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Intraocular lens power calculation remains difficult after previous laser vision correction because conventional keratometry does not accurately represent the altered relationship between corneal curvature and effective refractive power. This 2025 study compared legacy and newer no-history formulas in eyes that had previously undergone hyperopic laser vision correction and later required cataract surgery. The investigators found that newer formulas generally performed better than legacy approaches and that formulas incorporating posterior or total keratometry often ranked highly for prediction accuracy. Barrett True-K, K6-TK and EVO 2.0-PK were among the stronger performers when the relevant measurements were available. The study is clinically useful because patients with previous refractive surgery often expect a premium refractive result after cataract surgery, making residual error particularly frustrating. For HCPs, the practical lesson is to avoid relying on a single calculation method and to use modern no-history strategies when pre-refractive data are unavailable. Posterior corneal information may add value when captured reliably. This evidence directly supports AIOC's emphasis on advanced IOL power calculation in post-refractive eyes.
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Intraocular lens power calculation remains difficult after previous laser vision correction because conventional keratometry does not accurately represent the altered relationship between corneal curvature and effective refractive power. This 2025 study compared legacy and newer no-history formulas in eyes that had previously undergone hyperopic laser vision correction and later required cataract surgery. The investigators found that newer formulas generally performed better than legacy approaches and that formulas incorporating posterior or total keratometry often ranked highly for prediction accuracy. Barrett True-K, K6-TK and EVO 2.0-PK were among the stronger performers when the relevant measurements were available. The study is clinically useful because patients with previous refractive surgery often expect a premium refractive result after cataract surgery, making residual error particularly frustrating. For HCPs, the practical lesson is to avoid relying on a single calculation method and to use modern no-history strategies when pre-refractive data are unavailable. Posterior corneal information may add value when captured reliably. This evidence directly supports AIOC's emphasis on advanced IOL power calculation in post-refractive eyes.
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