Clear lensectomy and intraocular lens implantation for hyperopia from +7 to +14 diopters.

BACKGROUND: Our results of clear lens extraction and intraocular lens implantation to correct hyperopia from +6.75 to +13.75 D are presented, as well as evaluation of two intraocular lens calculation formulae.

METHODS: Clear lens extraction and posterior chamber intraocular lens implantation was performed in 35 normally sighted eyes of 21 patients with a mean baseline hyperopic spherical equivalent refraction of +9.19 +/- 0.34 D (range +6.75 to +13.75 D). The refractive goal was -1.50 D, using the SRK II formula in 17 eyes and the SRK-T formula in 18 eyes. Follow-up was up to 5 years.

RESULTS: Mean uncorrected visual acuity after surgery was 0.8 (range 0.5 to 1.0). Stability of refraction was noted from the second month after surgery. No eyes lost any lines of spectacle-corrected visual acuity. Using the SRK II formula, 100% of eyes were within +/-1.00 D of emmetropia and with the SRK-T formula, 83.3% for a combined 91.4% of eyes within +/-1.00 D of emmetropia. One eye required intraocular lens exchange and another eye required photorefractive keratectomy for myopia. Both procedures were necessitated by an intraocular lens miscalculation of more than +/-2.00 D. Nineteen eyes (54.2%) developed posterior capsular opacification and were treated with Nd:YAG laser capsulotomy.

CONCLUSION: Clear lens extraction is a safe, effective, and predictable procedure for the treatment of hyperopia from +6.75 to +13.75 D. The SRK II formula proved slightly superior to the SRK-T in intraocular lens calculation when using the "-1.50 D rule."