Calculations of corneal power after corneo-refractive surgery from keratometry and change of spectacle refraction: some considerations on the "clinical history method"

Curr Eye Res. 2007 May;32(5):421-9. doi: 10.1080/02713680701329313.

Abstract

Purpose: To derive corneal power after kerato-refractive laser surgery (KRS) to be used for a subsequent intraocular lens (IOL) power calculation.

Model: Based on the proportion of curvatures of the corneal front and back surface, the central thickness, and the ablation characteristics, we demonstrate a vergence-based formalism to derive the equivalent and back vertex corneal power before and after KRS from the preoperative measured keratometry. As a second option, we demonstrate in the paper how to derive the respective values from the postoperative (instead of the preoperative) measured keratometry.

Example: Initial refraction before/after KRS, -12.0/-2.0 D; corneal thickness, 550/440 microm; front/back surface power 48.20-5.81 D, measured Zeiss keratometry before KRS, 42.5 D. After KRS, we calculate a corneal front surface power of 39.82 D and an equivalent/back vertex power and keratometry of 34.08/34.48/35.11 D (result of the "Clinical History Method" at spectacle/corneal plane 32.50/33.96 D). Calculated corneal power values are around 2-3 D lower than measured Zeiss keratometry (37.0 D), which will lead to an IOL power overestimation of about 3-4 D and subsequent hyperopia.

Conclusions: This formalism may help to prevent hyperopia after cataract surgery subsequent to refractive surgery for myopia.

MeSH terms

  • Cornea / pathology
  • Cornea / physiopathology*
  • Cornea / surgery*
  • Diagnostic Techniques, Ophthalmological*
  • Eyeglasses*
  • Humans
  • Laser Therapy*
  • Lenses, Intraocular*
  • Models, Biological*
  • Optics and Photonics
  • Postoperative Period
  • Refraction, Ocular
  • Refractive Errors / physiopathology
  • Refractive Surgical Procedures*