Optical Biometry Lens Constants.
LENSTAR Lens Constants
IOLMaster Lens Constants
Because there is no corneal contact, optical biometry lens constants will always be higher than those optimized for applanation A-scans in which there is a variable amount of corneal compression.
Optical biometry measures from the corneal vertex to the retinal
pigment epithelium, but the axial length displayed by optical biometry
is adjusted by an internal algorithm to mirror immersion A-scan
results with the exquisitely accurate Grieshaber Biometric System.
In essence, the axial length displayed by optical biometry is the
equivalent of an upright, non-contact, ultra high resolution immersion
A-scan. For this reason, optical biometry lens constants will be very
close to those optimized for immersion A-scan ultrasonography,
but always higher than those optimized for applanation A-scans.
If you already have optimized immersion A-scan lens constants,
you can begin with these as a starting point.
Dr. Wolfgang Haigis, at the University
of Würzburg has recommended the following approach for calculating the initial
IOL Master SRK/T A-constant:
| Optical Biometry |
=
|
A
Ultrasound
+ 3 * (AL Optical Biometry
- AL Ultrasound
)
|
| A Optical Biometry |
= |
Optimized A-constant for Optical Biometry |
| A Ultrasound |
= |
Optimized A-constant for ultrasonography |
| AL Optical Biometry |
= |
Average Optical Biometry axial length |
| AL Ultrasound |
= |
Average ultrasound axial length |
For example, if your previously optimized applanation A-scan ultrasound constant for a specific IOL was 118.00, and for a specific patient the applanation A-scan axial length was 23.46 mm, and optical biometry axial length was measured at 23.74 mm, then the SRK/T A-constant for optical biometry would be:
118.00 + (3 * (23.74 - 23.56)) = 118.54
If you are making the transition from previously optimized applanation
A-scan lens constants to optical biometry, below is a general rule of
thumb that will give you a reasonable starting point with one of
several popular IOL power calculation formulas.
|
Formula |
Add to Applanation Lens Constant |
|
Holladay 1 |
0.16 |
|
Holladay 2 |
0.16 |
|
Hoffer Q |
0.16 |
|
SRK/T |
0.34 |
|
SRK II |
0.36 |
It is recommended that every 10 to 20 patients, the results be reviewed
and the lens constant for the formula being used be adjusted up, or
down, by no more than 0.10. This will prevent wide oscillations within
a relatively small sample size.
LENSTAR Lens Constants
IOLMaster Lens Constants
|