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      Cataract Surgery following Sequential Myopic and Hyperopic LASIK

      case-report

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          Abstract

          We report a case of patient dissatisfaction after sequential myopic and hyperopic LASIK in the same eye. We discuss the course of management for this patient involving eventual cataract extraction and intraocular lens (IOL) implantation with attention to the IOL power calculation method used.

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          Most cited references 11

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          Evaluation of intraocular lens power prediction methods using the American Society of Cataract and Refractive Surgeons Post-Keratorefractive Intraocular Lens Power Calculator.

          To evaluate the accuracy of methods of intraocular lens (IOL) power prediction after previous laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) using the American Society of Cataract and Refractive Surgery IOL power calculator. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, and private practice, Mesa, Arizona, USA. The following methods were evaluated: methods using pre-LASIK/PRK keratometry (K) and surgically induced change in refraction, methods using surgically induced change in refraction, and methods using no previous data. The predicted IOL power was calculated with each method using the actual refraction after cataract surgery as the target. The IOL prediction error was calculated as the implanted IOL power minus the predicted IOL power. Arithmetic and absolute IOL prediction errors, variances in mean arithmetic IOL prediction error, and percentage of eyes within +/-0.50 diopter (D) and +/-1.00 D of refractive prediction errors were calculated. Methods using surgically induced change in refraction or no previous data had significantly smaller mean absolute IOL prediction errors, smaller variances, and a greater percentage of eyes within +/-0.50 D and +/-1.00 D of refractive prediction errors than methods using pre-LASIK/PRK keratometry (K) values and surgically induced change in refraction (all P<.05 with Bonferroni correction). There were no statistically significant differences between methods using surgically induced change in refraction and methods using no previous data. Methods using surgically induced change in refraction and methods using no previous data gave better results than methods using pre-LASIK/PRK K values and surgically induced change in refraction. Copyright (c) 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
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            Comparison of Newer Intraocular Lens Power Calculation Methods for Eyes after Corneal Refractive Surgery.

            To compare the newer formulae, the optical coherence tomography (OCT)-based intraocular lens (IOL) power formula (OCT formula) and the Barrett True-K formula (True-K), with the methods on the American Society of Cataract and Refractive Surgery (ASCRS) calculator in eyes with previous myopic LASIK/photorefractive keratectomy (PRK).
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              Comparison of intraocular lens power calculation methods in eyes that have undergone LASIK.

              To compare methods of calculating intraocular lens (IOL) power for cataract surgery in eyes that have undergone myopic LASIK. Noncomparative case series. Eleven eyes of 8 patients who had previously undergone myopic LASIK (amount of LASIK correction [+/-standard deviation], -5.50+/-2.61 diopters [D]; range, -8.78 to -2.38 D) and subsequently phacoemulsification with implantation of the SA60AT IOLs (Alcon Surgical, Inc., Fort Worth, TX) were included (refractive error after cataract surgery, -0.61 +/- 0.79 D; range, -2.0 to 1.0 D). We evaluated the accuracy of various combinations of: (1) single-K versus double-K (in which pre-LASIK keratometry is used to estimate effective lens position) versions of the IOL formulas; the Feiz-Mannis method was also evaluated; (2) 4 methods for calculating corneal refractive power (clinical history, contact lens overrefraction, adjusted effective refractive power [EffRP(adj)], and Maloney methods); and (3) 4 IOL formulas (SRK/T, Hoffer Q, Holladay 1, and Holladay 2). The IOL prediction error was obtained by subtracting the IOL power calculated using various methods from the power of the implanted IOL, and the F test for variances was performed to assess the consistency of the prediction performance by different methods. Mean arithmetic IOL prediction error, mean absolute IOL prediction error, and variance of the IOL prediction error. Compared with double-K formulas, single-K formulas predicted lower IOL powers than the power implanted and would have left patients hyperopic in most cases; the Feiz-Mannis method had the largest variance. For the Hoffer Q and Holladay 1 formulas, the variances for EffRP(adj) were significantly smaller than those for the clinical history method (0.43 D2 vs. 1.74 D2, P = 0.018 for Hoffer Q; 0.75 D2 vs. 2.35 D2, P = 0.043 for Holladay 1). The Maloney method consistently underestimated the IOL power but had significantly smaller variances (0.19-0.55 D2) than those for the clinical history method (1.09-2.35 D2; P<0.015). There were no significant differences among the variances for the 4 formulas when using each corneal power calculation method. The most accurate method was the combination of a double-K formula and corneal values derived from EffRP(adj). The variances in IOL prediction error were smaller with the Maloney and EffRP(adj) methods, and we propose a modified Maloney method and second method using Humphrey data for further evaluation.
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                Author and article information

                Journal
                COP
                COP
                10.1159/issn.1663-2699
                Case Reports in Ophthalmology
                S. Karger AG
                1663-2699
                2018
                May – August 2018
                24 May 2018
                : 9
                : 2
                : 264-268
                Affiliations
                [_a] aUniversity of Southern California – Roski Eye Institute, Los Angeles, California, USA
                [_b] bUniversity of Washington, Veterans Affairs Puget Sound Hospital Department of Ophthalmology, Seattle, Washington, USA
                Author notes
                *Hoon C. Jung, MD, VA Puget Sound, Eye Clinic, 1660 South Columbian Way, Seattle, WA 98108 (USA), E-Mail Hoon.jung2@va.gov
                Article
                488849 PMC6006602 Case Rep Ophthalmol 2018;9:264–268
                10.1159/000488849
                PMC6006602
                29928221
                b465865b-b6a7-48bf-98e4-cd4a6c7463af
                © 2018 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 4, Pages: 5
                Categories
                Case Report

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