Mark Speaker, M.D., Ph.D. Coauthors Cataract Surgery & Lens Implant Calculation After Myopic Refractive Surgery Study

Mark Speaker, M.D., Ph.D. is a Corneal Specialist and LASIK Surgeon in New York at Laser and Corneal Surgery Associates in Manhattan. He is widely recognized for his contributions to the fields of corneal and refractive surgery including LASIK and Corneal Transplantation through his efforts in patient care, research and ongoing physician education. Dr. Speaker, along with coauthors Drs. Khalil, Chokshi, Latkany and Yu published the results of their study ” Prospective Evaluation of Intraocular Lens Calculation After Myopic Refractive Surgery” in the January 2008 Journal of Refractive Surgery.

Abstract of Study and Publication

PURPOSE: To evaluate outcome after refractive surgery in cataract patients for whom intraocular lens (IOL) selection was based on the use of a myopic regression formula.

METHODS: This prospective case series included 20 eyes of 14 patients who had previous uncomplicated myopic refractive surgery, followed by uncomplicated cataract extraction with IOL implantation. Calculation of IOL was based on flattest keratometry readings, spherical equivalent refraction before refractive surgery, and an adjustment factor derived from the regression formula: -(0.47x + 0.85). Following cataract extraction, refractive error was compared against refractive aim. The power of IOL obtained by the regression formula (IOL(RF)) was compared to those obtained using the clinical history method at the spectacle plane (IOL(HisKs)) and the Double-K formula (LOL(DoubleK)). The results acquired with each technique were compared with those achieved using an IOL back-calculated for emmetropia (IOL(exact)).

RESULTS: Using the regression formula, IOL calculations produced postoperative cataract extraction refractions within 1.00 diopter (D) (range: -1.00 to 0.78 D) of the intended outcome. Mean spherical equivalent refraction after cataract extraction was -0.31 +/- 0.56 D. Twelve of 20 eyes had sufficient data to evaluate the statistical relationships among the three formulas compared with IOL(exact). Paired t test results revealed IOL(RF) (P = .0932) and IOL(HisKs) (P = .9955) were not statistically different from IOL(exact) whereas IOL(DoubleK) was statistically different from IOL(exact) (P = .0008).

CONCLUSION: The myopic regression formula is recommended for postoperative myopic LASIK IOL selection to provide a simple, accurate, and consistent method of predicting IOL calculation that is not statistically different from IOL(exact).

About Mark Speaker, M.D., Ph.D.

Mark Speaker, M.D. received his Doctor of Medicine (M.D.) and Doctor of Philosophy (Ph.D.) degrees from the Albert Einstein College of Medicine and completed his residency in Ophthalmology at The New York Eye and Ear Infirmary in Manhattan where he served as the Chief Resident. In addition he completed a Fellowship in Corneal and Refractive Surgery at Wills Eye Hospital in Philadelphia. He has served as the Director of the Cornea Service and Director of the Ophthalmology Residency Program at The New York Eye and Ear Infirmary. He has served on the Board of Directors of the Cornea Society, the Program Committee of the American Academy of Ophthalmology, and has received the Honor Award from the American Academy of Ophthalmology. He is currently Medical Director of TLC Laser Eye Centers Manhattan. In addition, he is the author of numerous articles and publications in the areas of Corneal Disease, Cornea Transplants, LASIK and Ocular Surface Disease including Dry Eyes and Dry Eye Syndrome.