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Year : 2017  |  Volume : 65  |  Issue : 8  |  Page : 690-699

Preliminary validation of an optimized algorithm for intraocular lens power calculation in keratoconus

1 Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
2 Department of Optics, Pharmacology and Anatomy, University of Alicante; Department of Ophthalmology (Oftalmar), Vithas Medimar International Hospital, Alicante, Spain

Correspondence Address:
David P Piñero
Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante
Dolores De Fez
Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_274_16

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Purpose: This study aimed to evaluate the theoretical influence on intraocular lens power (PIOL) calculation of the use of keratometric approach for corneal power (Pc) calculation in keratoconus and to develop and validate an algorithm preliminarily to minimize this influence. Methods: Pcwas calculated theoretically with the classical keratometric approach, the Gaussian equation, and the keratometric approach using a variable keratometric index (nkadj) dependent on r1c(Pkadj). Differences in PIOLcalculations (ΔPIOL) using keratometric and Gaussian Pcvalues were evaluated. Preliminary clinical validation of a PIOLalgorithm using Pkadjwas performed in 13 keratoconus eyes. Results: PIOLunderestimation was present if Pcwas overestimated, and vice versa. Theoretical PIOLoverestimation up to −5.6 D and −6.2 D using Le Grand and Gullstrand eye models was found for a keratometric index of 1.3375. If nkadjwas used, maximal Δ PIOLwas ±1.1 D, with most of the values ≤±0.6 D. Clinically, PIOLunder- and over-estimations ranged from −1.1 to − 0.4 D. No statistically significant differences were found between PIOLobtained with Pkadjand Gaussian equation (P > 0.05). Conclusion: The use of the keratometric Pcfor PIOLcalculations in keratoconus can lead to significant errors that may be minimized using a Pkadjapproach.

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