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

Daniel E. Savage, Seth M. Pantanelli

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Purpose of reviewThere 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 findingsPostmyopic 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.SummaryRefractive 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.

Original languageEnglish (US)
Pages (from-to)34-43
Number of pages10
JournalCurrent Opinion in Ophthalmology
Issue number1
StatePublished - Jan 1 2024

All Science Journal Classification (ASJC) codes

  • Ophthalmology

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