Review factors in refractive error to close the gap on IOL power accuracy

KIAWAH ISLAND, S.C. — A multitude of factors can push post-implantation IOL power outside the acceptable range of refractive error, so surgeons should examine each causative factor to correct errors in IOL power calculations, according to a speaker here.

According to a study by the National Health Service of the United Kingdom, 55% of patients should be within 0.5 D of the intended target and 85% should be within 1 D, Warren E. Hill, MD, FACS, said at Kiawah Eye 2009. Those benchmarks have become the standard of practice in refractive correction, he said, but even greater success rates are possible. However, surgical success will hinge on how close correction matches the target refraction.

"You are being judged by your patients, by your peers and, more recently, the malpractice community, in terms of your refractive outcomes," Dr. Hill said.

For that reason, it is important to regularly track absolute refractive errors on both sides of emmetropia. Surgeons should look at the effect that biometry, keratotomy, configuration of the rhexis, IOL power formula, retinal thickness around the fovea and the IOL manufacturing tolerance have on the final refractive outcome, Dr. Hill said.

"One perfect component part will not lead to perfect results, but one bad component may lead to a large refractive surprise," he said.

Kiawah Eye 2010 will be held May 13-15, 2010 at the Kiawah Island Golf Resort in South Carolina. Learn more at KiawahEye.com.