New Formula to Calculate Corneal Power After Refractive Surgery

Abstract

To assess the validity of intraocular lens (IOL) power calculations utilizing a theoretical variable refractive index correlated to axial length after myopic photorefractive keratectomy (PRK) in a clinical simulation and in patients who underwent cataract surgery after PRK for myopia. Our study included 374 eyes of 300 patients who had PRK for myopia (-2.00 to -12.00 D, mean -4.83 +/- 2.57 D), divided into three groups: Group I had 44 eyes with small ablation zones of 5 to 5.5 mm; Group II had 49 eyes with large ablation zones of 6 to 7 mm; Group III was the control group of 281 eyes (201 patients; 87 males and 114 females) with small and large ablation zones. PRK was performed using the Aesculap-Meditec MEL 60/94 and MEL 70 lasers, and the corneal power was acquired by corneal topography (EyeSys 2000) and a Nidek KM-800 keratometer. There was a higher correlation between corneal power and both the change in refraction and axial length when calculated using keratometric measurements. IOL power calculated using keratometric postoperative PRK power was underestimated. The difference between the mean calculated and actual IOL power for emmetropia was 4.30 +/- 2.34 D. A theoretical variable refractive index (obtained from eyes treated with large PRK ablation zones) that correlated with axial length provided the correct keratometric postoperative PRK power: difference between mean calculated and mean actual IOL power was 0.42 +/- 1.23 D. We propose a theoretical variable refractive index that is correlated to axial length. Utilizing this keratometric correct power, we calculated IOL power similar to that for emmetropia.