title: Analysis of intraocular lens power calculation in post-radial keratotomy eyes.
abstract: OBJECTIVE
  To determine whether refractive complications can be prevented by applying the currently most accurate method of intraocular lens (IOL) power calculation in the post-radial keratotomy (RK) patient.
  
  
  METHODS
  Department of Ophthalmology, University of California, Davis, Sacramento, and American Eye Institute, Cedars Sinai Medical Center, Los Angeles, California, USA.
  
  
  METHODS
  Twenty-four eyes having cataract surgery after RK were studied retrospectively for the final postcataract refraction and for the target refraction used in selecting the IOL. Nine of the eyes were further studied for the keratometry (K) values obtained with different methods and for the theoretical postoperative refraction with an IOL aiming for plano or -1.50 diopters (D) based on the known flatter calculated K, axial length, power of the implanted IOL, and refraction after cataract surgery.
  
  
  RESULTS
  Implantation of an IOL aiming for plano in the 24 post-RK eyes would have resulted in a hyperopic refraction in 83.4% cases. The choice of an IOL targeted at myopia reduced the frequency of hyperopia to 42.0% (24 cases). Selection of an IOL calculated with a flatter calculated K and aiming for plano decreased the frequency of hyperopia to 44.4%; however, aiming for -1.50 D still resulted in hyperopia in 44.4% of eyes (9 cases).
  
  
  CONCLUSIONS
  Unintentional hyperopia can be significantly decreased but not eliminated as a complication of post-RK cataract surgery. The accuracy of the IOL power determination can be improved if myopia is targeted as the postcataract surgery refractive error and the flatter calculated K is used in the IOL determination.
authors.affiliation: Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Lin
authors.initials: L
authors.lastname: Chen
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Mannis
authors.forename: James J
authors.initials: JJ
authors.lastname: Salz
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Garcia-Ferrer
authors.forename: Jayne
authors.initials: J
authors.lastname: Ge
mesh_terms: D006801:Humans; D006956:Hyperopia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D015994:Incidence; D054018:Lasers, Excimer; D007910:Lenses, Intraocular; D055095:Optics and Photonics; D018903:Photorefractive Keratectomy / Q000009:adverse effects; D011184:Postoperative Period; D012030:Refractive Errors / Q000517:prevention & control*; D012189:Retrospective Studies