This article describes different strategies for corneal measurements and/or intraocular lens (IOL) calculations and proposes a systematic approach for IOL selection in patients who have undergone laser corneal refractive surgery.
Corneal measurements and IOL calculations cannot be obtained accurately with the standard measuring technologies and formulas in patients with history of laser corneal refractive surgery; therefore a variety of methods and formulas, some of which required prerefractive surgery data, have been proposed to improve the accuracy of measurements and calculations. Formulas that do not rely on prerefractive data seem to be as accurate as those that do; therefore the lack of prerefractive data no longer presents an obstacle for accurate IOL selection in these patients.
Postrefractive patients undergoing cataract extraction and IOL implantation should have corneal measurements and IOL calculations that take into account and compensate for the limitations in accurate measurements and calculations. IOL selection should also aim to compensate for induced spherical aberration according to the ablation pattern.
aCornea, External Disease and Refractive Surgery, Private Practice, Atlanta, Georgia
bUSC Department of Ophthalmology, Keck School of Medicine of USC
cUSC Roski Eye Institute, Los Angeles, California, USA
Correspondence to Dr J. Bradley Randleman, MD, Professor, USC Department of Ophthalmology, Keck School of Medicine of USC, Director, Cornea, External Disease and Refractive Surgery, USC Roski Eye Institute, 1450 San Pablo Street, Suite 4700, Los Angeles, CA 90033, USA. Tel: +1 323 745 2223; e-mail: firstname.lastname@example.org