If I were a golfer, I would be interested in where the ball landed. The abstract below highlights an article that points out the advantage of knowing where the first eye “ended up” relative to the “target” in preparation for surgery in the second eye.

First Eye Prediction Error Improves Second Eye Refractive Outcome:
Results in 2129 Patients after Bilateral Sequential Cataract Surgery
Petros Aristodemou, FRCOphth
Affiliations
Academic Unit of Ophthalmology, University of Bristol, Bristol Eye Hospital, Lower Maudlin Street, Bristol, United Kingdom
Vitreous Retina Macula Clinic Limassol, Limassol, Cyprus
CorrespondencePetros Aristodemou, FRCOphth, Academic Unit of Ophthalmology, University of Bristol, Bristol Eye Hospital, Lower Maudlin Street, Bristol BS1 2LX, UK
, Nathaniel E. Knox Cartwright, MRCOphth
Affiliations
Bristol Eye Hospital, Lower Maudlin Street, Bristol, United Kingdom
, John M. Sparrow, DPhil, FRCOphth
Affiliations
Bristol Eye Hospital, Lower Maudlin Street, Bristol, United Kingdom
International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, United Kingdom
, Robert L. Johnston, FRCOphth
Affiliations
Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham General Hospital, Sandford Road, Cheltenham, United Kingdom
Received 8 December 2010; received in revised form 5 May 2011; accepted 6 May 2011. published online 15 July 2011.
Corrected Proof

Abstract Full Text PDFImages References Supplemental MaterialsObjective
To define theoretical correction factors for second-eye intraocular lens (IOL) power adjustment based on first eye refractive prediction error (PE).

Design
Database study.

Participants
We included 2129 patients who underwent bilateral sequential phacoemulsification cataract surgery with the same IOL model.

Methods
Retrospectively calculated PEs (Hoffer Q, Holladay 1, SRK/T) were analyzed for association between paired eyes, examining the effect of interocular differences in axial length (AL) and corneal power. A range of correction factors (CF) derived from the first eye PE were applied to the second eye PE using optimized and non-optimized IOL constants (IOLCs).

Main Outcome Measures
Second eye mean absolute error (MAE).

Results
Prediction errors of paired eyes were correlated. Interocular corneal power differences exceeding 0.60 diopters (D) were associated with a weaker correlation but interocular AL differences did not affect the correlation. When a 50% CF was applied to second eyes of patients with a first eye PE between ±0.50 and ±1.50 D, it improved refractive outcomes from 30%, 56%, and 92% to 42%, 75%, and 96% within ±0.25 D, ±0.50 D and ±1.00 D, respectively, and reduced the MAE from 0.49 to 0.37 D (P<0.0001). For first eye PE below ±0.50 D, a 50% CF reduced the MAE from 0.32 to 0.30 D (P<0.00001). A 50% CF also reduces second eye MAE for eyes with nonoptimized IOLCs.

Conclusions
A 50% CF reduces second eye PE when either first eye optimized PE is within ±1.50 D or when nonoptimized IOLCs are used. The correlation is weaker when interocular corneal power differences are >0.60 D.