ReviewClinical optometry2026
Refractive Surprises After Cataract Surgery: Identification and Management in Optometric Practice- A Comprehensive Review.
Review in Clinical optometry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Refractive surprises remain one of the most challenging postoperative complications in modern cataract surgery, where precision and patient expectations for plano refractive outcomes continue to rise. Despite advances in optical biometry, intraocular lens (IOL) formula optimization, and surgical technology, postoperative refractive error still occurs in a subset of patients and may significantly affect visual satisfaction and quality of life. This review synthesizes contemporary evidence on the causes, detection, and optometric management of refractive surprises, with a practical focus on the evolving role of the optometrist in co-management. Residual refractive error most commonly results from biometric inaccuracies, keratometric misalignment, incorrect estimation of effective lens position, prior corneal refractive procedures, and anatomical extremes such as axial myopia or hyperopia. Early recognition through comprehensive postoperative assessment-including manifest refraction, keratometric stability, IOL position evaluation, corneal tomography, and retinal imaging-is critical to differentiating optical errors from pathology. Management options include spectacles and contact lenses for mild errors, while significant ametropia may require corneal refractive surgery, arcuate keratotomy, piggyback IOL implantation, or IOL exchange depending on patient factors, ocular anatomy, and refractive stability. The review further discusses algorithmic approaches to decision-making, counseling strategies for dissatisfied patients, and considerations when dealing with toric and multifocal IOLs. As optometrists increasingly serve as primary comanagers of cataract surgery patients, understanding the etiology and management of refractive surprises is essential. Improved diagnostic workflows, individualized IOL planning, and collaborative postoperative care pathways can greatly enhance refractive predictability and visual outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.