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ARTIGO ORIGINAL 103Refractive results of cataract surgeryusing optical biometry and Haigis formulain eyes with refractive keratotomyResultado refracional da cirurgia de catarata utilizando biômetroóptico e fórmula Haigis em olhos com ceratotomia refrativaJuan Carlos Sánchez Caballero 1 ; Virgilio Centurion 2 ABSTRACTObjective: To analyze refractive results in postoperative cataract surgery in eyes previously submitted to keratotomy using Haigisformula and data provided by IOL Master ® optical biometer. Methods: The measurements for IOL calculation were obtained throughoptical biometry by partial coherence interferometry (IOL Master ® - Zeiss, 5.4 and 5.5 version) that provides us with the axial length,the central keratometry of 2.5mm, white-to-white diameter and anterior chamber anatomical depth. The formula chosen was Haigis. Thesurgical technique applied was with the scleral incision at 1.5 mm from the limbus, with scleral-corneal tunnel of 2.2 mm wide,phacoemulsification using INFINITI Ozil ® - Alcon and implantation of hydrophobic acrylic aspheric intraocular lens - SN60WF ® -Alcon. Results: We studied 20 eyes submitted to keratotomy in the past and currently with cataract with indication for cataract surgerywithintraocular lens implantation using phacoemulsification. Postoperative spherical equivalent was plano in 40% of the eyes and lowerthan -1.00 in 85% of the eyes. Conclusion: The optical biometry by partial coherence interferometry associated with Haigis formula isa valid alternative in IOL calculation for eyes submitted to keratotomy. The refractive results are highly predictable and reproducible.Keywords: Intraocular lens;Anterior chamber; keratotomy, radial; Biometry/instrumentation; Axial length, eye/pathologyRESUMOObjetivo: Analisar os resultados refracionais no pós-operatório de cirurgia de catarata em olhos previamente submetidos à ceratotomia,utilizando a fórmula Haigis e os dados fornecidos pelo biômetro óptico IOL Master ® . Métodos: As medidas para o cálculo da LIOforam obtidas por meio da biometria óptica por interferometria de coerência parcial (IOL Master ® - Zeiss, versão 5.4 e 5.5) que nosfornece o comprimento axial, a ceratometria central de 2.5mm, o diâmetro branco-a-branco e a profundidade anatômica da câmaraanterior. A fórmula escolhida foi a Haigis. A técnica cirúrgica aplicada foi com incisão escleral a 1.5mm do limbo, com túnel esclerocornealde 2.2mm de largura, facoemulsificação com equipamento INFINITI Ozil ® – Alcon e implante de lente intraocular acrílicahidrofóbica asférica – SN60WF ® – Alcon. Resultados: Foram estudados 20 olhos submetidos à ceratotomia no passado e atualmenteportadores de catarata com indicação de facectomia com implante de lente intraocular por meio da facoemulsificação. O equivalenteesférico pós-operatório foi plano em 40% dos olhos e menor que -1.00 em 85% dos olhos. Conclusão: A biometria óptica porinterferometria de coerência parcial associada à fórmula Haigis se apresenta como uma alternativa válida no cálculo da LIO emolhos submetidos à ceratotomia. Os resultados refrativos são altamente previsíveis e reproduzíveis.Descritores: Lentes intraoculares; Câmara anterior; Ceratotomia radial; Biometria/instrumentação; Comprimento axial do olho1Oftalmologista do Instituto de Moléstias Oculares (IMO) – São Paulo (SP), Brasil;2Oftalmologista do Instituto de Moléstias Oculares (IMO) – São Paulo (SP), Brasil.Trabalho realizado no Instituto de Moléstias Oculares (IMO) – São Paulo (SP), BrasilThe authors declare no conflicts of interestRecebido para publicação em: 28/6/2012 - Aceito para publicação em: 27/1/2012Rev Bras Oftalmol. 2013; 72 (2): 103-7
