Cataracts Clinical Trial
Official title:
Accuracy of the Galilei Analyzer to Calculate the Effective Corneal Power After Corneal Refractive Surgery
The purpose of this study is to determine the accuracy of the Galilei corneal analyzer to calculate the effective corneal power (keratometry, corneal curvature) in patients who have undergone both corneal refractive surgery and lens extraction with intraocular lens implantation.
The accuracy of IOL calculation is important for the visual outcome of patients undergoing
cataract extraction and IOL implantation. Different formulas such as Holladay I, HofferQ,
SRKT have been used with excellent results. All formulas use the corneal power among other
factors to calculate the IOL power. Corneal refractive surgery i.e. radial keratotomy (RK),
photorefractive keratectomy (PRK), and Laser in situ keratomileusis (LASIK) changes the
corneal power; therefore, it is difficult to measure the true corneal power after surgery by
any form of direct measurement, such as keratometry, or corneal topography. Keratometry and
topography assume a normal relationship between the anterior and posterior corneal
curvatures, and measure the anterior corneal radius. RK for myopia flattens both the anterior
corneal radius and the posterior corneal radius while PRK and LASIK for myopia flattens the
anterior corneal radius but leaves the posterior corneal radius mostly unchanged.
Standard keratometry measures an intermediate area and extrapolates the central power based
on some very broad assumptions. For this reason, keratometry, autokeratometry and simulated
keratometry by topography will typically over-estimate central corneal power following
keratorefractive surgery for myopia. This inaccuracy leads to an inability to meet the
patients' rising expectations and with the increasing popularity of refractive surgery,
calculating intraocular lens (IOL) power after refractive surgery is becoming increasingly
important.
Different methods to calculate the effective corneal power (keratometry) after refractive
surgery have been described (historical data, effective refractive power, modified Maloney
method, etc), however, intraocular lens power calculations in eyes with previous refractive
surgery remains difficult because of the inaccuracy of keratometry power measurements.
The Galilei dual Scheimpflug analyzer is a non-invasive, diagnostic system that combines dual
rotating Scheimpflug camera measurements and Placido optical system for corneal topography
and 3D analysis of the anterior eye segment. It provides pachymetry as well as elevation and
curvature mapping of the cornea. Additionally, the Ray tracing system delivers a more
accurate total corneal power and anterior chamber depth. The total corneal power that the
Galilei provides is an alternative that seems to be more accurate to calculate the IOL power
in patients who have undergone keratorefractive surgery prior to cataract extraction and IOL
implantation.
The purpose of this study is to determine the accuracy of the Galilei to calculate the
effective corneal power (keratometry, corneal curvature) in patients who have undergone both
corneal refractive surgery and lens extraction with intraocular lens implantation.
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