Media Type: Text

Synopsis: IOL Power is a comprehensive work by an author who is able to make a relatively dry topic quite readable. There is consistent attention to topics that have clear clinical significance. This is a very good title to have in the library. It can be used by the clinician to plan an upcoming procedure or be available in the case of a peri-operative quandary. It’s the next best thing to having Dr Hoffer available for a consultation.

Target Audience: General ophthalmologists, cataract and refractive specialists, ophthalmic technicians

Review: On November 29, 1949, Sir Harold Ridley implanted the first intraocular lens at St. Thomas’ Hospital in London. According to the author of this text, he experienced a 21 diopter “surprise” on his first two cases. Three years later the era of high patient expectations was entered: one of Sir Ridley’s patients achieved a post-operative visual acuity of 20/20. During the last two decades we have experienced tremendous advances in cataract surgical technique. Incisions are smaller, phaco times have diminished and IOLs are being designed to more closely replicate the physiologic function of the pre-cataractous crystalline lens. The line between cataract and refractive surgeries is now blurred, with the modern cataract surgeon needing to have a deep knowledge of optics and refractive principles in order to provide patients with consistently excellent visual outcomes. Further, advanced or “premium” IOLs require precise placement, alignment and of course, power calculation. In order to meet the expectations of our patients and provide the best possible functional outcomes, the cataract surgeon needs the latest information on IOL power calculation. All the better if the resource also contains detailed information on special and difficult clinical scenarios. IOL Power by Dr Kenneth Hoffer largely fulfills these requirements. Dr Hoffer has dedicated much of his career to the subject of IOL power calculation. This, his first book on the topic, is a coalescence of his and his fellow authors’ many lectures and papers. At its most efficient, IOL Power provides the surgeon with readily available and concise information on choosing the proper IOL power. Where the text soars is in its attention to the situations that do not occur on each operating day.

The book is divided into two main sections: I. Basics and Accurate Biometry, II. Formulas and Special Circumstances. Section I covers in depth the techniques and instruments needed for precise IOL power calculation. There is consistent dialogue between Dr Hoffer, his fellow authors and the reader. The writing style is relaxed and the prose is not overburdened with technical jargon. The book takes photos and figures from many sources and some of them appear dated; however this is only a minor distraction. It seems as though the author is sitting next you and guiding you through the technical processes and steps needed to complete the task. There is always great attention paid toward patient safety and the avoidance of errors in calculation. Section II is where most readers will find the greatest value. The chapters are only a few pages long and address a very specific clinical situation in which IOL power calculation is difficult. For example, the authors provide concise information on proper IOL power measurement on eyes filled with silicone oil or on those having corneal scars from radial keratotomy. The last part of the book contains several chapters on avoiding and treating errors in IOL power. Again, Dr Hoffer provides the reader with practical information that can be used in pre-operative measurements as well as during the surgical case. Overall this is an excellent text and will be very useful to the cataract surgeon; especially to one with a practice consisting of patients with diverse lens pathology.