104Caballero JCS, Centurion VINTRODUCTIONIndividuals submitted to keratotomy for correction of myopiaand / or astigmatism in the 80’s, an average age of 30, nowreaching 60 years, are looking for cataract surgery or forsurgical correction of other refractive errors such as secondaryprogressive hyperopia.These patients have behavioralcharacteristics that is known as “refractive profile”, that is, theyare individuals who have had correction of refractive errors andnow, at the moment of selecting a new surgery they have anexpectation equal to or higher than in the first experience. Theyare well informed about advances in eye surgery and demand orexpect to have results that meet or exceed their expectations (1) .Another characteristic is related to the cornea that usuallyshows a progressive central flattening, with fluctuation of thevisual acuity.When submitted to lens surgery may have asignificant flattening, though temporary, which may compromisethe final result (2) .Refractive (1) predictability and reproducibility of IOLcalculation may be difficult due to the peculiarities of the corneapreviously submitted to keratotomy.The objective of this study is to analyze the cataract surgerypostoperative refractive results in eyes previously submitted tokeratotomy, using Haigis formula and the data provided by IOLMaster ® optical biometer.METHODSThis is a retrospective, non-comparative study of 20 eyeswhich were submitted to keratotomy in the past and have cataractwith an indication for intraocular lens implantation byphacoemulsification.All the eyes underwent a complete ophthalmologicexamination with emphasis on the biomicroscopy of the anteriorsegment, for analysis of radial cuts in the cornea, IOL calculation,analysis of vision potential (PAM) and evaluation of retina.The measurements for IOL calculation were obtainedfrom the optical biometry based on partial coherenceinterferometry (IOL Master ® , Zeiss, version 5.4, 5.5). Thisequipment provides:1. Axial length2. Central keratometry of 2.50mm3. White-to-white diameter4. Anatomic depth of the anterior chamber.To obtain more detailed analysis of the corneal surface,theeyes were submitted to corneal topography (Tomey - TMS) andcorneal tomography (Pentacam - Oculus).The keratometry used for the calculation of IOL was theone provided by IOL Master ® that when compared to Pentacam ® ,module Holladay Report, the 3mm does not present a significantdifference.The biometric formula used was Haigis. The surgicaltechnique was with scleral incision 1.50mm from the limbus, withsclero-corneal tunnel of 2.2mm wide, phacoemulsification usingAlcon INFINITI equipment and implantation of hydrophobicacrylic aspheric intraocular lens - SN60WF - Alcon. All surgerieswere performed by one surgeon (VC). The refraction studiedwas collected between the third and the sixth monthspostoperative. The chosen preoperative target refraction inbiometric calculation was for emmetropia (plano).All patients signed an inform consent about the procedure.The statistic method used was the T Student.Table1Data of eyes with previous keratotomy submitted to cataract surgeryNº K1K2 Pre Axial L ACD IOL RX Post S.E. UDVA LogMAR CDVA LogMAR Formula1. 33.35 x 83 / 37.63 x 173M = 35.49 27.48 3.50 21.00SN60WF +0.50-2.50 90º -0.75 20/60 0.48 20/20 0.00 Haigis2. 43.44 x 14 / 43.83 x 104M = 43.63 23.97 3.32 18.50SN60WF Plana Plano 20/20 0.00 20/20 0.00 Haigis3. 