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Published on: September 16, 2025
Reliability of the IOLMaster in measuring corneal power changes after hyperopic photorefractive keratectomy
Nicola Rosa1, Maddalena De Bernardo, Maria Borrelli
1Centro Grandi Apparecchiature, 2nd University of Naples, Italy. nicola.rosa@unina2.it
Purpose:
To test the accuracy of the IOLMaster (Carl Zeiss Meditec) in detecting corneal power changes after hyperopic photorefractive keratectomy (PRK).
Methods:
Forty-five consecutive eyes that underwent hyperopic PRK with the SCHWIND ESIRIS excimer laser, ranging from +0.75 to +7.00 diopters (D) (mean: +3.84±1.56 D), were analyzed. Data included pre- and postoperative (1, 3, and 6 months) fogging refraction and automated keratometry (K). Statistical analysis was performed to determine the correlation between the changes in refraction at the corneal plane and the changes in keratometry.
Results:
The mean difference between the changes in refraction and the measured corneal changes was +0.27±1.19 D (range: -1.91 to +4.28 D) (P=.18) at 1 month; +0.56±0.97 D (range: -1.00 to +2.96 D) (P=.006) at 3 months; and +0.67±0.80 D (range: -0.73 to +2.31 D) (P=.00002) at 6 months. Based on these results, we suggest using the regression formula found at 6-month follow-up (y=0.8074 x + 0.092) to better calculate the effective corneal power. Comparison between the data obtained with IOLMaster measurements and equivalent K readings from the Holladay report obtained with the Pentacam (Oculus Optikgeräte GmbH) shows good agreement (R(2)=0.9).
Conclusions:
Automated keratometry provided by the IOLMaster underestimates the effective refractive changes after hyperopic PRK, and a correcting factor is needed to calculate the corneal power in these cases.