An update on intraocular lens power calculations in eyes with previous laser refractive surgery.

IF 3 2区医学 Q1 OPHTHALMOLOGY Current Opinion in Ophthalmology Pub Date : 2024-01-01 Epub Date: 2023-10-11 DOI:10.1097/ICU.0000000000001004

Daniel E Savage, Seth M Pantanelli

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Abstract

Purpose of review: There is an ever-growing body of research regarding intraocular lens (IOL) power calculations following photorefractive keratectomy (PRK), laser-assisted in-situ keratomileusis (LASIK), and small-incision lenticule extraction (SMILE). This review intends to summarize recent data and offer updated recommendations.

Recent findings: Postmyopic LASIK/PRK eyes have the best refractive outcomes when multiple methods are averaged, or when Barrett True-K is used. Posthyperopic LASIK/PRK eyes also seem to do best when Barrett True-K is used, but with more variable results. With both aforementioned methods, using measured total corneal power incrementally improves results. For post-SMILE eyes, the first nontheoretical data favors raytracing.

Summary: Refractive outcomes after cataract surgery in eyes with prior laser refractive surgery are less accurate and more variable compared to virgin eyes. Surgeons may simplify their approach to IOL power calculations in postmyopic and posthyperopic LASIK/PRK by using Barrett True-K, and employing measured total corneal power when available. For post-SMILE eyes, ray tracing seems to work well, but lack of accessibility may hamper its adoption.

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既往激光屈光手术患者人工晶状体屈光力计算的最新进展。

综述目的：越来越多的研究涉及屈光性角膜切除术（PRK）、激光辅助原位角膜磨镶术（LASIK）和小切口晶状体摘除术（SMILE）后的人工晶状体（IOL）功率计算。本次审查旨在总结最新数据并提出最新建议。最近的研究结果：当多种方法取平均值或使用Barrett True-K时，近视后LASIK/PRK眼的屈光效果最好。当使用Barrett True-K时，远视后LASIK/PRK眼睛似乎也表现得最好，但结果更为多变。使用上述两种方法，使用测量的总角膜屈光力逐渐改善结果。对于微笑后的眼睛，第一个非理论数据支持光线追踪。总结：与裸眼相比，既往接受过激光屈光手术的白内障手术后的屈光结果准确性较低，变化较大。外科医生可以通过使用Barrett True-K，并在可用的情况下使用测量的总角膜屈光力，简化近视后和近视后LASIK/PRK的IOL屈光力计算方法。对于微笑后的眼睛来说，光线追踪似乎效果良好，但缺乏可访问性可能会阻碍其采用。

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来源期刊

Current Opinion in Ophthalmology 医学-眼科学

CiteScore

6.80

自引率

5.40%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Ophthalmology is an indispensable resource featuring key up-to-date and important advances in the field from around the world. With renowned guest editors for each section, every bimonthly issue of Current Opinion in Ophthalmology delivers a fresh insight into topics such as glaucoma, refractive surgery and corneal and external disorders. With ten sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, clinicians and other healthcare professionals alike.