Abstract：
PURPOSE:To review the progress and challenges in obtaining accurate corneal power measurements for intraocular lens (IOL) calculations. DESIGN:Personal perspective, review of literature, case presentations, and personal data. METHODS:Through literature review findings, case presentations, and data from the author's center, the types of corneal measurement errors that can occur in IOL calculation are categorized and described, along with discussion of future options to improve accuracy. RESULTS:Advances in IOL calculation technology and formulas have greatly increased the accuracy of IOL calculations. Recent reports suggest that over 90% of normal eyes implanted with IOLs may achieve accuracy to within 0.5 diopter (D) of the refractive target. Though errors in estimation of corneal power can cause IOL calculation errors in eyes with normal corneas, greater difficulties in measuring corneal power are encountered in eyes with diseased, scarred, and postsurgical corneas. For these corneas, problematic issues are quantifying anterior corneal power and measuring posterior corneal power and astigmatism. Results in these eyes are improving, but 2 examples illustrate current limitations: (1) spherical accuracy within 0.5 D is achieved in only 70% of eyes with post-refractive surgery corneas, and (2) astigmatism accuracy within 0.5 D is achieved in only 80% of eyes implanted with toric IOLs. CONCLUSION:Corneal power measurements are a major source of error in IOL calculations. New corneal imaging technology and IOL calculation formulas have improved outcomes and hold the promise of ongoing progress.
journal_name
Am J Ophthalmoljournal_title
American journal of ophthalmologyauthors
Koch DDdoi
10.1016/j.ajo.2016.08.020subject
Has Abstractpub_date
2016-11-01 00:00:00pages
xv-xxxeissn
0002-9394issn
1879-1891pii
S0002-9394(16)30404-4journal_volume
171pub_type
abstract：:A patient who used contact lenses and had a history of blunt trauma developed vaccinia keratouveitis after accidental ocular autoinoculation from a recent vaccination site. Corneal and conjunctival cultures were taken for bacteria, fungi, Acanthamoeba, and viruses. Viral-like cytopathic effects became evident in tissu...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/s0002-9394(14)70008-x
更新日期：1994-04-15 00:00:00
abstract：:Two homosexual men, 35 and 42 years old, had bilateral acute angle-closure glaucoma in association with the acquired immune deficiency syndrome. In one patient, the angle-closure attack was the initial manifestation of AIDS. Choroidal effusion with secondary anterior rotation of the ciliary body at the scleral spur ap...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/0002-9394(86)90639-2
更新日期：1986-04-15 00:00:00
abstract：PURPOSE:To report the clinical and histopathologic features of orbital hemangiopericytoma. METHOD:We review the clinical and histopathologic features in seven patients. RESULTS:Ultrasonography, computed tomography, and magnetic resonance imaging defined the location and extent of the tumor in each patient but did not...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/s0002-9394(14)70904-3
更新日期：1997-11-01 00:00:00
abstract：:Deposits resembling foreign-body giant cells, which can be seen on specular reflex slit-lamp examination, were studied in vivo with a wide-field specular microscope using a low-power dipping cone lens in three cases of posterior chamber lens implantation. The deposits seen as iris pigment on routine examination showed...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/0002-9394(85)90360-5
更新日期：1985-03-15 00:00:00
abstract：PURPOSE:To study the effect of higher-order aberrations (HOAs) on visual function in keratoconus with a rigid gas permeable (RGP) contact lens (CLs). DESIGN:Retrospective nonrandomized study. METHODS:Thirteen eyes of 10 subjects with keratoconus who wore a RGP CLs (KC-RGP group), 15 eyes of nine normal subjects (norm...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/j.ajo.2007.08.004
更新日期：2007-12-01 00:00:00
abstract：PURPOSE:To compare three different methods of measuring corneal thickness (CT) and anterior chamber depth (ACD). DESIGN:Prospective clinical trial (Medical University of Vienna, Austria). METHODS:Central CT (CCT), CT at four peripheral points, and central ACD were measured in 88 eyes of 44 healthy subjects with the P...
