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17 Holladay Report & Holladay EKR65 Detail Report
Figure 160: Holladay EKR65 Detail Report of a normal exam
With a normal pupil of 5.48 mm the 4.5 mm grey column, with EKR65 flat K1 = 40.11 A 161° and
steep K2 = 41.42 A 71°
(Figure
IOL calculator for the proper spheroequivalent power and toricity of the IOL. An exact toric calculator
such as the one provided in the "Holladay IOL Consultant Program" (www.hicsoap.com) which does
not use a constant ratio of the corneal astigmatism to the ideal toricity of the IOL [39]. When EKR65
values are used and an exact toric calculator, the back surface power and astigmatism have been
already been implemented and there is no need for additional adjustments!
The blue line in the upper right graph demonstrates that there is approximately a 0.75 D increase in
power from the 1 to 4.5 mm zone. This was also confirmed by the Q-value and total SA values on
page 1. Note the EKR65 uses "Snell's law, whereas the axial power lines (green and red) are not and
therefore do not reflect actual refractive power changes due to the cornea.
The distribution of EKR in the 4.5 mm zone shows that the EKR65 mean (40.76), global mean (40.93)
and the highest peak (41.20) are all within 0.50 D of each other. The difference in these values is a
measure of the irregular astigmatism as well as a measure of the precision of the EKR65, which is
the best value to use. The greater the differences, the broader the range of the distribution and the
greater the number of individual peaks, the lower is the reliability of the EKR65 which results in a
lower predictability of the IOL power outcome. Multiple examinations are helpful for repeatability,
but when the range is large the patient should be prepared for the possibility of a "fine tune" to
achieve the exact refractive spheroequivalent power target and elimination of astigmatism. The EKR
map in the lower right allows the clinician to see the EKR distribution graphically.
132
160), would provide the correct keratometric values to enter into an
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