Patients will have accelerated cataract development after a pars plana vitrectomy, and these patients will be sent to you for cataract surgery. In doing these cases, the IOL calculations may be different than a typical eye because of the loss of the vitreous. When the anterior hyaloid face is removed the effective lens position of the IOL optic can change and this will affect the IOL calculations. This video shows two cases where the calculations are different and we are alerted to this based on the measured anterior chamber depth.
This figure shows that despite having a prior pars plana vitrectomy in the right eye, the patient has a similar ACD in both eyes (yellow arrows). The standard, static formulae all agree that the +18.0 D IOL would give the post-op result closest to plano (blue arrows). When we use IOLcalc.com and the Ladas Super Formula 2.0 with AI (which evolves with time), we see that a +18.5 D IOL is anticipated to give a post-op result of -0.23 and that was the IOL power that was implanted. This video has some great teaching points that will help you improve accuracy for these patients.
