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Vol. 25, Art. 8 (pp. 132-142)    |    2024       

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Toric intraocular lens calculation in patients with superior eyelid malpositions

L.K. Anikina1, 2, S. Yu. Astakhov1, Yu. V. Takhtaev1, V.V. Potemkin1,2, A. S. Cherkashina2, T.S. Varganova2

1 Federal State Budgetary Educational Institution of Higher Education ?Academician I.P. Pavlov First St. Petersburg State Medical University? of the Ministry of Healthcare of Russian Federation;197022, St. Petersburg, Lva Tolstogo St., 6-8; 2 St. Petersburg State Budgetary Healthcare Institution "City Multifunctional Hospital No. 2" 194354, St. Petersburg, Uchebny Pereulok, 5

Brief summary

The aim of modern cataract surgery is to achieve good refractive results by correcting small degrees of astigmatism. It is important to consider the condition of ocular surface when calculating the optical power of intraocular lens. Patient with various eyelid malpositions have dry eye syndrome, Meibomian gland dysfunction, keratotopography irregularities. Surgery of blepharoptosis and blepharoplasty leads to changes of corneal astigmatism and optical power of intraocular lens. However, the influence of surgical treatment of upper eyelid retraction on the optical power of intraocular lens calculation has not been studied yet. The aim of the study is to compare the optical power of toric intraocular lens in patients with upper eyelid retraction associated with thyroid eye disease before and after surgical treatment. Materials and methods. The study included data of 56 eyes (37 patients) with upper eyelid retraction associated with thyroid eye disease. 45 eyes (28 patients) underwent full-thickness blepharotomy with spacer implantation (the Alloplant? was performed) according to original method - group I, 22 eyes (18 patients) underwent superior tarsal muscle extirpation - group II. All patients underwent keratotopography before and after surgical treatment. Calculation of the intraocular lens optical power has been based on this data. Results. The average value of spherical component of intraocular lens was 22,14?1,85 before surgical treatment and 1,93?1,96 D post-op in group I, p=0,097. In group II this parameter was 23,0?2,0 D and 23,14?2,12 D post-op, p=1,0. The average value of toric component was 2,28?1,51 D before surgical treatment and - 2,59?1,74 D post-op in group I, p=0,061. In group I this index was 2,57?1,4 D before surgical treatment and 2,71?1,98 D, p=0,99. It is important, that the toric component of intraocular lens changed in 37,78% cases in group I and 54,55% cases in group II. The implantation axis changed on average 3? ([min 0; max 39]) in group I and 4,5? ([min 0; max 13]) in group II. Conclusion. Surgical treatment of blepharoptosis, upper eyelid retraction and blepharoplasty influence on the choice of the intraocular lens optical power. Therefore, the calculation of it should be performed after stabilization of keratotopography parameters after surgery.


Key words

upper eyelid retraction, blepharoptosis, blepharoplasty, ocular surface, optical power of intraocular lens, phacoemulsification.

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