Biometry of the silicone oil-filled eye: II

Abstract

Purpose. In phakic silicone oil-filled eyes, removal of the silicone oil can be combined with phacoemulsification and intraocular lens (IOL) implantation. True axial length (AL) of the silicone oil-filled (viscosity 1300 centistokes) eye can be estimated from the measured AL (MAL) obtained on A and/or B scan echography, by multiplying MAL by a conversion factor of 0.71. IOL power can then be calculated using current biometry formulae (SRK/T). This study aims to evaluate the conversion factor in clinical practice. Methods. Eleven patients undergoing combined removal of silicone oil and phacoemulsification with IOL implant were studied. Patients were divided into two groups. In Group 1 (seven patients), the IOL was placed in the capsular bag and in Group 2 (four patients) the IOL was placed in the ciliary sulcus. Calculated AL (CAL) was obtained by multiplying the MAL of the silicone oil-filled eye (as measured on A or B scan ultrasonagraphy) by the conversion factor of 0.71. IOL power was then estimated using the CAL in the SRK/T formula. The spherical equivalent of the postoperative refractive error was compared to predicted refractive error. Results. The mean difference in actual and predicted refractive error was 0.74 dioptres (D) (standard deviation 0.75 D) for Group 1 and 1.31 D (standard deviation 1.4 D) for Group 2. Conclusions. The conversion factor of 0.71 corrects for the apparent increase in AL induced by silicone oil of viscosity 1300 centistokes. This allows accurate prediction of the required IOL power in eyes undergoing combined cataract extraction, removal of silicone oil and lens implant. Sulcus placement of the IOL gives a less predictable result than placement in the capsular bag.