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Related Experiment Video

Updated: May 24, 2026

Correction of Presbyopia by Monocular Bi-Aspheric Ablation Profile

Published on: September 20, 2024

Improving the second-eye refractive error in patients undergoing bilateral sequential cataract surgery.

Renu V Jivrajka¹, Maya C Shammas, H John Shammas

¹Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago Eye and Ear Infirmary, Chicago, Illinois 60612, USA. renujiv@gmail.com

|March 6, 2012

Summary

For sequential cataract surgery, adjusting intraocular lens (IOL) power to correct 50% of the first eye's refractive error significantly improves the second eye's outcome. This strategy enhances refractive accuracy in bilateral procedures.

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Area of Science:

Ophthalmology
Refractive Surgery
Cataract Surgery

Background:

Cataract surgery involves replacing the clouded natural lens with an artificial intraocular lens (IOL).
Achieving precise refractive outcomes in sequential bilateral cataract surgery remains a challenge.
First-eye refractive errors can impact the planning for the second eye.

Purpose of the Study:

To evaluate the effectiveness of modifying intraocular lens (IOL) power in the second eye.
To correct 50% of the refractive error from the first eye when it exceeds 0.50 diopters.
To assess the impact of this adjustment on the second eye's postoperative refractive error.

Main Methods:

Prospective, observational case series of 250 patients undergoing bilateral, sequential cataract surgery.
IOL power for the second eye was adjusted to correct 50% of the first-eye refractive error (FERE).
Postoperative refractive error in the second eye (aSERE) was measured 6-8 weeks after surgery and compared to predicted outcomes.

Main Results:

The median adjusted second-eye refractive error (aSERE) was significantly lower than the first-eye refractive error (FERE) across all tested ranges.
In cases with FERE between -0.50 to -1.00 D, median aSERE was -0.12 D versus -0.66 D FERE.
In cases with FERE exceeding 1.00 D, median aSERE was -0.29 D versus 1.19 D FERE, with statistically significant differences (P<0.00001).

Conclusions:

Modifying IOL power to correct up to 50% of the first eye's refractive error improves outcomes in the second eye.
This strategy is particularly beneficial when the initial refractive error exceeds 0.50 diopters.
The findings support a targeted adjustment approach for enhanced refractive predictability in sequential bilateral cataract surgery.