Intraocular lens power calculation using ray tracing following excimer laser surgery.
OBJECTIVE
To evaluate intraocular lens (IOL) power calculation using ray tracing in patients presenting with cataract after excimer laser surgery.


METHODS
Ten eyes of seven consecutive patients who presented for cataract surgery following excimer laser treatment without any pre-refractive biometry data were enrolled in this prospective clinical study. Preoperatively, IOL power calculation was performed using a ray tracing software called OKULIX. Keratometry data (C-Scan) were imported and axial length (IOLMaster) was entered manually. Accuracy of IOL power calculation was investigated by subtracting attempted and achieved spherical equivalent.


RESULTS
Mean spherical equivalent was -3.51+/-2.77 D (range -10.38 to -0.5 D) preoperatively and -1.01+/-1.08 D (range -2.5 to +0.75 D) postoperatively. Mean error was 0.31+/-0.84 D, mean absolute error was 0.74+/-0.46 D, and IOL calculation errors ranged from -1.39 to +1.47 D. A total of 40% of eyes were within +/-0.5 D, 70% within +/-1.0 D, and 100% within +/-1.5 D. Three eyes with corneal radii over 10 mm showed calculation errors exceeding +/-1.0 D. Mean best-corrected visual acuity increased from 20/60 to 20/30 postoperatively.


CONCLUSIONS
IOL power calculation after excimer laser surgery can be difficult, especially when pre-refractive keratometry values are not available. In these cases, ray tracing combined with corneal topography measurements provides reliable and satisfactory postoperative results. However, it is advisable to be careful when calculating IOL power for eyes with corneal radii exceeding 10 mm because of slightly higher prediction errors.
Rabsilber
T M
TM
Heidelberg IOL and Refractive Surgery Research Group, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany. tanja.rabsilber@med.uni-heidelberg.de
Reuland
A J
AJ
Holzer
M P
MP
Auffarth
G U
GU
D000368:Aged; D001699:Biometry / Q000379:methods; D019781:Corneal Topography / Q000379:methods; D006801:Humans; D054018:Lasers, Excimer; D007910:Lenses, Intraocular; D008875:Middle Aged; D009907:Optometry / Q000379:methods; D018918:Phacoemulsification; D018903:Photorefractive Keratectomy; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012029:Refraction, Ocular; D012984:Software; D016896:Treatment Outcome; D014792:Visual Acuity