| <9 D | No change |
| 9 – 17 D | Reduce by 0.5 D |
| 18 – 26 D | Reduce by 1.0 D |
| ≥ 27 D | Reduce by 1.5 D |
When placing an IOL in the sulcus instead of the capsular bag, the more anterior position (~0.5 mm) shifts the focal point forward, resulting in a myopic surprise. Higher power IOLs are more sensitive to this positional change because the relationship between power and positional effect is nonlinear.
Source & credit: This rule was invented by the cataractcoach @uday.devgan. Check out his website cataractcoach.com and his YouTube channel @UdayDevgan for a ton of useful tricks in cataract surgery.
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