As a resident more than 2 decades ago, I was taught by my attendings that the best refractive target for most patients was –0.5 D in order to achieve good uncorrected distance vision.
This made sense at the time because our IOL calculations were limited by the accuracy of third-generation formulas, which determined IOL power by estimating effective lens position solely based on the keratometry and axial length. In those days, it was also unusual to be concerned with corneal astigmatism because that could be addressed with spectacles after healing (Read more...)