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To compare accuracy of current intraocular lens (IOL) power calculation formulas with intraoperative wavefront aberrometry in eyes with history of radial keratotomy (RK).
A retrospective comparative case-control series of 18 eyes with history of prior RK (study) and 36 age-matched nonrefractive eyes (control). All eyes underwent intraoperative biometry using the Optiwave Refractive Analysis (ORA) (Alcon, Fort Worth, TX, USA) and pre-op biometry using IOL Master (Carl Zeiss Meditec, Inc., Dublin CA, USA) between April 2015 and September 2019. IOL power was also calculated using the ASCRS post keratorefractive online calculator (http://iolcalc.ascrs.org). Comparison between ORA-recommended, ASCRS recommended, Barrett True K, and IOL implanted was conducted in the study group.
There was no statistically significant difference between ORA recommended, ASCRS average, and Barrett True K (all p>0.182). Mean ORA-recommended was significantly higher than IOL implanted (22.13 vs. 22.83 diopters, p=0.013). In contrast, there was not statistically significant difference between mean IOL implanted and ASCRS average (p=0.501) or Barrett True K (p=0.792). Compared to the controls (study vs. control) there was no difference in ORA predicted error or post-operative SEQ (all p>194). The difference in ORA recommended (22.1 vs. 19.4 diopters, p<0.01) and difference between ORA recommended and IOL implanted (0.694 vs. 0.107, p=0.04) were statistically significant between groups.
Pre-op ASCRS post-refractive formula, Barrett True K, and ORA are helpful in determining IOL power in eyes with prior RK.