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Ophthalmology. 2011 May;118(5):940-4. doi: 10.1016/j.ophtha.2010.08.048. Epub 2010 Dec 4.

Intraocular lens power calculations after myopic laser refractive surgery: a comparison of methods in 173 eyes.

Author information

1
Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada. martinmc@interchange.ubc.ca

Abstract

PURPOSE:

To evaluate and compare published methods of intraocular lens (IOL) power calculation after myopic laser refractive surgery in a large, multi-surgeon study.

DESIGN:

Retrospective case series.

PARTICIPANTS:

A total of 173 eyes of 117 patients who had uneventful LASIK (89) or photorefractive keratectomy (84) for myopia and subsequent cataract surgery.

METHODS:

Data were collected from primary sources in patient charts. The Clinical History Method (vertex corrected to the corneal plane), the Aramberri Double-K, the Latkany Flat-K, the Feiz and Mannis, the R-Factor, the Corneal Bypass, the Masket (2006), the Haigis-L, and the Shammas.cd postrefractive adjustment methods were evaluated in conjunction with third- and fourth-generation optical vergence formulas, as appropriate. Intraocular lens power required for emmetropia was back-calculated using stable post-cataract surgery manifest refraction and implanted IOL power, and then formula accuracy was compared.

MAIN OUTCOME MEASURES:

Prediction error arithmetic mean ± standard deviation (SD), range (minimum and maximum), and percent within 0 to -1.0 diopters (D), ±0.5 D, ±1.0 D, and ±2.0 D relative to target refraction.

RESULTS:

The top 5 corneal power adjustment techniques and formula combinations in terms of mean prediction errors, standard deviations, and minimizing hyperopic "refractive surprises" were the Masket with the Hoffer Q formula, the Shammas.cd with the Shammas-PL formula, the Haigis-L, the Clinical History Method with the Hoffer Q, and the Latkany Flat-K with the SRK/T with mean arithmetic prediction errors and standard deviations of -0.18±0.87 D, -0.10±1.02 D, -0.26±1.13 D, -0.27±1.04 D, and -0.37±0.91 D, respectively.

CONCLUSIONS:

By using these methods, 70% to 85% of eyes could achieve visual outcomes within 1.0 D of target refraction. The Shammas and the Haigis-L methods have the advantage of not requiring potentially inaccurate historical information.

PMID:
21131054
DOI:
10.1016/j.ophtha.2010.08.048
[Indexed for MEDLINE]

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