Comparison of IOL Prediction Error and Contributing Factors in Patients With and Without Prior Laser Refractive Surgery
Narrative Responses:
Purpose
To compare IOL prediction error in patients with prior history of laser vision correction (LVC) with patients without. Additionally, to compare post-LVC outcome with respect to formula used (Holladay II, Haigis, ASCRS calculator), myopic versus hyperopic, post-PRK versus post-LASIK, Custom versus Standard treatment, and axial length.
Methods
This is a retrospective comparative study of 114 cataract surgery patients (173 eyes); 38 patients had LVC prior to undergoing cataract surgery. The other 76 patients served as the control cataract surgery group. The main outcome measures were IOL prediction error with respect to IOL power calculation formula used, myopic versus hyperopic treatment, PRK versus LASIK, Custom versus Standard treatments, and axial length. Patients with history of corneal transplant, glaucoma surgery, history of macular issues, and previous retinal surgery were excluded.
Results
With prior LVC, the IOL prediction error was -0.36 D (range -1.75 to +1.50 D, SD 0.72 D). 59.5% of patients were within +/- 0.5 D, 78.6% within +/- 1.0 D, and 97.6% within +/- 1.5 D. For patients without prior LVC, IOL prediction error was 0.07D (range -0.88 to +1.50 D, SD 0.46 D). 82.6 % of patients were within +/- 0.5 D, and 97.8% were within +/- 1.0 D. (p = 0.00084). Formula used for IOL calculation, type of treatment, PRK versus LASIK, the use of Customvue, and axial length were not found to be statistically significantly different.
Conclusion
Our study shows that while ASCRS calculator, Holladay II, and Haigis were relatively good at picking accurate IOL’s for implantation during cataract surgery after LVC, there is still a statistically significant difference in outcome for post-LVC eyes regardless of the type or method of LVC treatment.