2013, 39(6): 942-947. DOI: 10.1016/j.jcrs.2013.04.012.
18. Sardar DK, Swanland GY, Yow RM, et al. Optical properties of ocular tissues in the near infrared region[J]. Lasers Med Sci, 2007, 22(1): 46-52. DOI: 10.1007/s10103-006-0421-y.
19. Lee NY, Park SH, Joo CK. Refractive outcomes of phacoemulsification and intraocular lens implantation after pars plana vitrectomy[J]. Retina, 2009, 29(4): 487-491. DOI: 10.1097/IAE.0b013e318195caee.
20. Fajgenbaum MAP, Robins J, Williamson TH. Refractive outcomes using the lenstar optical low coherence reflectometry biometer in phacovitrectomy for epiretrinal membranes and macular holes[J]. Open J ophthalmol, 2017, 7(3): 216-224. DOI: 10.4236/ojoph.2017.73029.

Chinese Journal of Ocular Fundus Diseases

Clinical observation of refractive outcome after surgery of idiopathic macular hole

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