journal_title：American journal of ophthalmology
pub_type： 临床试验,杂志文章
doi：10.1016/j.ajo.2005.08.048
更新日期：2006-01-01 00:00:00
abstract：PURPOSE:To investigate the outcome of manuscripts submitted to the American Journal of Ophthalmology (AJO) between July 23, 2002 and December 31, 2003. DESIGN:Observational series. METHODS:Data were collected on all Full-Length Articles and Brief Reports submitted to the AJO. Data were recorded for rejected or withdr...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/j.ajo.2006.12.004
更新日期：2007-04-01 00:00:00
abstract：:We examined 29 patients with homozygous beta thalassemia. The mean age of the patients was 15.6 +/- 8.9 years. Twelve patients (mean age, 02.0 +/- 10.4 years) had one or more ocular abnormalities. Five patients had degeneration of the retinal pigment epithelium, one had lens opacities, two had lens opacities and degen...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/0002-9394(89)90864-7
更新日期：1989-12-15 00:00:00
abstract：PURPOSE:To report a rare complication, delayed suprachoroidal hemorrhage, of needle revision of a nonfunctioning trabeculectomy bleb in a patient with previously undetected hairy cell leukemia. DESIGN:Interventional case report. METHODS; An 89-year-old man presented with massive delayed suprachoroidal hemorrhage after...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/s0002-9394(03)00574-9
更新日期：2003-12-01 00:00:00
abstract：PURPOSE:To report a case of an occult, metallic, anterior-chamber intraocular foreign body after uneventful phacoemulsification that was masquerading as chronic recalcitrant postoperative inflammation. DESIGN:Interventional case report. METHODS:A 73-year-old patient was referred to us for recalcitrant anterior-chambe...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/j.ajo.2004.08.031
更新日期：2005-03-01 00:00:00
abstract：PURPOSE:To describe a novel imaging technique, which we call "dense B-scan optical coherence tomography angiography" (DB OCTA), in which thin dense raster scans are used to produce highly resolved structural B-scans with superimposed flow signal that provide precise correlation between retinal microstructure and blood ...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/j.ajo.2018.03.029
更新日期：2018-06-01 00:00:00
abstract：PURPOSE:To evaluate the complications associated with the primary placement of a motility coupling post (MCP) in spherical porous polyethylene (PP) implants at the time of enucleation. DESIGN:Retrospective, interventional case series. METHODS:The records of all patients who had undergone primary enucleation and spher...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/j.ajo.2007.01.049
更新日期：2007-05-01 00:00:00
abstract：PURPOSE:To describe the results of strabismus surgery on three patients with chronic progressive external ophthalmoplegia, a group of rare disorders characterized by ptosis and slowly progressive ophthalmoparesis that has been shown to result from defects in mitochondrial DNA. METHODS:Strabismus surgery using the adju...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/s0002-9394(14)71041-4
更新日期：1997-02-01 00:00:00
abstract：:A 20-month-old boy with a ciliary body tumor presented with two white flocculi floating in the anterior chamber of his left eye. This material was examined by electron microscopy. Both the clinical appearance of the tumor and the ultrastructural findings suggested the diagnosis of medulloepithelioma. The flocculi cont...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/0002-9394(75)90089-6
更新日期：1975-02-01 00:00:00
abstract：:We perfused enucleated human eyes via the anterior chamber by the constant pressure technique. Infusion of human serum into the anterior chamber of enucleated human eyes for 30 minutes at 23 mm Hg pressure induced a 42% decrease in facility of outflow, which was not relieved by irrigation of the anterior chamber with ...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/0002-9394(78)90023-5
更新日期：1978-07-01 00:00:00
abstract：:T-cell and B-cell lymphocyte subpopulations, monocytes, granulocytes, and immunoglobulin receptors were measured with monoclonal antibodies and flow cytometric techniques in the peripheral blood of 266 patients with posterior uveal melanoma before therapy. Statistically significant differences were found in T-helper/i...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/0002-9394(86)90587-8
更新日期：1986-02-15 00:00:00
abstract：PURPOSE:To describe a case of Langerhans cell histiocytosis (LCH) that involved the anterior uveal tract. DESIGN:Interventional case report. METHODS:A retrospective review was conducted on a patient with iris nodules and anterior uveitis in the setting of LCH. Visual acuity and clinical findings that were noted on sl...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/j.ajo.2005.06.059
更新日期：2005-12-01 00:00:00
abstract：PURPOSE:To analyze the indocyanine green angiographic findings of drusen in the early stages of age-related macular degeneration. METHODS:Sixty-nine eyes of 53 consecutive patients with drusen but without exudative complications of age-related macular degeneration were studied. Drusen were classified into four groups:...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/s0002-9394(14)70826-8
更新日期：1997-09-01 00:00:00
abstract：PURPOSE:To evaluate the repeatability of an extensive number of relevant indices with the Pentacam HR in keratoconus of varying severity and normal eyes. DESIGN:Reliability analysis. METHODS:This study was performed at Antwerp University Hospital, Belgium, and enrolled 20 healthy volunteers (20 eyes) and 69 patients ...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/j.ajo.2020.06.013
更新日期：2020-11-01 00:00:00
abstract：PURPOSE:Evaluate the effect of visual acuity on color vision testing. DESIGN:University based clinical experimental study. METHODS:Right eyes of 12 healthy subjects were fogged with plus lenses to logMAR 1.88 and assessed with D-15 panel, Ishihara, and Hardy-Rand-Rittler (HRR) plates. Subjects were tested at lesser d...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/j.ajo.2005.07.041
更新日期：2006-01-01 00:00:00
abstract：PURPOSE:To compare the extent of mucosal margins remaining unsutured at the end of external dacryocystorhinostomy (DCR) using single or double flap techniques and to evaluate the influence on outcome. DESIGN:Prospective, consecutive case series. METHODS:The number and length of mucosal margins remaining unsutured at ...