42.75 x 16 / 43.44 x 106M = 43.10 24.57 3.26 18.00SN60WF Plana Plano 20/30 0.18 20/30 0.18 Haigis4. 35.20 x 180 / 36.20 x 90M = 35.70 25.79 3.20 25.00SN60WF -1.75140º -0.87 20/40 0.30 20/20 0.00 Haigis5. 35.00 x 55 / 34.40 x 145M = 34.70 25.64 3.27 27.00SN60WF -0.50160º -0.25 20/30 0.18 20/20 0.00 Haigis6. 36.25 x 104 / 37.09 x 14M = 36.67 27.03 3.77 20.00SN60WF +0.50 +0.50 20/30 0.18 20/20 0.00 Haigis7. 34.23 x 129 / 44.53 x 39M = 39.38 25.59 3.58 20.00SN60WF -5.00120º -2.50 20/100 0.70 20/30 0.18 Haigis8. 35.83 x 85 / 36.64 x 175M = 36.23 26.04 3.51 23.00SN60WF -1.00115º -0.50 20/40 0.30 20/20 0.00 Haigis9. 31.96 x 119 / 37.84 x 29M = 34.90 26.95 2.87 23.00SN60WF Plana-5.50 105º -2.75 20/200 1.00 20/40 0.30 Haigis10. 30.00 x 94 / 35.00 x 4M = 32.50 28.87 2.86 21.00SN60WF +1.00-4.50 92º -1.25 20/200 1.00 20/40 0.30 Haigis11. 35.53 x 17 / 37.38 x 107M = 36.45 27.43 3.06 20.00SN60WF +0.50-1.50 15º -0.25 20/60 0.48 20/20 0.00 Haigis12. 34.62 x 88 / 36.06 x 178M = 35.34 26.50 3.10 23.00SN60WF +0.50-0.75 105º +0.25 20/40 0.30 20/20 0.00 Haigis13. 35.87x 98 / 36.76 x 8M = 36.31 26.12 3.48 23.00SN60WF Plana Plano 20/30 0.18 20/20 0.00 Haigis14. 36.93 x 146 / 37.46 x 56M = 37.19 25.83 4.96 22.50SN60WF Plana Plano 20/30 0.18 20/20 0.00 Haigis15. 35.38 x 123 / 35.83 x 33M = 35.60 29.38 3.19 16.50SN60WF Plana Plano 20/50 0.40 20/30 0.18 Haigis16. 34.97 x 151 / 35.71 x 61M = 35.34 27.19 3.40 21.00SN60WF -1.00145º -0.50 20/50 0.40 20/30 0.18 Haigis17. 35.94 x 172º / 39.06 x 82ºM = 37.50 26.75 3.67 20.00SN60WF +0.50-0.50 70º +0.25 20/30 0.18 20/30 0.18 Haigis18. 35.60 x 11 / 37.01 x 101ºM = 36.30 26.56 3.76 23.00SN60WF Plana Plano 20/20 0.00 20/20 0.00 Haigis19. 41.11 x 5 / 41.93 x 95ºM = 41.52 23.37 3.09 24.50SN60WF Plana Plano 20/20 0.00 20/20 0.00 Haigis20. 41.82 x 151 / 42.13 x 61ºM = 41.97 23.29 2.97 24.50SN60WF -1.00120º -0.50 20/40 0.30 20/20 0.00 HaigisRev Bras Oftalmol. 2013; 72 (2): 103-7
Page 1 and 2: Versão impressavol. 72 - nº 2 - M
Page 3 and 4: 80Revista Brasileira de Oftalmologi
Page 5 and 6: 82108 Efeitos de algumas drogas sob
Page 7 and 8: 84Kara-Junior Ninúmeras vezes ante
Page 9 and 10: 86Ambrósio Júnior Raplicação de
Page 11 and 12: 88Monte FQ, Stadtherr NMINTRODUÇÃ
Page 13 and 14: 90Monte FQ, Stadtherr NMFigura 1AFi
Page 15 and 16: 92Monte FQ, Stadtherr NMtempo (3) .
Page 17 and 18: 94Monte FQ, Stadtherr NM11. Höffli
Page 19 and 20: 96Grandinetti AA, Dias J, Trautwein
Page 21 and 22: 98Grandinetti AA, Dias J, Trautwein
Page 23 and 24: 100Ambrósio Jr R, Ramos I, Luz A,
Page 25: 102Ambrósio Jr R, Ramos I, Luz A,
Page 29 and 30: 106Caballero JCS, Centurion VDISCUS
Page 31 and 32: ARTIGO ORIGINALEfeitos de algumas d
Page 33 and 34: 110Almodin J, Almodin F, Almodin E,
Page 35 and 36: 112 ARTIGO ORIGINALFluência do las
Page 37 and 38: 114Lucena AR, Andrade NL, Lucena DR
Page 39 and 40: 116RELATO DE CASOAsymptomatic ocula
Page 41 and 42: 118Freitas LGA, Gabriel LAR, Isaac
Page 43 and 44: 120Ticly FG, Lira RPC, Fulco EAM, V
Page 45 and 46: 122RELATO DE CASOAssociation of mac
Page 47 and 48: 124Tavares RLP, Novelli FJ, Nóbreg
Page 49 and 50: 126Marback EF, Freitas MS, Spínola
Page 51 and 52: 128RELATO DE CASONeurofibromatose t
Page 53 and 54: 130Moraes FS, Santos WEM, Salomão
Page 55 and 56: 132 ARTIGO DE REVISÃOAntifúngicos
Page 57 and 58: 134Müller GG, Kara-José N, Castro
Page 65 and 66: 142 ARTIGO DE REVISÃOImportância
Page 67 and 68: 144Rehder JRCL, Paulino LV, Paulino
Page 69 and 70: 146Rehder JRCL, Paulino LV, Paulino
Page 71 and 72: 148Instruções aos autoresA Revist
Page 73: 150RevistaBrasileira deOftalmologia

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