Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
Medicine (Baltimore). 2022 Jul 8;101(27):e29465. doi: 10.1097/MD.0000000000029465.
To report a rare case of calculating the IOL power in a cataract patient who underwent both radial keratotomy (RK) and photorefractive keratectomy (PRK).
A 48-year-old woman underwent bilateral RK at age 22 and bilateral PRK at age 46. She developed bilateral corneal haze and corneal endothelial inflammation and received steroids therapy for long time after PRK. Then she was referred to our hospital due to decreased vision in the both eyes.
The patient was diagnosed with binocular complicated cataract, corneal haze, high myopia and post corneal refractive surgery (RK and PRK).
The patient underwent bilateral phacoemulsification. The IOL power was calculated using SRK/T formula for RK and Haigis-L formula for PRK, respectively. We finally selected the Haigis-L formula and the intraocular lens (SN60WF) was implanted within the capsular bag.
After the surgery, both eyes showed myopia drift, and the right eye continuously fluctuated in refractive results. However, by nearly 1 year later, refractive results in both eyes had stabilized, and no other complications had occurred.
IOL power in patients who undergo both RK and PRK can be reliably calculated using the Shammas-PL, Average of multiple formulas, or Barret True-K No History formulas. Haigis-L formula is not suitable. Such patients require at least three months after surgery to attain refractive stability in both eyes.
报告 1 例同时行放射状角膜切开术（RK）和准分子激光角膜切削术（PRK）的白内障患者的 IOL 计算。
1 例 48 岁女性，22 岁时行双眼 RK，46 岁时行双眼 PRK。PRK 后出现双眼角膜混浊和角膜内皮炎症，长期接受皮质类固醇治疗。PRK 后因双眼视力下降来我院就诊。
双眼并发性白内障，角膜混浊，高度近视，RK 和 PRK 后。
患者行双眼白内障超声乳化吸除术。RK 应用 SRK/T 公式，PRK 应用 Haigis-L 公式计算 IOL 度数。最终选择 Haigis-L 公式，植入囊袋内人工晶状体（SN60WF）。
术后双眼均出现近视漂移，右眼屈光结果持续波动。但近 1 年后，双眼屈光结果稳定，未发生其他并发症。
对同时行 RK 和 PRK 的患者，可使用 Shammas-PL、多公式平均值或 Barret True-K No History 公式可靠计算 IOL 度数，不适合使用 Haigis-L 公式。此类患者需要至少 3 个月的时间才能使双眼屈光稳定。
