Determining Corneal Power Following Keratorefractive Surgery.
The true corneal power following RK, ALK, PRK and LASIK is difficult to measure by any form of direct measurement, such as keratometry, or corneal topography.
Keratometry and topography assume a normal relationship between the anterior and posterior corneal curvatures, and measure the anterior corneal radius.
Incisional keratorefractive surgery for myopia flattens both the anterior corneal radius and the posterior corneal radius. Ablative keratorefractive surgery for myopia flattens the anterior corneal radius but leaves the posterior corneal radius mostly unchanged.
Standard keratometry measures an intermediate area and extrapolates the
central power based on some very broad assumptions.
For this reason,
keratometry, autokeratometry and simulated keratometry by topography
will typically over-estimate central corneal power, following
keratorefractive surgery for myopia. Failure to keep this important
fact in mind will often result in an unexpected and unpleasant
post-operative hyperopic surprise.
The following link is a way to estimate the central corneal power following
RADIAL KERATOTOMY (see: http://doctor-hill/postRK.htm).
The following link is a summary of the various methods used to estimate the
central corneal power following MYOPIC LASIK (see: http://doctor-hill/iol-main/lasik.htm).
The following link is a way to estimate the central corneal power following
HYPEROPIC LASIK (see: http://doctor-hill/iol-main/lasik-hyperopic.htm).
The following link is about how 2-VARIABLE IOL POWER CALCULATION FORMULAS
may be another source of errors following keratorefractive surgery (see: http://doctor-hill/prior-keratorefractive.htm).
Keep in mind that the above methods will give an estimation of the true central corneal power and may not be exact. At present, these techniques represent the best clinical methods available. Hopefully, in the future we may have a more accurate, and less time-consuming, method for measuring these challenging eyes.
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