Accurate intraocular lens power calculation after myopic laser in situ keratomileusis, bypassing corneal power

Purpose

To describe a novel method for calculating intraocular lens (IOL) power after myopic laser in situ keratomileusis (LASIK) without using the inaccuracies of the post-LASIK corneal power.

Setting

Department of Ophthalmology, Wake Forest University Eye Center, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.

Methods

This retrospective chart review comprised 9 eyes of 9 patients who had phacoemulsification after LASIK using our method for IOL calculation. This new method assumes the patient never had myopic LASIK to calculate IOL power and then targets the IOL at the pre-LASIK amount of myopia. The pre-LASIK keratometry values, pre-LASIK manifest refraction, and the current axial length are placed in the Holladay formula, bypassing the post-LASIK corneal power. In theory, assuming that the patient had satisfactory LASIK results, the correct IOL can then be determined.

Results

The mean spherical equivalent postoperative refraction was +0.03 diopter (D) ± 0.42 (SD) (range −0.625 to +0.75 D). In all 9 eyes, our method consistently chose the most accurate and precise IOL compared with other methods.

Conclusions

The new method of calculating IOL power after LASIK provided excellent results and the most accurate and precise results to date.