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World J Ophthalmol. Nov 12, 2014; 4(4): 140-146
Published online Nov 12, 2014. doi: 10.5318/wjo.v4.i4.140
Improving refractive outcomes in cataract surgery: A global perspective
Petros Aristodemou, Nathaniel E Knox Cartwright, John M Sparrow, Robert L Johnston
Petros Aristodemou, John M Sparrow, Department of Ophthalmology, University of Bristol, Bristol Eye Hospital, Bristol BS1 2LX, United Kingdom
Petros Aristodemou, Vitreous Retina Macula Clinic, Limassol 3025, Cyprus
Nathaniel E Knox Cartwright, West of England Eye Unit, Royal Devon and Exeter NHS Foundation Trust, Exeter EX2 5DW, United Kingdom
Robert L Johnston, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham GL53 7AN, United Kingdom
Author contributions: All authors performed a literature review and coauthored this review article.
Correspondence to: Petros Aristodemou, FRCOphth, Department of Ophthalmology, University of Bristol, Bristol Eye Hospital, Lower Maudlin St, Bristol BS1 2LX, United Kingdom. topetros@yahoo.com
Telephone: +357-25-878789 Fax: +357-25-878789
Received: April 29, 2014
Revised: July 24, 2014
Accepted: September 23, 2014
Published online: November 12, 2014
Abstract

This review summarises the current evidence base and provides guidelines for obtaining good refractive outcomes following cataract surgery. Important background information is also provided. In summary, the requirements are: (1) standardisation of biometry equipment used for axial length and keratometry measurement and the use of optical or immersion ultrasound biometry; (2) sutureless cataract surgery with “in the bag” intraocular lens (IOL) placement; (3) an appropriate 3rd, 4th or 5th Generation IOL power formula should be used; (4) IOL formula constants must be optimized; (5) under certain conditions, the refractive outcome of the 2nd eye can be improved based on the refractive error of the first eye; and (6) results should be audited for refinement and to ensure that standards are met.

Keywords: Biometry, Cataract extraction, Ocular refraction, Intraocular lens, Intraocular lens Power Formula

Core tip: The requirements for good refractive outcomes in cataract surgery are: (1) standardisation of biometry equipment used for axial length and keratometry measurement and the use of optical or immersion ultrasound biometry; (2) sutureless cataract surgery with “in the bag” intraocular lens placement; (3) an appropriate 3rd, 4th or 5th Generation intraocular lens (IOL) power formula should be used; (4) IOL formula constants must be optimized; (5) under certain conditions, the refractive outcome of the 2nd eye can be improved based on the prediction error of the cataract surgery for the first eye; and (6) results should be audited for refinement and to ensure that standards are met.