A New Method for Measuring Corneal Refractive Power after Refractive Surgery

ABSTRACT

PURPOSE: To report a new method for measuring corneal refractive power after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) using the Orbscan(R) and autorefractokeratometer. METHODS: This study involved 12 cases that had undergone cataract surgery after corneal refractive surgery. Five cases had PRK and seven had LASIK. Keratometric values were evaluated with three different methods. The first, defined as RK, used an autorefractokeratometer (AK) (n=1.3375). The second, defined as K1, added the posterior surface diopter using AK and anterior surface diopter using an Orbscan. The last, defined as K2, added the posterior surface diopter and the anterior surface diopter using an Orbscan. Low K was a lower value between K1 and K2. RK, K1, K2 and Low K were compared with the back-calculated K value (Real K) 2 months after cataract surgery. RESULTS: The mean differences between RK, K1, K2, Low K and Real K were 3.08 +/- 0.98D, 0.41 +/- 0.66D, 0.27 +/- 0.77D, and -0.02 +/- 0.53D, respectively. In 9 of the 12 patients the difference was within 1D (75%) when either K1 or K2 was selected and in all patients, the difference between Low K and Real K was within 1D. CONCLUSIONS: The method of IOL calculation using Low K showed more accurate and predictable results in patients who had had cataract surgery after corneal refractive surgery.