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Savage DE, Pantanelli SM. An update on intraocular lens power calculations in eyes with previous laser refractive surgery. Curr Opin Ophthalmol 2024; 35:34-43. [PMID: 37820078 DOI: 10.1097/icu.0000000000001004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
PURPOSE OF REVIEW There is an ever-growing body of research regarding intraocular lens (IOL) power calculations following photorefractive keratectomy (PRK), laser-assisted in-situ keratomileusis (LASIK), and small-incision lenticule extraction (SMILE). This review intends to summarize recent data and offer updated recommendations. RECENT FINDINGS Postmyopic LASIK/PRK eyes have the best refractive outcomes when multiple methods are averaged, or when Barrett True-K is used. Posthyperopic LASIK/PRK eyes also seem to do best when Barrett True-K is used, but with more variable results. With both aforementioned methods, using measured total corneal power incrementally improves results. For post-SMILE eyes, the first nontheoretical data favors raytracing. SUMMARY Refractive outcomes after cataract surgery in eyes with prior laser refractive surgery are less accurate and more variable compared to virgin eyes. Surgeons may simplify their approach to IOL power calculations in postmyopic and posthyperopic LASIK/PRK by using Barrett True-K, and employing measured total corneal power when available. For post-SMILE eyes, ray tracing seems to work well, but lack of accessibility may hamper its adoption.
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Affiliation(s)
- Daniel E Savage
- Department of Ophthalmology, David and Ilene Flaum Eye Institute
- Center for Visual Science, University of Rochester, Rochester, New York
| | - Seth M Pantanelli
- Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania, USA
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Wang L, Koch D. Intraocular lens power calculations in eyes with previous corneal refractive surgery: Challenges, approaches, and outcomes. Taiwan J Ophthalmol 2022; 12:22-31. [PMID: 35399961 PMCID: PMC8988985 DOI: 10.4103/tjo.tjo_38_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/10/2021] [Indexed: 11/04/2022] Open
Abstract
In eyes with previous corneal refractive surgery, difficulties in accurately determining corneal refractive power and in predicting the effective lens position create challenges in intraocular lens (IOL) power calculations. There are three categories of methods proposed based on the use of historical data acquired prior to the corneal refractive surgery. The American Society of Cataract and Refractive Surgery postrefractive IOL calculator incorporates many commonly used methods. Accuracy of refractive prediction errors within ± 0.5 D is achieved in 0% to 85% of eyes with previous myopic LASIK/photorefractive keratectomy (PRK), 38.1% to 71.9% of eyes with prior hyperopic LASIK/PRK, and 29% to 87.5% of eyes with previous radial keratotomy. IOLs with negative spherical aberration (SA) may reduce the positive corneal SA induced by myopic correction, and IOLs with zero SA best match corneal SA in eyes with prior hyperopic correction. Toric, extended-depth-of-focus, and multifocal IOLs may provide excellent outcomes in selected cases that meet certain corneal topographic criteria. Further advances are needed to improve the accuracy of IOL power calculation in eyes with previous corneal refractive surgery.
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Wang L, Koch DD. Intraocular Lens Power Calculations in Eyes with Previous Corneal Refractive Surgery. Ophthalmology 2021; 128:e121-e131. [DOI: 10.1016/j.ophtha.2020.06.054] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/10/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022] Open
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Zhang J, Shao J, Zheng L, Shen Y, Zhao X. Comparative clinical accuracy analysis of the newly developed ZZ IOL and four existing IOL formulas for post-corneal refractive surgery eyes. BMC Ophthalmol 2021; 21:231. [PMID: 34034681 PMCID: PMC8146991 DOI: 10.1186/s12886-021-01991-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intraocular lens (IOL) calculation using traditional formulas for post-corneal refractive surgery eyes can yield inaccurate results. This study aimed to compare the clinical accuracy of the newly developed Zhang & Zheng (ZZ) formula with previously reported IOL formulas. STUDY DESIGN Retrospective study. METHODS Post-corneal refractive surgery eyes were assessed for IOL power using the ZZ, Haigis-L, Shammas, Barrett True-K (no history), and ray tracing (C.S.O Sirius) IOL formulas, and their accuracy was compared. No pre-refractive surgery information was used in the calculations. RESULTS This study included 38 eyes in 26 patients. ZZ IOL yielded a lower arithmetic IOL prediction error (PE) compared with ray tracing (P = 0.04), whereas the other formulas had values like that of ZZ IOL (P > 0.05). The arithmetic IOL PE for the ZZ IOL formula was not significantly different from zero (P = 0.96). ZZ IOL yielded a lower absolute IOL PE compared with Shammas (P < 0.01), Haigis-L (P = 0.02), Barrett true K (P = 0.03), and ray tracing (P < 0.01). The variance of the mean arithmetic IOL PE for ZZ IOL was significantly smaller than those of Shammas (P < 0.01), Haigis-L (P = 0.03), Barrett True K (P = 0.02), and ray tracing (P < 0.01). The percentages of eyes within ± 0.5 D of the target refraction with the ZZ IOL, Shammas, Haigis-L, Barrett True-K, and ray-tracing formulas were 86.8 %, 45.5 %, 66.7 %, 73.7 %, and 50.0 %, respectively (P < 0.05 for Shammas and ray tracing vs. ZZ IOL). CONCLUSIONS The ZZ IOL formula might offer superior outcomes for IOL power calculation for post-corneal refractive surgery eyes without prior refractive data.
