Abstract

Introduction

Measurement problems in short eyes

IOL related problems in short eyes

Measurements on glaucomatous eyes

Conclusion

Discussion
Board

Short eyes require a more precise attention to the calculation of intraocular lenses. In order to focus on the retina, the natural lens of these eyes is usually thicker, the corneal diameter as well as the corneal radius of curvature is smaller, and the anterior chamber is shallower than in normal eyes. Due to the small anatomical dimensions, keratometry and ultrasonic measurements are more sensitive to systematic measurement errors. Moreover, depending on the individual A-scan unit used for biometry, a shallow anterior chamber as well as a thick lens might result in faulty measurements since the system does not anticipate such variations in ocular dimensions. Assuming that we have obtained precise measurements, we then have to deal with the necessary high dioptric power of the intraocular lens (IOL). Usually, these powers are not readily available. The lenses even might have to be especially designed and manufactured. High-powered lenses are 'thick' lenses optically, giving rise to calculation problems for the usual IOL algorithms which are based on infinitely thin lenses. In addition, possible errors due to different power-labelling policies (total power vs (back) vertex power) of lens manufacturers become more pronounced for high power IOLs. In acute angle closure glaucoma, we normally are faced with an extreme situation of the above increased thickness of the lens and small corneal diameter and radii. Corneal edema may contribute to problems occuring with keratometry. We retrospectively analyzed the results of IOL implantations in patients with short eyes, among them cases with non-glaucomatous short eyes as well as patients with a history of angle closure glaucoma. Factors (like differences in anterior chamber depth, lens thickness and axial length) contributing to the quality of IOL calculation will be demonstrated and discussed in detail for both groups.

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Presentation Number SAhaigis0830
Keywords: iol calculation, short eyes, thick lenses, glaucoma, iol labelling