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No-History IOL Power Calculation After Myopic Laser Vision Correction: A Multicenter Retrospective Database Study of
David L Cooke1, Cecily L Kaufmann2, Colya N Englisch3
1Great Lakes Eye Care, Saint Joseph, Michigan, USA; Department of Neurology and Ophthalmology, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA.
American Journal of Ophthalmology
|August 5, 2026
Summary
Modern intraocular lens (IOL) power formulas, especially those using posterior corneal curvature (PCC), offer improved accuracy for cataract surgery in eyes with prior myopic laser vision correction (M-LVC). Specific formulas like K6 and EVO 2.0 show notable gains in extreme cases.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Biomedical Engineering
Background:
- Accurate intraocular lens (IOL) power calculation is crucial for successful cataract surgery.
- Prior myopic laser vision correction (M-LVC) alters corneal parameters, complicating standard IOL power calculations.
- Evaluating the performance of various IOL power formulas in these eyes is essential.
Purpose of the Study:
- To investigate and compare the accuracy of 14 different IOL power formulas in eyes that have undergone prior M-LVC.
- To determine which formulas provide the most reliable refractive outcomes post-cataract surgery.
Main Methods:
- Retrospective analysis of 3,738 eyes from patients with M-LVC undergoing cataract surgery.
- Biometry data collected using IOLMaster 700; refractive prediction errors calculated for 14 formulas.
- Formulas included early-generation, modern (with/without posterior corneal curvature input), and specific variants like Shammas-Cooke and Haigis-TK.
Main Results:
- Modern formulas significantly outperformed early-generation formulas.
- Formulas incorporating posterior corneal curvature (PCC) showed lower mean absolute errors (MAE) than non-PCC versions.
- Cooke K6 and EVO 2.0 (non-PCC) and K6, PEARL-DGS, EVO 2.0, and Barrett True K (PCC) demonstrated top performance.
- K6 showed particular benefit in steep corneas and short eyes, increasing accuracy within ±0.50 D.
Conclusions:
- Modern IOL power formulas, particularly PCC-adjusted versions, are preferable for eyes with prior M-LVC.
- Formulas like K6 and EVO 2.0 offer significant accuracy gains in eyes with specific biometric characteristics (e.g., short axial length, steep corneas).
- For typical post-M-LVC eyes, the accuracy gains are clinically minor; Shammas-Cooke is a viable option when full biometry is unavailable.
