The Influencing Factors Of Biometry With The IOL-Master System In Silicone Oil-filled Eyes

Objective: Silicone oil is widely used in vitreous surgery, specially inretinal detachment with huge hole, severe proliferative vitreoretinopathy andocular trauma with the continuous development of vitreoretinal surgery.Silicone oil with good optical transparency, no poison to the body andsimilarly refractive index with vitreous is used as an effective vitreoussubstitutes in the surgery.If retina reattachment well in silicone oil-filled eyes,remove of the silicone oil can be combined with phacoemulsification of thecataract and intraocular lens implantion.Because of the special acousticcharacteristics of the silicone oil,echographically measured axial length(AL)of silicone oil-filled eyes is not particularly accurate. Study shows thatbiometry of silicone oil-filled eyes with the IOL-Master system is relativelyaccurate.We performed the power of IOL of28cases(28eyes) with siliconeoil-filled,in order to determine the influencing factors of biometry with theIOL-Master system in silicone oil-filled eyes.Methods: The present study is included28silicone oil-filled eyes from28patients, who were after silicone oil removal and intraocular lensimplantation surgery from October2010to November2011in our hospital.Strictly follow-up the28patients,who have been vitrectomy combined withsilicone oil tamponade in the hospital. During follow-up,there are23caseswith varying degrees of cataracts,which is the main factors for the decline invisual acuity again. Three cases of cataract nuclear grade III level and aboveand two cases with corneal scarring which can not be applied to the IOLMaster are not in this study.In the remaining23cases (23),there are18casesof silicone oil filled eyes complicated cataract,but5without lens;6cases ofsecondary glaucoma with intraocular pressure having a history of greater than21mmHg during follow-up;5cases of high myopia with optometry myopia greater than-6D before vitrectomy. All patients with retinal detachment and nospecial complications have not obvious epiretinal proliferation or tractionneeded to deal with.In the23patients,18patients had surgery of silicone oilremoval combined with cataract phacoemulsification and intraocular lensimplantation;4patients had surgery of silicone oil removal and intraocular lenssuspension;One patient had silicone oil removal and intraocular lensimplantation. Checked visual acuity, intraocular pressure, slit lamp, andretinoscopy refraction for the patients before surgery. At the same time, IOLpower was measured in23silicone oil-filled eyes23patients prior to thesurgery with the IOL-Master system according to the different factors such ashigh myopia, secondary glaucoma and with or without lens. Followed up aftersurgery for3months,23cases (23) without retinal detachment and vitreoushemorrhage,there were no special complications.Checked visual acuity,intraocular pressure, slit lamp, retinoscopy examination,and measured IOLpower with the IOL-Master system again.Result: In the last follow-up record, postoperative visual acuity wasvarying degrees of improved in all of the patients.Six patients' best correctedvisual acu ity were less than0.1(15before surgery);eight patients' bestcorrected visual acuity were beween0.1and0.2(5before surgery);respectively, four patients' best corrected visual acuity were more than0.2and0.4;only one patien t's bes t corrected visual acuity was index(3beforesurgery). The average predictive refractive error was0.1991±1.26565(-2.55～+2.98D). High myopia(t=-0.88, P=0.932)and secondary glaucoma(t=0.093, P=0.926)have no correlation with postoperative refrac tiveerror. Without lens(t=2.304, P=0.032)have a certain relationship withpostoperative refractive error.Conclusions:For the silicone oil-filled eyes of patients with retinaldetachment and retinal function,remove silicone oil combined with cataractextraction and intraocular lens implantation. Combined surgery can reduce therisk of multiple surgeries, shorter operative period, and can save costs, reducepatient pain.Post-operative visual acuity was improved in varying degrees. High myopia and non-high myopia silicone oil-filled eyes were measured IOLpower with the IOL-Master system before surgery, and the postoperativerefractive error had no difference.The IOL-Master biometry for the highmyopia silicone oil filled eyes was accurate and reliable. The measurementerror was not increased.The measurement in secondary glaucoma and non-secondary glaucoma silicone oil-filled eyes had no difference in postoperativerefractive error. Also,the IOL-Master biometry for the secondary glaucomasilicone oil-filled eyes was accurate and reliable. Because of the position of thelens could be changed after surgery in aphakia silicone oil-filled eyes,refractive status was changed.So for this patients, a variety of methods shouldbe combined and comprehensive analysis the suitable IOL power. Overall theIOL-Master biometry in silicone oil-filled eyes is relatively accurate,convenient and safety.