Laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) for the correction of near-sightedness represent the majority of refractive surgeries. Some of these patients will develop cataracts, and will likely expect excellent uncorrected visual acuity following cataract surgery, as they experienced after LASIK or PRK.
Early experience with eyes that had undergone myopic LASIK or PRK has shown that refractive predictability after cataract surgery is relatively poor. Errors in the calculation of corneal power and in estimated lens position are often introduced when intraocular lens (IOL) power calculation is performed on post–LASIK/PRK eyes.
This Focal Points issue concentrates on the changes that occur after myopic LASIK and how to correct for them in lens power calculations. PRK causes similar changes to the cornea and requires identical correction. A much smaller number of patients present for cataract surgery after a hyperopic LASIK, or after an old radial keratotomy (RK). These cases will also be discussed.
Upon completion of this Focal Points issue, you should be able to:
- Evaluate preoperatively the patient with prior corneal refractive surgery
- Demonstrate understanding of the differences in IOL calculation in patients with prior myopic LASIK/PRK, hyperopic LASIK/PRK, and radial keratotomy
- Apply the most appropriate IOL power formulas and corneal power correction equations to obtain the best postoperative result
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