Abstract
Purpose. To validate clinically a new method for estimating the corneal power (P c) using a variable keratometric index (n kadj) in eyes with previous laser refractive surgery. Setting. University of Alicante and Medimar International Hospital (Oftalmar), Alicante, (Spain). Design. Retrospective case series. Methods. This retrospective study comprised 62 eyes of 62 patients that had undergone myopic LASIK surgery. An algorithm for the calculation of n kadj was used for the estimation of the adjusted keratometric corneal power (P kadj). This value was compared with the classical keratometric corneal power (P k), the True Net Power (TNP), and the Gaussian corneal power (P cGauss). Likewise, P kadj was compared with other previously described methods. Results. Differences between P cGauss and P c values obtained with all methods evaluated were statistically significant (p < 0.01). Differences between P kadj and P cGauss were in the limit of clinical significance (p < 0.01, loA [−0.33,0.60] D). Differences between P kadj and TNP were not statistically and clinically significant (p = 0.319, loA [−0.50,0.44] D). Differences between P kadj and previously described methods were statistically significant (p < 0.01), except with P cHaigisL (p = 0.09, loA [−0.37,0.29] D). Conclusion. The use of the adjusted keratometric index (n kadj) is a valid method to estimate the central corneal power in corneas with previous myopic laser refractive surgery, providing results comparable to P cHaigisL.
Highlights
The precise measurement of corneal power after myopic laser refractive surgery is still currently an issue under debate
Several methods have been proposed during the last years which are classified as methods requiring historical clinical data and methods not requiring historical data. Among those methods requiring previous clinical data, some of them are based on a correction of the corneal power using the refracting change achieved [1,2,3] and others on performing such correction by adjusting the keratometric index [4,5,6,7]
Our research group has recently proposed a new method for estimating with enough accuracy the corneal power using the keratometric approach that has been found to be valid in both healthy [12] and post-laser in Journal of Ophthalmology situ keratomileusis (LASIK) eyes [13]
Summary
The precise measurement of corneal power after myopic laser refractive surgery is still currently an issue under debate. Other methods that do not require patient’s historical data have been developed [3, 5, 8,9,10,11] In this line, our research group has recently proposed a new method for estimating with enough accuracy the corneal power using the keratometric approach that has been found to be valid in both healthy [12] and post-LASIK eyes [13]. Our research group has recently proposed a new method for estimating with enough accuracy the corneal power using the keratometric approach that has been found to be valid in both healthy [12] and post-LASIK eyes [13] This algorithm based on a variable keratometric index was named adjusted keratometric index (nkadj) and it has been prevalidated clinically in a sample of 32 eyes that had undergone previously myopic LASIK surgery [13]. The aim of the current study is to validate clinically this algorithm for the estimation of the corneal power in eyes with previous myopic LASIK in a larger population including a larger range of intended refractive corrections
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