title: Intraocular lens power adjustment nomogram after laser in situ keratomileusis.
abstract: OBJECTIVE
  To develop a nomogram for improving the accuracy of intraocular lens (IOL) power calculation at the time of cataract surgery based on the manifest refraction spherical equivalent (MRSE) change produced by laser in situ keratomileusis (LASIK).
  
  
  METHODS
  University-based clinical practice, Jules Stein Eye Institute, Los Angeles, California, USA.
  
  
  METHODS
  This was a retrospective review of the records of consecutive patients who had cataract surgery after LASIK. Spherical equivalent refractive data before and after LASIK and cataract surgery were recorded. The differences between the targeted postoperative refractive errors after cataract surgery and the achieved refractive errors were plotted against the LASIK-induced MRSE change, yielding postoperative refractive errors to target during IOL power calculation to achieve emmetropia.
  
  
  RESULTS
  Thirty-two eyes of 23 patients were identified; 25 eyes had myopic LASIK and 7, hyperopic LASIK. Regression analysis yielded the following polynomial relationship: target postoperative refractive error (D) to achieve emmetropia during IOL power calculation = -0.018(MRSE Change)(2) + 0.192(MRSE Change) - 0.062. The outcomes in 97% of eyes fell within +/-1.00 D of the value predicted by this formula.
  
  
  CONCLUSIONS
  A 2nd-order polynomial relationship was found between LASIK-induced MRSE change and the MRSE error after cataract surgery. From this equation, a simple adjustment nomogram was generated and put into a look-up table format. The formula and nomogram should improve IOL power calculation accuracy in post-LASIK eyes when the MRSE change is known.
authors.affiliation: Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-7002, USA.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Diehl
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Michael D
authors.initials: MD
authors.lastname: Olson
authors.forename: Joel N
authors.initials: JN
authors.lastname: Moral
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Miller
mesh_terms: D000368:Aged; D002386:Cataract / Q000150:complications; D003315:Cornea / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D049451:Nomograms; D055095:Optics and Photonics; D018918:Phacoemulsification; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies