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Influence of miosis and laser peripheral iridotomy on intraocular lens power calculation in patients with primary angle closure disease

Eye (2023)Cite this article

Subjects

Abstract

Objectives

To evaluate the effect of miosis and laser peripheral iridotomy (LPI) on intraocular lens (IOL) power prediction and ocular biometry in eyes with primary angle closure disease (PACD).

Methods

In this prospective observational study, primary angle closure suspects (PACS), and subjects classified with primary angle closure (PAC)/primary angle-closure glaucoma (PACG) undergoing LPI were enrolled. Ocular biometric parameters were measured with IOLMaster700 at baseline (T0), one week after pilocarpine instillation (T1), and another week post LPI (T2). Biometric changes and the IOL power predicted for emmetropia using Barrett Universal II, Haigis, Holladay2, Hoffer Q and SRK/T formulae were analysed and compared among different time points.

Results

100 eyes of 50 PACS and 50 PAC/PACG patients were enrolled. Following pilocarpine-induced miosis, lens thickness (LT) increased and anterior chamber depth (ACD) decreased (all groups p < 0.01), while white-to-white diameter decreased and central corneal thickness increased significantly only in the PACS cohort (both p < 0.01). Compared to baseline, LPI induced an increase of ACD and a slight decrease of LT in PACS (both p < 0.01), whereas only axial length changed significantly (p = 0.012) in the PAC/PACG cohort. Regardless of the formula used, no significant difference to the predicted IOL power for emmetropia existed among the three time points in each group (all p > 0.1).

Conclusion

We report the changes of anterior segment parameters induced by miosis and LPI in PACD. These interventions do not significantly affect the IOL power calculation predicted for emmetropia in Chinese eyes when common third-, fourth-and new generation IOL formulae are used.

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Fig. 1: Comparisons of the changes in ocular parameters along three timepoints between PACS and PAC/PACG.
Fig. 2: Comparisons between PACS and PAC/PACG in terms of the changing pattern of IOL power prediction along three timepoints with various formulae.

Data availability

The datasets generated and analysed during the current study are available from the corresponding author, YHC, on reasonable request. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

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Funding

This research project was supported directly by Shanghai Municipal Health Commission (20214Y0073), Clinical Research Plan of SHDC (Grant No. SHDC2020CR6029). The authors were also supported by grants from the State Program of National Natural Science Foundation of China (81870692), Shanghai Committee of Science and Technology (Grant no. 20S31905800), National Key Research and Development Program of China (2020YFA0112700), the State Key Program of National Natural Science Foundation of China (82030027), the subject of major projects of National Natural Science Foundation of China (81790641), and National Natural Science Foundation of China (82101123).

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China

    Hongfang Yang, Dongjin Qian, Jiajian Wang, Xinghuai Sun & Yuhong Chen

  2. Department of Ophthalmology & Visual Science, Shanghai Medical College, Fudan University, Shanghai, China

    Hongfang Yang, Dongjin Qian, Jiajian Wang, Xinghuai Sun & Yuhong Chen

  3. NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China

    Hongfang Yang, Dongjin Qian, Jiajian Wang, Xinghuai Sun & Yuhong Chen

  4. Lions Eye Institute, University of Western Australia, Perth, WA, Australia

    Geoffrey Chan

  5. Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia

    Geoffrey Chan

  6. State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China

    Xinghuai Sun

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  1. Hongfang Yang
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Contributions

XS and YC conceived and designed the work. HY and DQ majorly carried out this clinic trial and acquired data. JW, GC and HY played an important role in data analysis and results interpretation. HY, GC and YC drafted and revised the manuscript. All the authors approved the final version to be published.

Corresponding authors

Correspondence to Xinghuai Sun or Yuhong Chen.

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Yang, H., Qian, D., Chan, G. et al. Influence of miosis and laser peripheral iridotomy on intraocular lens power calculation in patients with primary angle closure disease. Eye (2023). https://doi.org/10.1038/s41433-023-02408-z

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