To avoid post-operative refractive error in cataract surgery

One of the greatest issues facing the cataract surgeon today is accurate prediction of post-operative refractive error. With use of intraoperative autorefractometry (IOAR), such errors can be detected and post-operative refractive errors avoided. An 83-year-old woman was admitted for right eye phacoemulsification, with aimed at -1.78D with Sanders/Retzlaff/Kraff/T (SRK/T) formula implantation under local anesthesia. IOAR was performed after IOL insertion. The first estimate was +1.1D, indicating hyperopia, and far from the desired refraction above 2D. IOL exchange to +11.5D was, therefore, performed. The second estimate was -0.13D and the operation was completed. The final refraction (3 years after operation) was -0.25D. With IOAR, we were able to avoid the unpleasant surprise of a mistaken intraocular lens power. Intraoperative autorefractometry is useful for avoiding errors in IOL power.