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  • Title: Nomogram-based intraocular lens power adjustment after myopic photorefractive keratectomy and LASIK: a new approach.
    Author: Feiz V, Moshirfar M, Mannis MJ, Reilly CD, Garcia-Ferrer F, Caspar JJ, Lim MC.
    Journal: Ophthalmology; 2005 Aug; 112(8):1381-7. PubMed ID: 16061093.
    Abstract:
    PURPOSE: (1) To evaluate the accuracy of nomogram-based adjustment of intraocular lens (IOL) power to achieve a desired refractive target after cataract surgery in postmyopic LASIK and photorefractive keratectomy (PRK) eyes and (2) to compare the accuracy of the nomogram-based method with the clinical history method. DESIGN: Multicenter, retrospective, interventional, noncomparative case series. SUBJECTS: Fourteen patients (19 eyes) after myopic LASIK or PRK with visually significant cataracts. INTERVENTION: All eyes underwent cataract extraction and posterior chamber intraocular lens implantation. In each case, IOL power was determined with standard keratometry and biometry. Power adjustment was made by use of a theoretical nomogram followed by implantation. MAIN OUTCOME MEASURES: (1) Final refraction and spherical equivalent after cataract surgery and (2) deviation of the final spherical equivalent from the refractive target. RESULTS: After cataract extraction, by use of nomogram adjustment, 63.2% of eyes were within 0.5 D of the intended spherical equivalent, 84.2% were within 1.0 diopter of the intended spherical equivalent, and 100% were within 1.5 D of the intended spherical equivalent. The clinical history method was accurate in predicting the correct IOL power in 37.5% of cases, regardless of whether spectacle or corneal plane refraction was used. CONCLUSIONS: (1) Given the change in spherical equivalent induced by myopic LASIK/PRK, IOL power can be adjusted accurately to avoid undercorrection without the need for the prerefractive surgery corneal power. (2) The nomogram-based method was more accurate than the clinical history method.
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