Inaccuracy of intraocular lens power calculation after traumatic corneal laceration and cataract

A 53-year-old man sustained a perforating, central corneal injury with a nail in his right eye. After primary repair of the laceration, a traumatic cataract was removed and a Multiflex-style intraocular lens (IOL) was inserted. A 4.00 diopter surprise resulted, probably due to calculation of the IOL power using measurements from the contralateral normal eye. Inability to wear a contact lens for visual correction resulted in IOL exchange surgery in which a sulcus-sutured IOL was implanted. The IOL power was calculated using simulated keratometry from videokeratoscopy and axial length measurements of the injured eye, This resulted in an IOL power closer to emmetropia, allowing for a best spectacle-corrected visual acuity of 20/20 and comfortable wearing of spectacles.