Accuracy of intraocular lens calculation formulas in cataract patients with steep corneal curvature.

Chenguang Zhang,Xianwei Wu,Hongda Zhang,Tiezhu Lin,Guangzheng Dai,Ling Xu,Emmanuel Eric Pazo,Wei He,Michael Mimouni

doi:10.1371/journal.pone.0241630

Chenguang Zhang, Xianwei Wu + Show 7 more

Open Access

https://doi.org/10.1371/journal.pone.0241630

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Journal: PloS one	Publication Date: Nov 20, 2020
Citations: 11	License type: CC BY 4.0

Affiliation: He Eye Hospital

Abstract

ObjectiveTo compare the accuracy of five kinds of intraocular lens calculation formulas (SRK/T, Haigis, Hoffer Q, Holladay and Barrett Universal Ⅱ) in cataract patients with steep curvature cornea ≥ 46.0 diopters.MethodsThis is a retrospective study of cataract phacoemulsification combined with intraocular lens implantation in patients with steep curvature cornea (corneal curvature ≥ 46D). The refractive prediction errors of IOL power calculation formulas (SRK/T, Haigis, Holladay, Hoffer Q, and Barrett Universal II) using User Group for Laser Interference Biometry (ULIB) constants were evaluated and compared. Objective refraction results were assessed at one month postoperatively. According to axial length (AL), all patients were divided into three groups: short AL group (<22mm), normal AL group (>22 to ≤24.5mm) and long AL group (>24.5mm). Calculate the refractive error and absolute refractive error (AE) between the actual postoperative refractive power and the predicted postoperative refractive power. The covariance analysis was used for the comparison of five formulas in each group. The correlation between the absolute refractive error and AL from every formula were analyzed by Pearson correlation test, respectively.ResultTotal 112 eyes of 83 cataract patients with steep curvature cornea were collected. The anterior chamber depth (ACD) was a covariate in the short AL group in the covariance analysis of absolute refractive error (P<0.001). The SRK/T and Holladay formula had the lowest mean absolute error (MAE) (0.47D), there were statistically significant differences in MAE between the five formulas for short AL group (P = 0.024). The anterior chamber depth had no significant correlation in the five calculation formulas in the normal AL group and long AL group (P = 0.521, P = 0.609 respectively). In the normal AL group, there was no significant difference in MAE between the five calculation formulas (P = 0.609). In the long AL group, Barrett Universal II formula had the lowest MAE (0.35), and there were statistically significant differences in MAE between the five formulas (P = 0.012). Over the entire AL range, the Barrett Universal II formula had the lowest MAE and the highest percentage of eyes within ± 0.50 D, ± 1.00 D, and ± 1.50 D (69.6%, 93.8%, and 98.2% respectively).ConclusionCompared to SRK/T, Haigis, Hoffer Q, and Holladay, Barrett Universal Ⅱ formula is more accurate in predicting the IOL power in the cataract patients with steep curvature cornea ≥ 46.0 diopters.

Highlights

Cataract surgery is one of the most commonly performed procedures in the increasingly ageing population
Compared to SRK/T, Haigis, Hoffer Q, and Holladay, Barrett Universal II formula is more accurate in predicting the IOL power in the cataract patients with steep curvature cornea 46.0 diopters
Some scholars found that Hoffer Q performed best for eyes shorter than 22.0 mm [2], while most modern theoretical IOL formulas perform well for eyes with the normal eye axis lengths (22.0– 24.5 mm) [3], Barrett Universal II formula is considered to be most accurate in the long axis lengths [4, 5]

Summary

Introduction

Cataract surgery is one of the most commonly performed procedures in the increasingly ageing population. Postoperative refractive error is one of the primary cause of postoperative visual outcome dissatisfaction among patients. Accurate IOL power calculations have become extremely important. The calculation formula of artificial crystal has gradually developed from the first generation of theoretical formula to the Hill-radial basis function formula [1]. There is still considerable debate about which formula provides the most accurate refractive prediction. Some scholars found that Hoffer Q performed best for eyes shorter than 22.0 mm [2], while most modern theoretical IOL formulas perform well for eyes with the normal eye axis lengths (22.0– 24.5 mm) [3], Barrett Universal II formula is considered to be most accurate in the long axis lengths [4, 5]

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Conclusion