Precision in IOL Calculation for Cataract Patients with Prior History of Combined RK and LASIK Histories

Purpose: This study aimed to evaluate the accuracy of 12 intraocular lens (IOL) power calculation formulae for eyes that have undergone both radial keratotomy (RK) and laser assisted in situ keratomileusis (LASIK) surgery to determine the efficacy of various IOL calculations for this unique patient group. Currently, research on this surgical topic is limited. Methods: In this retrospective study, 11 eyes from 7 individuals with a history of RK and LASIK who underwent cataract surgery at Hoopes Vision were analyzed. Preoperative biometric and corneal topographic measurements were performed. Subjective refraction was obtained postoperatively. Twelve different intraocular lens (IOL) power calculations were used: Barrett True K No History, Barrett True K (prior LASIK, Prior RK history), Barrett Universal 2, Camellin-Calossi-Camellin (3C), Double K-Modified Holladay, Haigis-L, Galilei, OCT, PEARL-DGS, Potvin-Hill, Panacea, and Shammas. Results: The rankings of mean arithmetic error (MAE), from least to greatest, were as follows: 3C (0.088), Haigis-L-L (− 0.508), Shammas (− 0.516), OCT Average (− 0.538), Barrett True K (− 0.557), OCT RK (− 0.563), Galilei (− 0.570), IOL Master (− 0.571), OCT LASIK (− 0.583), Barrett True K No History (− 0.597), Pearl-DGS (− 0.606), Potvin-Hill SF (− 0.770), Potvin-Hill TNP (− 0.778), Panacea (− 0.876), and Barrett Universal 2 (− 1.522). The 3C formula achieved the greatest percentage of eyes within ± 0.25 D of target range (91%), while Haigis-L, Shammas, Galilei, Potvin Hill, Barrett True K, IOL Master, PEARL-DGS, and OCT formulae performed similarly, achieving 45% of eyes within ± 0.75D of target refraction. Conclusion: This study demonstrates the accuracy of the lesser known 3C formula in IOL calculation, particularly for patients who have undergone both RK and LASIK. Well-known formulae, such as Haigis-L, Shammas, and Galilei, which are used by the American Society of Cataract and Refractive Surgery (ASCRS), are viable options, although 3C formulae should be considered in this patient population. Furthermore, larger studies can confirm the best IOL power formulas for post-RK and LASIK cataract patients. Keywords: radial keratotomy, intraocular lens, laser assisted in situ keratomileusis, IOL power, IOL calculator, Barrett True K No History, Barrett True K, Barrett Universal 2, Camellin-Calossi-Camellin, double K-modified Holladay, Haigis-L, Galilei, OCT, PEARL-DGS, Potvin-Hill, Panacea, Shammas