title: Refractive outcomes in nanophthalmic eyes after phacoemulsification and implantation of a high-refractive-power foldable intraocular lens.
abstract: OBJECTIVE
  To evaluate the refractive and postoperative outcomes of a high-power foldable intraocular lens (IOL) in nanophthalmic eyes.
  
  
  METHODS
  Six ophthalmic surgical centers in Canada.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Consecutive charts of nanophthalmic patients having cataract extraction and insertion of the CT Xtreme D IOL were reviewed. Demographic and clinical data were collected, including age, sex, axial length (AL), minimum keratometry (K) value and maximum K value, corneal white-to-white (WTW), anterior chamber depth, lens thickness (LT), and complications. The following preoperative and operative data were collected: uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA), sphere, cylinder, and spherical equivalence (SE). The primary outcome measure was change in SE. The secondary outcome measures were changes in UDVA and CDVA.
  
  
  RESULTS
  A total of 21 eyes from 13 patients with a mean follow-up time of 9.6 ± 8.5 months were studied. Mean preoperative data were: age (51.4 ± 15.2 years), AL (16.63 ± 0.68 mm), minimum K value (46.20 ± 2.26 D), maximum K value (47.55 ± 2.34 D), anterior chamber depth (2.60 ± 0.49 mm), WTW (11.08 ± 1.38 mm), LT (4.70 ± 0.97 mm), and IOL power implanted (+49.9 ± 3.3 diopters [D]). SE improved from +16.11 ± 3.26 D preoperatively to +2.00 ± 2.37 D postoperatively (P < .0001). UDVA improved from 1.47 ± 0.30 logMAR preoperatively to 0.74 ± 0.43 logMAR postoperatively (P = .016). CDVA did not change significantly. Five eyes (23.8%) had serious postoperative complications. Of these eyes, 2 had malignant glaucoma, 2 had vitreous hemorrhages, and 1 eye had a vitreous hemorrhage with retinal detachment resulting in visual acuity of no light perception.
  
  
  CONCLUSIONS
  Implanting foldable high-power IOLs in a series of nanophthalmic eyes yielded significant improvement in UDVA and SE. Cataract surgery in these eyes carries increased risk.
  
  
  BACKGROUND
  Iqbal Ike K. Ahmed is a consultant to Carl Zeiss Meditec AG. No other author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada.
authors.forename: Harmanjit
authors.initials: H
authors.lastname: Singh
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada.
authors.forename: Jay Ching-Chieh
authors.initials: JC
authors.lastname: Wang
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada.
authors.forename: Daniel Christian
authors.initials: DC
authors.lastname: Desjardins
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada.
authors.forename: Kashif
authors.initials: K
authors.lastname: Baig
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Gagné
authors.affiliation: From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine (Wang), University of British Columbia, Vancouver, British Columbia, Canada; Département d'Ophtalmologie (Gagné), Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology (Baig), The Eye Institute, University of Ottawa, Ottawa, Ontario, Canada; Trillium Health Partners (Ahmed), Mississauga, Ontario, Canada; Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada. Electronic address: ikeahmed@mac.com.
authors.forename: Iqbal Ike K
authors.initials: II
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D000368:Aged; D000867:Anterior Chamber / Q000473:pathology; D058452:Axial Length, Eye / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008850:Microphthalmos / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D018918:Phacoemulsification; D011474:Prosthesis Design; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult