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    Critical Preop Calculation

    Millions of Americans have undergone refractive surgery (RK, PRK, LASIK, LASEK, INTACS, etc.) to reduce or eliminate their need for glasses and contact lenses.

    Millions of other Americans receive cataract surgery every year for removal of a cloudy lens. An artificial intraocular lens (IOL) is implanted to substitute for the natural lens.

    Now, these two groups of patients are beginning to collide and it’s not very pretty!

    Prior to cataract surgery precise measurements and calculations must be performed to determine the appropriate IOL lens power. Measurements include items like the current refractive error and the central corneal curvature. Data is entered into a sophisticated formula using customized computer software. These formulas assume the eye is healthy and has never had previous surgery.

    Now, a backstage peek: IOLs are stored in cabinets and organized by different lens powers (+ or – diopters in nearly every power imaginable) just like a shoe store. Miscalculate the IOL power and the patient cannot see clearly afterwards – even if the surgery itself was flawless.

    Over the past 25 years ophthalmologists have gotten very good at calculating the required IOL power so that the patient can drive without glasses following surgery.

    Today, refractive surgery has changed the rules and lowered expectations.

    Since refractive surgery changes the central corneal curvature the old formulas must be modified. Measurement devices are being updated to adapt to the increasing number of cataract patients who have had previous refractive surgery.

    Patients need to adapt, too! Before consenting to undergo cataract surgery, folks with prior refractive surgery should carefully consider the surgeon’s experience in managing these complex cases. Go ahead and ask, “Doctor, how many cases like mine have you performed and what were your results?” The next question to ask is, “How many times did you need to exchange the implant afterwards?”

    Don’t be hesitant. The surgical outcome will be yours for the rest of your life.

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