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Affiliation(s)
- Jun Zhang
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Jie Shao
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Li Zheng
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Ye Shen
- Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
| | - Xia Zhao
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
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Hamill EB, Wang L, Chopra HK, Hill W, Koch DD. Intraocular lens power calculations in eyes with previous hyperopic laser in situ keratomileusis or photorefractive keratectomy. J Cataract Refract Surg 2019; 43:189-194. [PMID: 28366365 DOI: 10.1016/j.jcrs.2016.11.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 10/30/2016] [Accepted: 11/07/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the accuracy of 7 intraocular lens (IOL) calculation formulas in patients with previous hyperopic laser in situ keratomileusis (LASIK) or excimer laser photorefractive keratectomy (PRK). DESIGN Retrospective case series. SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, and private practice, Mesa, Arizona, USA. METHODS The 7 formulas evaluated were the adjusted Atlas 0-3, Masket, Modified Masket, Haigis-L, Shammas-PL, Barrett True-K, and Barrett True-K No-History. The Masket and Modified Masket were calculated using the single-K version of Holladay 1 and Hoffer Q formulas; the adjusted Atlas 0-3 was calculated using the double-K version of Holladay 1 and Hoffer Q. The IOL power predicted by each formula was calculated by targeting the postoperative manifest refraction. The IOL prediction error was obtained by subtracting the predicted IOL power from the implanted IOL power. The mean IOL prediction error, median absolute refractive prediction error, and percentages of eyes within ±0.50 diopter (D) and ±1.00 D of the predicted refraction were calculated. RESULTS Twenty-one eyes of 21 patients were evaluated. There were no significant differences in the median absolute refractive prediction error or percentages of eyes within ±0.50 D or ±1.00 D of the predicted refraction between formulas or methods. The IOL mean prediction errors were comparable between the Holladay 1 and Hoffer Q calculations for all formulas except for a greater error for the double-K version of the Hoffer Q of the adjusted Atlas 0-3. CONCLUSION In eyes that had hyperopic LASIK or PRK, there were no significant differences in the accuracy between the 7 IOL calculation formulas.
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Affiliation(s)
- Eric B Hamill
- From the Cullen Eye Institute (Hamill, Wang, Chopra, Hill, Koch), Baylor College of Medicine, Houston, Texas, and East Valley Ophthalmology (Hill), Mesa, Arizona, USA; Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Li Wang
- From the Cullen Eye Institute (Hamill, Wang, Chopra, Hill, Koch), Baylor College of Medicine, Houston, Texas, and East Valley Ophthalmology (Hill), Mesa, Arizona, USA; Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Hayley K Chopra
- From the Cullen Eye Institute (Hamill, Wang, Chopra, Hill, Koch), Baylor College of Medicine, Houston, Texas, and East Valley Ophthalmology (Hill), Mesa, Arizona, USA; Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Warren Hill
- From the Cullen Eye Institute (Hamill, Wang, Chopra, Hill, Koch), Baylor College of Medicine, Houston, Texas, and East Valley Ophthalmology (Hill), Mesa, Arizona, USA; Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Douglas D Koch
- From the Cullen Eye Institute (Hamill, Wang, Chopra, Hill, Koch), Baylor College of Medicine, Houston, Texas, and East Valley Ophthalmology (Hill), Mesa, Arizona, USA; Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China.
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Francone A, Lemanski N, Charles M, Borboli-Gerogiannis S, Chen S, Robert MC, Pineda R. Retrospective comparative analysis of intraocular lens calculation formulas after hyperopic refractive surgery. PLoS One 2019; 14:e0224981. [PMID: 31697752 PMCID: PMC6837514 DOI: 10.1371/journal.pone.0224981] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 10/25/2019] [Indexed: 12/28/2022] Open
Abstract
Purpose To compare the intraocular lens calculation formulas and evaluate postoperative refractive results of patients with previous hyperopic corneal refractive surgery. Design Retrospective, comparative, observational study. Setting Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA. Methods Clinical charts and optical biometric data of 39 eyes from 24 consecutive patients diagnosed with previous hyperopic laser vision correction and cataract surgery were reviewed and analyzed. The Intraocular lens (IOL) power calculation using the Holladay 2 formula (Lenstar) and the American Society of Cataract and Refractive Surgery (ASCRS) Post-Refractive IOL Calculator (version 4.9, 2017) were compared to the actual manifest refractive spherical equivalent (MRSE) following cataract surgery. No pre-Lasik / PRK or post-Lasik / PRK information was used in any of the calculations. The IOL prediction error, the mean IOL prediction error, the median absolute refractive prediction error, and the percentages of eyes within ±0.50 diopter (D) and ±1.00 D of the predicted refraction were calculated. Results The Holladay 2 formula produced a mean arithmetic IOL prediction error significantly different from zero (P = 0.003). Surprisingly, the mean arithmetic IOL prediction errors generated by Shammas, Haigis-L and Barret True K No History formulas were not significantly different from zero (P = 0.14, P = 0.49, P = 0.81, respectively).There were no significant differences in the median absolute refractive prediction error or percentage of eyes within ± 0.50 D or ± 1.00 D of the predicted refraction between formulas or methods. Conclusion In eyes with previous hyperopic LASIK/PRK and no prior data, there were no significant differences in the accuracy of IOL power calculation between the Holladay 2 formula and the ASCRS Post-refractive IOL calculator.
