Limits of the precision in refractive results after cataract surgery

Valero, D. Romero; Serrano, J. Escolano; Lucas, C.E. Monera; Martínez, G Castilla; Toldos, J.J. Martínez

doi:10.1016/j.oftale.2021.11.002

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…Errors in estimating the anterior corneal radius of curvature result in either overestimation or underestimation of the refractive power [5]. This occurs because reflectance keratometry typically involves measuring a small central or annular region of the anterior cornea and extrapolating the data outward into the periphery.…”

Section: Sources Of Error In Intraocular Lens Power Calculations In P...mentioning

confidence: 99%

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

Savage,

Pantanelli

2023

Current Opinion in Ophthalmology

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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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Section: Sources Of Error In Intraocular Lens Power Calculations In P...mentioning

confidence: 99%

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

Savage,

Pantanelli

2023

Current Opinion in Ophthalmology

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Prediction of refraction error after toric lens implantation with biometric input data uncertainties and power labelling tolerances

Langenbucher,

Szentmáry,

Cayless

et al. 2024

Clinical Exper Ophthalmology

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BackgroundThe purpose of this study was to simulate the impact of biometric measure uncertainties, lens equivalent and toric power labelling tolerances and axis alignment errors on the refractive outcome after cataract surgery with toric lens implantation.MethodsIn this retrospective non‐randomised cross sectional Monte‐Carlo simulation study we evaluated a dataset containing 7458 LenStar 900 preoperative biometric measurements. The biometric uncertainties from literature, lens power labelling according to ISO 11979, and axis alignment tolerances of a modern toric lens (Hoya Vivinex) were taken to be normally distributed and used in a Monte‐Carlo simulation with 100 000 samples per eye. The target variable was the defocus equivalent (DEQ) derived using the Castrop (DEQC) and the Haigis (DEQH) formulae.ResultsMean/median / 90% quantile DEQC was 0.22/0.21/0.36 D and DEQH was 0.20/0.19/0.32 D. Ignoring the variation in lens power labelling and toric axis alignment the respective DEQC was 0.20/0.19/0.32 D and DEQH was 0.18/0.17/0.29 D. DEQC and DEQH increased with shorter eyes, steeper corneas, equivalent lens power and highly with toric lens power.ConclusionsAccording to our simulation results, uncertainties in biometric measures, lens power labelling tolerances, and axis alignment errors are responsible for a significant part of the refraction prediction error after cataract surgery with toric lens implantation. Additional labelling of the exact equivalent and toric power on the lens package could be a step to improve postoperative results.

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Limits of the precision in refractive results after cataract surgery

Cited by 2 publications

References 18 publications

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

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

Prediction of refraction error after toric lens implantation with biometric input data uncertainties and power labelling tolerances

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