How important is biometry? Most of us who perform intraocular lens (IOL) implantation have basically accepted it as the "gospel truth" without much discussion. Nobody wants to face the unhappy patient with aniseikonia or a markedly myopic or hyperopic refraction. It simply makes sense to do whatever is necessary to avoid these types of complications. Lo and behold, however, in this issue of the Archives is an iconoclastic article by Singh and Sommer1 suggesting that a standard 20-diopter (D) IOL for patients who have a preoperative refractive error of ± 4.5 D will produce a result just about as good. Their report is based on the results obtained by four experienced surgeons and, in my opinion, it simply cannot be dismissed out of hand.
See also p 1046.
So what do we do? Is it time to pitch A-scan apparatuses into the secondary junk market? There is no question
Olson RJ. Intraocular Lens Power Calculations: An Extra Edge or Expensive Waste? Arch Ophthalmol. 1987;105(8):1035–1036. doi:10.1001/archopht.1987.01060080037022
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