[Calculating the diameter of the anterior chamber before implanting an artificial lens]. 1987

W Hauff

Anterior chamber lenses sized correctly and positioned properly yield excellent results. Problems reported with anterior chamber implants are related to improper length/or lens placement to the scleral spur. In clinical routine examinations the "white to white data plus one mm" determine the overall length of an anterior chamber lens. However, variability of limbal anatomy causes great variations in estimations of corneal diameter. Approximation of corneal profile can be achieved by using ellipsoid or paraboloid functions. These data together with ultrasound measurements and keratometer readings serve as prerequisites for computations. For biometry an Ocuscan DBR 400-ST unit is used; the corneal refraction (r0) is measured with an automatic keratometer (Humphrey). The peripheral measurements are performed 13.5 degrees nasally and temporally (r1, r2). Using Euler's formula the horizontal radius is calculated (R0, R1, R2). Taking the constant epsilon 2 (epsilon 2 = r2-r0(2)/r2sin2 phi) the diameter can be calculated with the formula h = square root of (2ap-p2)(1-epsilon 2). Model A: two asymmetric halves are computed, the addition gives the corneal diameter (H = h1 + h2). Model B and C: only one symmetric half is computed, the double distance gives the corneal diameter (H = 2 h). The distance p is taken from biometry data; the distance from the anterior corneal surface to the posterior lens surface (ACD + LE) should be multiplied with the factor 0.32: p = (ACD + LE) 0.32. 250 eyes were examined comparing the optical data with the calculated results of our corneal model; the mean value for p was 2.4811 millimeter. Based on a control system the computer eliminated 35 eyes (14%). In the rest group of 215 eyes (100%) the difference to the optical measurements was not greater than +/- 0.25 mm in 181 calculations (84.2%). We noticed a tendency to predict too short internal diameters with external methods. Using optical measurements 1.25 millimeters should be added assuring correct position of the haptics. Using our computer-program for calculations of corneal diameter new anatomic conditions in eyes with abnormal dimensions may be detected.

UI MeSH Term Description Entries
D007910 Lenses, Intraocular Artificial implanted lenses. Implantable Contact Lens,Lens, Intraocular,Contact Lens, Implantable,Intraocular Lens,Intraocular Lenses,Lens, Implantable Contact
D008433 Mathematics The deductive study of shape, quantity, and dependence. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Mathematic
D008866 Microsurgery The performance of surgical procedures with the aid of a microscope.
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012029 Refraction, Ocular Refraction of LIGHT effected by the media of the EYE. Ocular Refraction,Ocular Refractions,Refractions, Ocular
D003315 Cornea The transparent anterior portion of the fibrous coat of the eye consisting of five layers: stratified squamous CORNEAL EPITHELIUM; BOWMAN MEMBRANE; CORNEAL STROMA; DESCEMET MEMBRANE; and mesenchymal CORNEAL ENDOTHELIUM. It serves as the first refracting medium of the eye. It is structurally continuous with the SCLERA, avascular, receiving its nourishment by permeation through spaces between the lamellae, and is innervated by the ophthalmic division of the TRIGEMINAL NERVE via the ciliary nerves and those of the surrounding conjunctiva which together form plexuses. (Cline et al., Dictionary of Visual Science, 4th ed) Corneas
D004727 Endothelium A layer of epithelium that lines the heart, blood vessels (ENDOTHELIUM, VASCULAR), lymph vessels (ENDOTHELIUM, LYMPHATIC), and the serous cavities of the body. Endotheliums
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000867 Anterior Chamber The space in the eye, filled with aqueous humor, bounded anteriorly by the cornea and a small portion of the sclera and posteriorly by a small portion of the ciliary body, the iris, and that part of the crystalline lens which presents through the pupil. (Cline et al., Dictionary of Visual Science, 4th ed, p109) Anterior Chambers,Chamber, Anterior,Chambers, Anterior
D001699 Biometry The use of statistical and mathematical methods to analyze biological observations and phenomena. Biometric Analysis,Biometrics,Analyses, Biometric,Analysis, Biometric,Biometric Analyses

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