Refractive surgery does not prevent one from having cataract surgery. However, in cataract surgery, calculations need to be made to determine the most appropriate power of the intraocular lens that is used to replace the natural lens that has been removed. These calculations depend on certain assumptions about the eye that may no longer be valid following refractive surgery. As a result, the ability to successfully target a certain refractive outcome (such as not needing glasses to see far away) is decreased.
There are many formulas or equations that attempt to compensate for the changes due to refractive surgery. These formulas do help, but our ability to predict refractive outcomes are still better in eyes that have not had refractive surgery. Because some of the formulas use historical data from the refractive surgery, we recommend patients obtain copies of all the medical records from their refractive surgeon, including pre-op and post-op measurements.
The latest technology to help with choosing intraocular lens powers is the ORA intraoperative aberrometer. The eye can be thought of as needing a certain refractive power to see clearly. If the eye has too much or too little refractive power, images become blurry and the eye needs some sort of refractive correction, such as glasses or contacts, to bring images back in focus.