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Affiliation(s)
- Anibal Francone
- Centro Oftalmológico Dr. Charles Sociedad Anónima, Buenos Aires, Argentina
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - Nicole Lemanski
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Martin Charles
- Centro Oftalmológico Dr. Charles Sociedad Anónima, Buenos Aires, Argentina
| | - Sheila Borboli-Gerogiannis
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sherleen Chen
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Marie-Claude Robert
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Roberto Pineda
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
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ASCRS calculator formula accuracy in multifocal intraocular lens implantation in hyperopic corneal refractive laser surgery eyes. J Cataract Refract Surg 2019; 45:582-586. [DOI: 10.1016/j.jcrs.2018.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 11/25/2018] [Accepted: 12/04/2018] [Indexed: 11/18/2022]
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Savini G, Hoffer KJ. Intraocular lens power calculation in eyes with previous corneal refractive surgery. EYE AND VISION 2018; 5:18. [PMID: 30038922 PMCID: PMC6053834 DOI: 10.1186/s40662-018-0110-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 06/22/2018] [Indexed: 01/14/2023]
Abstract
Background This review aims to explain the reasons why intraocular lens (IOL) power calculation is challenging in eyes with previous corneal refractive surgery and what solutions are currently available to obtain more accurate results. Review After IOL implantation in eyes with previous LASIK, PRK or RK, a refractive surprise can occur because i) the altered ratio between the anterior and posterior corneal surface makes the keratometric index invalid; ii) the corneal curvature radius is measured out of the optical zone; and iii) the effective lens position is erroneously predicted if such a prediction is based on the post-refractive surgery corneal curvature. Different methods are currently available to obtain the best refractive outcomes in these eyes, even when the perioperative data (i.e. preoperative corneal power and surgically induced refractive change) are not known. In this review, we describe the most accurate methods based on our clinical studies. Conclusions IOL power calculation after myopic corneal refractive surgery can be calculated with a variety of methods that lead to relatively accurate outcomes, with 60 to 70% of eyes showing a prediction error within 0.50 diopters.
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Affiliation(s)
| | - Kenneth J Hoffer
- 2Stein Eye Institute, University of California, Los Angeles, CA USA.,St. Mary's Eye Center, Santa Monica, CA USA
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Vrijman V, van der Linden JW, van der Meulen IJ, Mourits MP, Lapid-Gortzak R. Multifocal intraocular lens implantation after previous hyperopic corneal refractive laser surgery. J Cataract Refract Surg 2018; 44:466-470. [DOI: 10.1016/j.jcrs.2018.01.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 01/01/2018] [Accepted: 01/31/2018] [Indexed: 10/17/2022]
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Qu Y, Li F, Li J. Bilateral cataract surgery in a 56-year-old man following presbyopia laser in situ keratomileusis: A case report. Saudi J Ophthalmol 2016; 30:268-271. [PMID: 28003790 PMCID: PMC5161808 DOI: 10.1016/j.sjopt.2016.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 10/19/2016] [Accepted: 10/31/2016] [Indexed: 11/17/2022] Open
Abstract
We describe a case of bilateral cataract surgery in a 56-year-old man following presbyopia laser in situ keratomileusis. The preoperative refraction was −2.00 in the right eye and −0.75 × 105 in the left eye. On the last examination, the uncorrected distance visual acuity was 20/80 that can be corrected to 20/20 in the right eye with a refraction of −2.25 and 20/20 in the left eye, whereas the visual acuity for reading was 20/40 in the right eye and 20/80 in the left eye with a refraction of +2.25. His monovision surgery design of previous cornea surgery was also taken into consideration for the phacoemulsification and posterior chamber intraocular lens (IOL) implantation. Two-step surgery is helpful for predicting an accurate IOL degree.
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Affiliation(s)
- Ya Qu
- Southwest Eye Hospital, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Fuliang Li
- Southwest Eye Hospital, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Jiawen Li
- Southwest Eye Hospital, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
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Navas A. June consultation #6. J Cataract Refract Surg 2014; 40:1052-3; discussion 1054. [PMID: 24857449 DOI: 10.1016/j.jcrs.2014.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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