Orbscan II and double-K method for IOL calculation after refractive surgery

Abstract

Background: Precise IOL calculation in post-refractive surgery patients is still a challenge for the cataract surgeon. The purpose of this study is to test whether adding Orbscan II values into the double-K method improves IOL calculation in this group of patients.

Methods: A prospective study with 43 eyes previously submitted to refractive surgery that underwent cataract extraction. IOL calculation was performed with double-K method. Post-K value was derived from Orbscan total-mean power map. The average corneal curvature of the general population (43.8D) was used as the pre-K value. Refraction results 30 days after surgery were compared with refraction that would be obtained if we used: (1) post-K values from keratometry, (2) post-K values from topography, and (3) pre-K values from Orbscan total-mean power. Anterior chamber depth measures obtained with the IOL Master and Orbscan II were compared.

Results: Mean postoperative spherical equivalent (SE) was -0.25 ± 1.10 D in eyes submitted to radial keratotomy , -1.04 ± 1.42 D in eyes previously submitted to myopic Lasik, and +0.05 ± 1.76 D in those submitted to hyperopic surgeries. Had we inputted post-K values derived from keratometer and from topography, we would have obtained significantly higher postoperative refractive errors in eyes previously submitted to myopic refractive surgery (p < 0.05). Refractions using pre-K derived from the central 8 mm Orbscan instead of 43.8 D were similar in all studied groups (p > 0.05). Anterior chamber depth measured with IOL Master or Orbscan were similar.

Conclusions: Orbscan measurements used as the post-K values into the double-K method provide a precise IOL calculation, especially in post myopic refractive surgery patients.