Intraocular lens power calculation after refractive surgery.
OBJECTIVE
To analyze the results of phacoemulsification cataract surgery in eyes that had had refractive surgery and to compare the predictability of various methods of intraocular lens (IOL) power calculation.


METHODS
Instituto de la Visión, Buenos Aires, Argentina.


METHODS
The study involved 7 cases that had phacoemulsification after radial keratotomy or laser in situ keratomileusis. The spherical equivalent (SE) and visual acuity were evaluated preoperatively and postoperatively to assess the changes before cataract development. The IOL power calculated with conventional keratometry (CK), adjusted keratometry, the clinical history method (CHM), corneal topography (CT), and the contact lens method (CLM) was compared with the final refractive and keratometric results measured with the BackCalcs (Holladay(R) IOL Consultant Program, Holladay Consulting, Inc.) to assess the accuracy and predictability of each method.


RESULTS
The mean SE was -4.82 diopters (D) +/- 5.13 (SD) before phacoemulsification and +0.19 +/- 1.01 D after phacoemulsification, and the mean best corrected visual acuity was 0.39 +/- 0.07 (20/50) and 0.80 +/- 0.06 (20/25), respectively.


CONCLUSIONS
Post-phacoemulsification refraction in cases with previous refractive surgery appeared to be predictable when the appropriate calculation method was applied. When all the data were available, the CHM provided the best results. Adjusted keratometry and CT seemed to be more accurate than CK and the CLM.
Argento
Carlos
C
Instituto de la Visión, and Hospital de Clínicas "José de San Martin" School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
Cosentino
María José
MJ
Badoza
Daniel
D
D002387:Cataract Extraction; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D007646:Keratotomy, Radial; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D055095:Optics and Photonics; D018918:Phacoemulsification; D054140:Refractive Surgical Procedures; D012086:Reoperation