An update on intraocular lens power calculations in eyes with previous laser refractive surgery

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: Post-myopic LASIK/PRK eyes have the best refractive outcomes when multiple methods are averaged, or when Barrett True-K is used. Post-hyperopic LRS 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 non-theoretical 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 post-myopic and post-hyperopic 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.

This is a pre-copyedited, author-produced version of an article accepted for publication in Current Opinion in Ophthalmology. The published version of record [An update on intraocular lens power calculations in eyes with previous laser refractive surgery. Current Opinion in Ophthalmology 35, 1 p34-43 (2024)] is available online at: 10.1097/icu.0000000000001004.

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Work Title An update on intraocular lens power calculations in eyes with previous laser refractive surgery
Access
Open Access
Creators
  1. Daniel E. Savage
  2. Seth M. Pantanelli
Keyword
  1. Cataract surgery
  2. Keratometry
  3. Intraocular lens power calculation
  4. Refractive surgery
  5. PRK
  6. LASIK
  7. SMILE
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. Current Opinion in Ophthalmology
Publication Date October 12, 2023
Publisher Identifier (DOI)
  1. https://doi.org/10.1097/icu.0000000000001004
Deposited February 26, 2024

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Version 1
published

  • Created
  • Added Curr_Opinion_Ophthalmol_v2023-08-04_SP_EDIT_FINAL.docx
  • Added Creator Daniel E Savage
  • Added Creator Seth Michel Pantanelli
  • Published
  • Updated Keyword, Publisher, Description Show Changes
    Keyword
    • Cataract surgery, Keratometry, Intraocular lens power calculation, Refractive surgery, PRK, LASIK, SMILE
    Publisher
    • Curr Opin Ophthalmol.
    • Current Opinion in Ophthalmology
    Description
    • 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
    • Post-myopic LASIK/PRK eyes have the best refractive outcomes when multiple methods are averaged, or when Barrett True-K is used. Post-hyperopic LRS 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 non-theoretical 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 post-myopic and post-hyperopic 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.
    • 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: Post-myopic LASIK/PRK eyes have the best refractive outcomes when multiple methods are averaged, or when Barrett True-K is used. Post-hyperopic LRS 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 non-theoretical 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 post-myopic and post-hyperopic 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.
  • Renamed Creator Daniel E. Savage Show Changes
    • Daniel E Savage
    • Daniel E. Savage
  • Renamed Creator Seth M. Pantanelli Show Changes
    • Seth Michel Pantanelli
    • Seth M. Pantanelli
  • Updated