Nomogram-based intraocular lens power adjustment after myopic photorefractive keratectomy and LASIK: A new approach

Vahid Feiz, Majid Moshirfar, Mark J Mannis, Charles D. Reilly, Francisco Garcia-Ferrer, Jeffrey J Caspar, Michele C Lim

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Purpose: (1) To evaluate the accuracy of nomogram-based adjustment of intraocular lens (IOL) power to achieve a desired refractive target after cataract surgery in postmyopic LASIK and photorefractive keratectomy (PRK) eyes and (2) to compare the accuracy of the nomogram-based method with the clinical history method. Design: Multicenter, retrospective, interventional, noncomparative case series. Subjects: Fourteen patients (19 eyes) after myopic LASIK or PRK with visually significant cataracts. Intervention: All eyes underwent cataract extraction and posterior chamber intraocular lens implantation. In each case, IOL power was determined with standard keratometry and biometry. Power adjustment was made by use of a theoretical nomogram followed by implantation. Main Outcome Measures: (1) Final refraction and spherical equivalent after cataract surgery and (2) deviation of the final spherical equivalent from the refractive target. Results: After cataract extraction, by use of nomogram adjustment, 63.2% of eyes were within 0.5 D of the intended spherical equivalent, 84.2% were within 1.0 diopter of the intended spherical equivalent, and 100% were within 1.5 D of the intended spherical equivalent. The clinical history method was accurate in predicting the correct IOL power in 37.5% of cases, regardless of whether spectacle or corneal plane refraction was used. Conclusions: (1) Given the change in spherical equivalent induced by myopic LASIK/PRK, IOL power can be adjusted accurately to avoid undercorrection without the need for the prerefractive surgery corneal power. (2) The nomogram-based method was more accurate than the clinical history method.

Original languageEnglish (US)
Pages (from-to)1381-1387
Number of pages7
Issue number8
StatePublished - Aug 2005

ASJC Scopus subject areas

  • Ophthalmology


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