Ten commandments for biometry in tricky situations

BACKGROUND: Recently, the number of litigations on cataract surgeons has increased. Because of the increasing ambitions of surgeons and demands for a spectacle-free life, the incidence of unhappy patients is at an all-time high. To an ophthalmologist, the fruits of a good surgery are dependent largely on their skills. However, more importantly, the roots of good results of a surgery are laid by a perfect IOL (intraocular lens) power calculation. Inaccurate biometry is one of the major reasons for unhappy patients, especially in some challenging scenarios. PURPOSE: To hit the bull’s eye, as far as target refraction is concerned, it is necessary to understand the benefits and limitations of currently available cutting-edge technology and formulae and apply them to the cataract surgery practice. The aim of the video is to familiarize modern-day ophthalmologists to these situations to achieve a perfect IOL power calculation. SYNOPSIS: Using a step-by-step approach, we decoded biometry in special scenarios like poor cornea, ocular surface disorders, dry eyes, toric IOL calculation, cases with posterior corneal astigmatism, irregular corneas like keratoconus, pellucid marginal degeneration, post Lasik ectasia and penetrating keratoplasty. In this video we tried to address the solution to these special conditions and how to attain target refraction in such cases. A few more issues are addressed like biometry post retina surgery, very dense cataract where it is difficult to obtain axial length, and cases with extreme axial lengths. HIGHLIGHTS: In this case-based approach, with relevant example, we tried to provide solutions for biometry in tricky scenarios like poor cornea, biometry post refractive surgery, dense cataracts, and cataract post retinal surgery. On following these commandments, not only will the litigations stop but our patients will be happier as well. ONLINE VIDEO LINK: https://youtu.be/dNXP2nDYUZo