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Review
. 2021 Oct 20;12(1):22-31.
doi: 10.4103/tjo.tjo_38_21. eCollection 2022 Jan-Mar.

Intraocular lens power calculations in eyes with previous corneal refractive surgery: Challenges, approaches, and outcomes

Li Wang  1 , Douglas D Koch  1
Affiliations
Review

Intraocular lens power calculations in eyes with previous corneal refractive surgery: Challenges, approaches, and outcomes

Li Wang et al. Taiwan J Ophthalmol. .

Abstract

In eyes with previous corneal refractive surgery, difficulties in accurately determining corneal refractive power and in predicting the effective lens position create challenges in intraocular lens (IOL) power calculations. There are three categories of methods proposed based on the use of historical data acquired prior to the corneal refractive surgery. The American Society of Cataract and Refractive Surgery postrefractive IOL calculator incorporates many commonly used methods. Accuracy of refractive prediction errors within ± 0.5 D is achieved in 0% to 85% of eyes with previous myopic LASIK/photorefractive keratectomy (PRK), 38.1% to 71.9% of eyes with prior hyperopic LASIK/PRK, and 29% to 87.5% of eyes with previous radial keratotomy. IOLs with negative spherical aberration (SA) may reduce the positive corneal SA induced by myopic correction, and IOLs with zero SA best match corneal SA in eyes with prior hyperopic correction. Toric, extended-depth-of-focus, and multifocal IOLs may provide excellent outcomes in selected cases that meet certain corneal topographic criteria. Further advances are needed to improve the accuracy of IOL power calculation in eyes with previous corneal refractive surgery.

Keywords: Corneal refractive surgery; LASIK; intraocular lens power calculation; photorefractive keratectomy; radial keratotomy; small-incision lenticule extraction.

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Conflict of interest statement

Dr. Wang is a consultant for Carl Zeiss Meditec and Alcon Laboratories. Dr. Koch is a consultant for Alcon, Carl Zeiss Meditec, and Johnson and Johnson Vision.

Figures

Figure 1
Figure 1
Postrefractive intraocular lens calculator at the American Society of Cataract and refractive surgery (www.ascrs.org)
See this image and copyright information in PMC

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