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CASE REPORT
Year : 2022  |  Volume : 2  |  Issue : 2  |  Page : 365-368

Management of refractive surprise after phacoemulsification due to a decentered laser-assisted in situ keratomileusis zone: Intraocular lens power calculation using aphakic refraction methods


Cornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, India

Correspondence Address:
Samrat Chatterjee
MGM Eye Institute, 5th Mile, Vidhan Sabha Road, Raipur - 493111, Chhattisgarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2960_21

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A 39-year-old male with prior history of having undergone laser-assisted in situ keratomileusis (LASIK) in both eyes was referred for management of refractive surprise of +5.0 diopter following phacoemulsification with intraocular lens (IOL) implantation in the left eye. The IOL power was re-calculated using post-LASIK IOL power formulae, but it did not differ significantly from that of the implanted IOL. Topography in the left eye showed decentration of the laser ablation zone and mild ectasia. An IOL exchange was performed in the following steps: IOL extraction, postoperative aphakic refraction to calculate IOL power, and IOL implantation. Postoperatively, there was no refractive surprise. In the right eye, the IOL power was calculated using post-LASIK IOL power formulae, which did not result in postoperative refractive surprise. Our experience highlights the efficiency of aphakic refraction over post-LASIK IOL power formulae in predicting IOL power in eyes with decentered laser ablations.


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