Accuracy of intraocular lens power calculations in paediatric eyes.

Abstract

There is no clear consensus on which intraocular lens (IOL) power calculation formula provides the best refractive prediction in the paediatric population. To evaluate the predictability of desired postoperative refractive outcomes by using six IOL formulas in paediatric cataract cases. Retrospective case series. A total of 377 eyes in 377 paediatric patients (<13 years of age) who received primary IOL implants in the capsular bag. This study utilized formulas, namely, SRK II, SRK/T, Hoffer Q, Holladay 1, T2 and Super formula. Prediction errors were calculated based on the difference between the postoperative refraction and the refraction predicted by each formula. The mean prediction error, mean absolute error, median absolute error, percentages of eyes within the prediction errors of ±0.50 D, ±1.00 D and ± 2.00 D. The mean axial length was 22.48 ± 1.91 mm (<22.0 mm for 161 eyes). The average age at surgery was 55.21 ± 28.01 months (<24 months for 37 eyes). The mean prediction error was positive (hyperopic error) with all formulas. Compared to the other IOL power formulas, SRK II showed significantly higher absolute errors (P < .001). Hoffer Q and Holladay 1 generated the least absolute error, followed closely by Super formula. Multiple logistic analyses indicated that age at time of surgery was an independent factor significantly contributing to the refractive surprise using all formulas. SRK II was the least predictable formula in this study. HofferQ and Holladay 1 yielded the best predictive values.