Modern-day cataract surgery: can we match growing expectations?

Cataract surgery has evolved from the ancient technique of ‘couching’ with suboptimal results to femtosecond laser-assisted phacoemulsification with excellent visual results. It is the most frequently performed surgery in the world.1 The recent advances in surgical techniques have increased the safety and efficacy of this procedure. There have also been improvements in the techniques to measure ocular biometry and methods to calculate intraocular lens (IOL) power resulting in high expectations for increasingly better outcomes from surgeons and patients. The accuracy of the refractive end point depends on the potential errors from a multitude of factors, which are involved in the calculation of the IOL power, aside from the surgical aspects themselves. These variables include the axial length, corneal power measurements, assumed corneal refractive index, lens position and anterior chamber depth.2 Although these factors are closely related to each other, and a change in one may affect the other, they have been assumed to be relatively independent factors for the purposes of the mathematical formulae used to perform IOL power calculations. Hence, there is potential for errors …