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Clinical manifestations after cataract surgery in patients with moderate Fuchs corneal endothelial dystrophy
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Myung-Sun Song, Dong Hyun Kim
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Insights Cataract Refract Surg 2025;10(1):19-25. Published online February 28, 2025
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DOI: https://doi.org/10.63375/icrs.25.006
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 Abstract
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- Purpose
The aim of this study was to analyze the clinical outcomes of cataract surgery in patients with moderate Fuchs endothelial corneal dystrophy (FECD) in whom central endothelial cells could not be observed using specular microscopy.
Methods
This retrospective study included nine eyes in seven patients diagnosed with FECD who underwent phacoemulsification at a single institution between January 2023 and November 2024. A single experienced corneal specialist performed slit-lamp examination and phacoemulsification. Best-corrected visual acuity (BCVA), specular microscopy, and central corneal thickness (CCT) measurements were performed preoperatively and postoperatively, and the outcomes were compared.
Results
The mean age of the patients was 69.8±6.5 years. Three were male patients and four were female patients. The mean preoperative CCT was 559.5±51.8 μm and the mean peripheral endothelial cell density was 599.3±129.4 cells/mm2. BCVA significantly improved in all patients postoperatively, with a mean logMAR BCVA improving from 0.65±0.52 preoperatively to 0.19±0.14 postoperatively (P=0.002). The mean CCT showed no significant change (preoperative, 559.6±51.8 μm; postoperative, 566.8±45.1 μm; P=0.218). In patients with follow-up longer than 6 months, an increase in CCT was observed at 30 days postoperatively, but CCT returned to preoperative levels after 90 days.
Conclusion
In patients with moderate-to-severe FECD in whom central endothelial cells cannot be measured, phacoemulsification may provide favorable visual outcomes if peripheral endothelial cells are observed and corneal edema is absent preoperatively.
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EImpact of anterior chamber depth to axial length ratio on conventional intraocular lens power calculation formulas performance in axial myopia
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Youngsub Eom, Jinhwan Park, Youngbin Song, Dong Hyun Kim, Jong Suk Song
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Received December 25, 2025 Accepted January 14, 2026 Published online January 28, 2026
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DOI: https://doi.org/10.63375/icrs.25.017
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Abstract
ePub
- Purpose
To evaluate the effects of the ratio of anterior chamber depth to axial length (ACD/AL), as well as axial length (AL) itself, on the accuracy of conventional intraocular lens (IOL) power calculation formulas in eyes with axial myopia.
Methods
This retrospective cross-sectional study included 60 eyes from 44 patients with an AL greater than 25.0 mm who underwent uncomplicated phacoemulsification with IOL implantation. Eyes were categorized into high and low AL groups using an AL threshold of 27.0 mm, and into high and low ACD/AL groups based on the median ACD/AL value of 13.4. The median absolute errors (MedAEs) predicted by the Sanders-Retzlaff-Kraff theoretical (SRK/T) and Haigis formulas were compared according to AL and ACD/AL groupings.
Results
In the low ACD/AL group and in the high AL group, the MedAEs predicted by the Haigis formula were lower than those predicted by the SRK/T formula (P=0.002 and P=0.012, respectively). The MedAEs predicted by both the SRK/T and Haigis formulas were significantly lower in the high ACD/AL group than in the low ACD/AL group (P<0.001 and P=0.010, respectively). In contrast, no significant difference was observed between the low and high AL groups in the MedAEs predicted by the Haigis formula. When the ACD/AL ratio was less than 13.4, postoperative refractive outcomes were more hyperopic with both formulas.
Conclusion
In eyes with a long AL and a relatively shallow ACD, the Haigis formula demonstrated superior accuracy among conventional IOL power calculation formulas. Under these anatomical conditions, targeting slightly more myopic postoperative refractions may therefore be advisable.
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