It is relatively easy to do the IOL calculations on an average patient with an average axial length, average keratometry, and average anterior chamber depth. But what happens when you get a long axial length and a steep cornea with some degree of asymmetry? The IOL calculations are not quite as accurate and we need to keep that in mind when choosing the IOL power. For this patient, who was previously very myopic, we wanted to ensure that we would land on the myopic side instead of ending up hyperopic. The got an extended depth of focus lens in the first eye and ended up -1.00 which gives him great intermediate as well as near vision since the range of the EDOF IOL is about 1.5 diopters.
Now it is time for cataract surgery on the second eye and it would be nice to hit that plano outcome so that the patient achieves great distance vision. How can we use the results of the first eye to help enhance the accuracy for the second eye? This video shows you the way.