Optics of Transplanted Grafts: IOL Calculation in Grafted Patients

Modern methods of intraocular lens (IOL) calculation have significantly reduced the risk of employing an improper IOL power. The development of theoretical formulas has improved the accuracy of predicting the effective lens position, while the use of laser partial coherence interferometry has increased the accuracy of axial length measurement. IOL calculation in grafted patients, however, is more challenging due to different and peculiar clinical situations. These situations fall into two main scenarios. The first comprises patients who are candidates to combined cataract extraction, IOL implantation, and corneal graft (the triple procedure). The second includes patients who have previously undergone corneal graft. In this second scenario, IOL calculation may be required for cataract extraction, piggyback IOL, and phakic IOL implantation. This chapter examines the challenges inherent in each clinical situation and discusses the strategies that can be adopted to tackle these situations and optimize IOL power calculation.