Post-LVC and post-RK cataract planning should start by documenting the refractive history, the availability of historical data, and the level of formula agreement. Standard K-based formulas alone are not enough.
Myopic LASIK and PRK alter the anterior corneal curvature and disrupt the assumptions behind standard keratometry. Radial keratotomy adds additional instability and diurnal variation. In these eyes, ordinary formula agreement can look reassuring even when the underlying corneal power is wrong. The planning workflow should therefore explicitly identify the refractive history before the surgeon interprets the IOL power result.
The first branch is simple: no prior corneal refractive surgery, prior LASIK/PRK, or prior RK. If LASIK, PRK, or RK is selected, IOLDx flags the case as a special pathway and adds a warning that standard K-based planning may be misleading.
Historical data changes which methods can be reviewed. In the planner, mark one of three states:
Use official calculators for the proprietary or specialty methods. IOLDx links directly to the relevant tools so the surgeon can verify the plan outside the transparent in-app formulas.
Post-LASIK, PRK, and RK pathway for IOL power calculation.
Open ASCRS calculatorBarrett True-K pathway for prior LASIK/PRK/RK eyes.
Open Barrett True-KPost-refractive toric planning when corneal astigmatism is part of the case.
Open True-K ToricReview SRK/T, Hoffer Q, Holladay 1, and Haigis side by side as a consistency check.
Open IOL PlannerFormula spread is not the final answer, but it is a safety signal. Tight agreement suggests internal consistency; wider disagreement should prompt repeat biometry, ocular surface review, topography/tomography review, and external post-refractive calculator comparison. In post-LVC eyes, even a narrow spread should still be interpreted cautiously because the corneal power input can remain biased.
Post-refractive patients often have higher expectations and may have more optical quality issues than routine cataract patients. Premium IOL planning should include explicit documentation of ocular surface status, topography regularity, higher-order aberrations, mesopic pupil size, glare/halo tolerance, and the possibility of residual refractive error.
Open the planner, select LASIK/PRK or RK, mark historical-data status, and document formula spread before final verification.
Open IOL Planner