Personalized Pseudophakic Model for Refractive Assessment

PURPOSE To test a pseudophakic eye model that allows for intraocular lens power (IOL) calculation, both in normal eyes and in extreme conditions, such as post-LASIK. METHODS PARTICIPANTS The model's efficacy was tested in 54 participants (104 eyes) who underwent LASIK and were assessed before and after surgery, thus allowing to test the same method in the same eye after only changing corneal topography. MODELLING: The Liou-Brennan eye model was used as a starting point, and biometric values were replaced by individual measurements. Detailed corneal surface data were obtained from topography (Orbscan®) and a grid of elevation values was used to define corneal surfaces in an optical ray-tracing software (Zemax®). To determine IOL power, optimization criteria based on values of the modulation transfer function (MTF) weighted according to contrast sensitivity function (CSF), were applied. RESULTS Pre-operative refractive assessment calculated by our eye model correlated very strongly with SRK/T (r = 0.959, p<0.001) with no difference of average values (16.9±2.9 vs 17.1±2.9 D, p>0.05). Comparison of post-operative refractive assessment obtained using our eye model with the average of currently used formulas showed a strong correlation (r = 0.778, p<0.001), with no difference of average values (21.5±1.7 vs 21.8±1.6 D, p>0.05). CONCLUSIONS Results suggest that personalized pseudophakic eye models and ray-tracing allow for the use of the same methodology, regardless of previous LASIK, independent of population averages and commonly used regression correction factors, which represents a clinical advantage.