Patient preparation
✍ Ensure mydriasis
☝cyclopentolate 1 %
☝phenylephrine 2.5%
☝ diclofenac 0.1 %.
✍ Check consent form whether complete or not
✍ Check any new ophthalmic problems (evidence of active infection)
✍ Mark side of operation.
✍ confirm
☝ IOL type and power and axis
☝ operating position( superior or temporal )
✍ Inserting the incorrect IOL has become a NEVER-EVENT ( never allowed to happen)
✍ IOL selection
☝ biometry does indeed belong to your patient.
☝ axial length and K values consistency in the operated eye
☝ axial length and K values consistency in both eyes
• Most individuals have similar axial lengths and corneal curvatures in either eye
• 92% of axial lengths are within the range 21 –25.5 mm
• 99% of K readings are within the range 40–48D.
✍ Check appropriate formula used
☝ AL <22mm ( hoffer Q or SRK/T)
☝ AL 22–24.5 mm ( SRK/T, holladay, haigis)
☝AL >24.6 ( SRK/T)
✍ Select appropriate lens power (usually, but not always, aiming for emmetropia)
☝ slightly myopic ( 0.50 D) for presbyopic
✍ previous corneal refractive surgery
☝ enter corrected K values into the suitable IOL calculation formula or use IOL master
☝ if patient previously myopic (select the highest IOL power suggested).
☝ if patient previously hyperopic ( select the lowest IOL power suggested ).
Redo biometry whenever
✍ axial length is
☝AL < 21.20 mm
☝ AL >26.60 mm
✍ mean corneal power is
☝K <41 D
☝K >47D
✍ delta K ( astigmatism) is
☝ >2.5D
✍ difference in axial length between both eyes
☝ >0.7 mm
✍ difference in mean corneal power between both eyes
☝ > 0.9 D.