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We are firmly ensconced in the era of refractive cataract surgery. During the past 2 decades, several advances have improved the ability to achieve desired refractive outcomes. Small-incision phacoemulsification has significantly decreased surgically induced astigmatism. Preexisting astigmatism can now be modulated with toric intraocular lenses (IOLs) as well as corneal arcuate incisions performed manually or with a femtosecond laser. Use of the femtosecond laser has also standardized the shape and diameter of capsulorrhexis. Use of partial coherence interferometry has improved the accuracy and reproducibility of axial eye length measurements and aberrometry has enabled intraoperative estimation of corneal astigmatism and power. The use of multifocal and accommodative IOLs has begun to address presbyopia.
Hee MR. State-of-the-Art of Intraocular Lens Power Formulas. JAMA Ophthalmol. 2015;133(12):1436-1437. doi:10.1001/jamaophthalmol.2015.3844