Accuracy of Cataract Surgery after LASIK

Posted by Dr. LEONARD YUEN on August 6, 2017

Purpose
To report outcomes using the Haigis-L formula to calculate intraocular lens (IOL) power in Asian eyes with long axial lengths (ALs) that had previous myopic laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK).

Design
Retrospective case series.

Methods
Patients with ALs greater than 25.0 mm and previous myopic LASIK or PRK who had phacoemulsification were analyzed. The emmetropic IOL power was back-calculated using the 1-month postoperative manifest refraction and compared with the emmetropic IOL power calculated with the Haigis-L formula. The primary outcome measure was the mean arithmetic prediction error, defined as the difference between the actual postoperative refractive error and the intended formula-derived refractive target.

Results
Sixty-two eyes (52 patients) were analyzed. The mean arithmetic prediction error was −0.44 diopter (D) ± 0.98 (SD) and the mean absolute error, 0.87 ± 0.62 D. The mean arithmetic prediction error was −0.52 ± 0.96 D in eyes with an AL less than 27.0 mm and −0.36 ± 1.00 D in eyes with an AL of 27.0 mm or greater (P = .463). The predictability of being within ±0.50 D and ±1.00 D of target was 35.7% and 63.1%, respectively, overall; 31.6% and 60.5%, respectively, in eyes with an AL less than 27.0 mm; and 39.1% and 65.2%, respectively, in eyes with an AL of 27.0 mm or greater (P = .772).

Conclusion
The Haigis-L formula was acceptably accurate in predicting and achieving target outcomes after phacoemulsification in Asian eyes with a long AL that had previous myopic LASIK or PRK.

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Dr. LEONARD YUEN

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