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Changes after refractive surgery present problems when determining IOL power
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CLEVELAND — Choosing the correct IOL power will become increasingly difficult as more and more patients with previous refractive surgery become candidates for cataract surgery, said Roger H.S. Langston, MD, of the Cole Eye Institute. He spoke here at the institute’s Cornea and Refractive Surgery Summit 2005.
Previous corneal refractive surgery makes some implant selection formulas inaccurate, Dr. Langston said.
“The major issue is that the [keratometry] readings no longer have the same relationship to the central corneal power as they did prior to refractive surgery,” he said. Also, the difference between the anterior and posterior corneal curvatures in patients who have undergone LASIK, laser epithelial keratomeliusis or PRK is a factor, he said.
Other problems with cataract surgery after refractive surgery include the possibility that the refractive surgery was performed in another practice, thereby making pre-refractive-surgery data unavailable to the cataract surgeon, as well as the changes in refractive status that can occur after refractive surgery.
The various IOL power calculation methods have advantages and disadvantages, and there is no perfect method, according to Dr. Langston.
“It’s wise to use as many methods as you can,” he said.