Display Settings:


Send to:

Choose Destination
See comment in PubMed Commons below
Ophthalmology. 2014 Jan;121(1):56-60. doi: 10.1016/j.ophtha.2013.08.041. Epub 2013 Oct 30.

Intraoperative refractive biometry for predicting intraocular lens power calculation after prior myopic refractive surgery.

Author information

  • 1University of California at San Francisco, San Francisco, California. Electronic address: tianchul@yahoo.com.
  • 2Department of Ophthalmology, University of California at Los Angeles, Los Angeles, California; St. Mary's Eye Center, Santa Monica, California.
  • 3Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
  • 4Department of Ophthalmology, University of California at San Francisco, San Francisco, California.
  • 5WaveTec Vision, Inc, Aliso Viejo, California.
  • 6Private Practice, Long Beach, Orange, and Newport Beach, California.



To evaluate a new method of intraoperative refractive biometry (IRB) for intraocular lens (IOL) power calculation in eyes undergoing cataract surgery after prior myopic LASIK or photorefractive keratectomy.


Retrospective consecutive cases series.


We included 215 patients undergoing cataract surgery with a history of myopic LASIK or photorefractive keratectomy.


Patients underwent IRB for IOL power estimation. The Optiwave Refractive Analysis (ORA) System wavefront aberrometer was used to obtain aphakic refractive measurements intraoperatively and then calculate the IOL power with a modified vergence formula obtained before refractive surgery. Comparative effectiveness analysis was done for IRB predictive accuracy of IOL power determination against 3 conventional clinical practice methods: surgeon best preoperative choice (determined by the surgeon using all available clinical data), the Haigis L, and the Shammas IOL formulas.


Median absolute error of prediction and percentage of eyes within ±0.50 diopters (D) and ±1.00 D of refractive prediction error.


In 246 eyes (215 first eyes and 31 second eyes) IRB using ORA achieved the greatest predictive accuracy (P < 0.0001), with a median absolute error of 0.35 D and mean absolute error of 0.42 D. Sixty-seven percent of eyes were within ±0.5 D and 94% were within ±1.0 D of the IRB's predicted outcome. This was significantly more accurate than the other preoperative methods: Median absolute error was 0.6, 0.53, and 0.51 D for surgeon best choice, Haigis L method, and Shammas method, respectively.


The IOL power estimation in challenging eyes with prior LASIK/photorefractive keratectomy was most accurately predicted by IRB/ORA.

Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk