The Enigmatic Cornea and Intraocular Lens Calculations: The LXXIII Edward Jackson Memorial Lecture

Douglas Koch MD presents a comprehensive review of the problems associated with measuring the cornea’s refractive power in intraocular power calculations. Noting that the cornea is the most important optical element of the human eye, he points out that corneal power measurements remain a major source of error in IOL calculations. As an illustration, he cites a study by Warren Hill MD showing that over 90 % of cataract surgeons achieve a refractive accuracy within 0.5 D of target in less than 80% of eyes. Using case studies and a review of data obtained with different corneal measurement techniques and IOL calculation formulas, Dr Koch highlights the achievements in modern biometry while also underlining the work that remains to improve refractive predictability in cataract surgery.