Optimizing Intraocular Lens Calculation in Emergency Intraoperative Complications: A Surgical Challenge

Cataract surgery is one of the most frequently performed surgical procedures worldwide, with over 28 million cases annually, and its success hinges on precise intraocular lens (IOL) power calculation to achieve optimal refractive outcomes [1]. Advances in biometry and IOL formulas (e.g., Barrett Universal II (BUII), Holladay 2) have reduced postoperative refractive surprises. Still, emergency intraoperative complications—such as posterior capsule rupture, zonular dehiscence, or vitreous loss—dramatically alter the surgical landscape. These events disrupt preoperative assumptions about effective lens position (ELP), anterior chamber depth (ACD), and IOL fixation, demanding rapid recalibration of calculations to avoid hyperopic or myopic surprises that compromise patient satisfaction and surgical success [2].