journal_title：American journal of ophthalmology
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.ajo.2004.06.032
更新日期：2004-11-01 00:00:00
abstract：:Forty-three patients who initially presented with Krikenberg's spindles but with no glaucomatous field defects were observed for an average of 5.8 years in an attempt to evaluate the prognostic implication of spindle presence. Twenty-two of the patients had been followed for a minimum of five years. Analysis of the st...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/0002-9394(75)90075-6
更新日期：1975-02-01 00:00:00
abstract：PURPOSE:To present a case of congenital toxoplasmosis in a newborn whose mother had a 20-year history of a chorioretinal macular scar and positive serology for toxoplasmosis. DESIGN/METHODS:Case report. SETTING/RESULTS: A 38-year-old woman who had been treated for ocular toxoplasmosis 20 years earlier delivered a newb...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/s0002-9394(03)00191-0
更新日期：2003-08-01 00:00:00
abstract：:We analyzed two consecutive series of cataract extractions in patients with moderate to severe myopia for the incidence of postoperative retinal detachment. One series consisted of 122 intracapsular cataract extractions without surgical loss of vitreous and the other series consisted of 151 extracapsular (phacoemulsif...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/0002-9394(84)90445-8
更新日期：1984-01-01 00:00:00
abstract：PURPOSE:To determine whether alterations of p53, a tumor suppressor gene, were present in uveal melanoma, and to characterize further the nature of those changes. METHODS:Immunohistochemical analysis with a monoclonal antibody was used to determine whether alterations of p53 were present in 35 enucleated archival uvea...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/s0002-9394(14)75431-5
更新日期：1996-05-01 00:00:00
abstract：:A 29-year-old woman had a pigmented ciliary body mass that extended through the iris into the anterior chamber. On the basis of clinical findings and ancillary diagnostic studies, the clinical diagnosis was malignant melanoma of the ciliary body. The enucleated eye showed the tumor to be composed of cells identical to...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/0002-9394(80)90278-0
更新日期：1980-05-01 00:00:00
abstract：PURPOSE:To perform a reference case, cost-utility analysis of epiretinal membrane (ERM) surgery using current literature on outcomes and complications. DESIGN:Computer-based, value-based medicine analysis. METHODS:Decision analyses were performed under two scenarios: ERM surgery in better-seeing eye and ERM surgery i...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/j.ajo.2007.12.037
更新日期：2008-05-01 00:00:00
abstract：PURPOSE:To examine changes in the outer layer of the detached retina in rhegmatogenous retinal detachment (RRD) and central serous chorioretinopathy (CSC) with optical coherence tomography (OCT). DESIGN:Retrospective, observational case series. METHODS:Fifteen eyes (15 patients) with RRD and 16 eyes (16 patients) wit...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/j.ajo.2008.09.030
更新日期：2009-03-01 00:00:00
abstract：PURPOSE:To evaluate the use of disk diameter as an indicator in the identification of glaucomatous optic neuropathy. METHODS:We evaluated all available stereofundus photographs for 1,040 right eyes obtained in the Reykjavik Eye Study. Horizontal and vertical disk diameters were determined in a masked manner by a glauc...
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/s0002-9394(02)01928-1
更新日期：2003-02-01 00:00:00
abstract：PURPOSE:To report a case of Bartonella henselae infection. DESIGN:Observational case report. METHODS:Review of the clinical, laboratory, photographic, and angiographic records of a patient with cat scratch disease associated with central retinal artery and vein occlusion, neovascular glaucoma, and severe vision loss....
journal_title：American journal of ophthalmology
pub_type： 杂志文章
doi：10.1016/s0002-9394(03)00784-0
更新日期：2004-01-01 00:00:00
