Intraocular Lens Selection for Cataract Surgery in Patients with Previous Refractive Surgery

Akif ÖZDAMARa , Dilan ÇOLAKa

aMedicana Ataköy Hospital, Clinic of Ophthalmology, İstanbul, Türkiye

ABSTRACT
Patients with previous refractive surgery present unique challenges for cataract surgery due to altered corneal power, disrupted anterior-posterior corneal curvature relationships, and difficulties in measuring corneal curvature radius and predicting effective lens position. Using advanced diagnostic tools like corneal topography and tomography, and new generation multiple calculation methods such as Barrett True K No History and OCT-based formulas and making consensus-based selection are useful for precise measurements. Negative Spherical Aberration (SA) intraocular lens (IOL)s are generally preferable for eyes that have undergone myopic corneal refractive surgery. Zero SA IOLs are recommended for eyes with a history of hyperopic refractive procedures. Toric IOLs are effective for correcting pre-existing corneal astigmatism in selected cases. Multifocal and Extended Depth-of-Focus (EDOF) IOLs can have successful outcomes in patients with prior corneal refractive surgery, except for those who have had radial keratotomy (RK). These strategies improve the accuracy of IOL power calculations, leading to better visual outcomes for patients with prior refractive surgery.
Keywords: Corneal refractive surgery; LASIK; photorefractive keratectomy; cataract surgery; intraocular lens power calculation formulas; multifocal intraocular lenses; EDOF lenses

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