Premium IOL Implantation Calculations in Post-LASIK Cataract Eyes Using ASCRS IOL Calculator
Narrative Responses:
Purpose
To evaluate the clinical outcomes of post-LASIK cataract eyes undergoing phacoemulsification with toric (n=13) and multifocal lens (n=15) and to assess the accuracy of the ASCRS IOL Calculator for premium IOL power calculations.
Methods
Twenty-eight eyes of 24 patients underwent toric IOL or multifocal IOL implantation using the ASCRS IOL Calculator to optimize IOL powers. Postoperative refractive data was used to compare back-calculated optimum IOL powers among the various formulas of the ASCRS IOL calculator.. We analyzed the postoperative MRSE, UDVA, UNVA, and the rate of excimer laser enhancement necessary for obtaining the target postoperative refraction.
Results
After phacoemulsification, the MRSE was -0.21 +/- 1.19 D. UDVA improved to 0.22 +/- 0.21 (P=0.01). In the multifocal IOL group, UNVA improved from 0.50+/- 0.10 to 0.07 +/-0.10 (P<0.001). 62% of eyes were within +/- 0.5D of target outcomes, and 100% were withiin +/- 2.0 D. Back-calculated optimum IOL powers correlated highest with ASCRS Average IOL power (r=0.8604), Modified Masket (r=0.7439), Masket (r=0.6440), and Corneal bypass (r=0.6007) power calculations. Excimer laser enhancement was performed in 43% of eyes.
Conclusion
Implantation of premium lenses in post-LASIK cataract eyes results in excellent UDVA and UNVA but is associated with a high rate of excimer laser enhancement. the ASCRS Average IOL formula and the Masket formulae most effectively predicted postoperative refractive outcomes in premium IOL implantation of post-LASIK cataract eye.