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  • Comprehensive Ophthalmology

    This prospective study found that modifying IOL power to correct up to 50 percent of the first-eye refractive error can improve second-eye outcomes in cataract surgery.

    Subjects were 250 consecutive cataract surgery patients with residual refractive error exceeding 0.50 D in their first eye. The second-eye error was calculated six to eight weeks after surgery. All eyes were measured with the IOL Master version 5.2, and IOL power calculations were made with the Haigis formula. Adjusted second-eye refractive error was compared with theoretical full and nonadjustment.

    Most of the patients had high interocular correlation: axial length difference between the two eyes was within 0.3 mm, K reading difference was within 1 D, and preoperative anterior chamber depth was within 0.3 mm. All surgeries were performed by one surgeon using a 2.75mm limbal incision, phacoemulsification and in-the-bag placement of an Alcon SN60WF IOL. This was compared to a theoretical full adjustment for first-eye error and no adjustment.

    The median adjusted second-eye refractive error was significantly lower than median first-eye error in all eyes, including those with first-eye error of −0.50 to −1.00 D (−0.12 vs. −0.66 D), > −1.00 D (−0.12 vs. −1.25 D), 0.50 to 1.00 D (−0.03 vs. 0.65 D), and > 1.0 D (−0.29 vs. 1.19 D).

    The authors note that only one IOL power formula (Haigis) was used, and thus the results are limited to that formula.