Intraocular lens power calculations. A practical evaluation in normal subjects at the Wilmer Institute

The practical value of preoperative intraocular lens power calculations in "normal" eyes with less than 4.50 diopters (D) of myopia or hyperopia was evaluated in a consecutive series of 520 eyes that underwent cataract extraction and lens implantation by four experienced surgeons at The Wilmer Ophthalmological Institute. The observed postoperative results with the lenses selected by the surgeons were compared with results calculated for the measurement-predicted emmetropic power lens and for a standard 20-D lens. The need for postoperative spectacle correction of residual refractive errors was comparable for all three choices of lens. Only two eyes (0.4%) would have developed greater than 4.00 D of refractive error with either the "implanted" or "predicted-emmetropic" lenses, as would 11 eyes (2.1%) with the "standard" 20-D lens. The surgeons' deviation from the calculated emmetropic lens did not reduce postoperative refractive error.