clinical notes of Preoperative check

☝cyclopentolate 1 %

☝phenylephrine 2.5%

☝ diclofenac 0.1 %.

✍ Check consent form whether complete or not

✍ Check any new ophthalmic problems (evidence of active infection)

✍ Mark side of operation.

✍ confirm

☝ IOL type and power and axis

☝ operating position( superior or temporal )

✍ Inserting the incorrect IOL has become a NEVER-EVENT ( never allowed to happen)

✍ IOL selection

☝ biometry does indeed belong to your patient.

☝ axial length and K values consistency in the operated eye

☝ axial length and K values consistency in both eyes

• Most individuals have similar axial lengths and corneal curvatures in either eye

• 92% of axial lengths are within the range 21 –25.5 mm

• 99% of K readings are within the range 40–48D.

✍ Check appropriate formula used

☝ AL <22mm ( hoffer Q or SRK/T)

☝ AL 22–24.5 mm ( SRK/T, holladay, haigis)

☝AL >24.6 ( SRK/T)

✍ Select appropriate lens power (usually, but not always, aiming for emmetropia)

☝ slightly myopic ( 0.50 D) for presbyopic

✍ previous corneal refractive surgery

☝ enter corrected K values into the suitable IOL calculation formula or use IOL master

☝ if patient previously myopic (select the highest IOL power suggested).

☝ if patient previously hyperopic ( select the lowest IOL power suggested ).

 Redo biometry whenever

✍ axial length is

☝AL < 21.20 mm

☝ AL >26.60 mm

✍ mean corneal power is

☝K <41 D

☝K >47D

✍ delta K ( astigmatism) is

☝ >2.5D

✍ difference in axial length between both eyes

☝ >0.7 mm

✍ difference in mean corneal power between both eyes

☝ > 0.9 D.