Accuracy of the PEARL-DGS Formula for Intraocular Lens Power Calculation in Post–Myopic Laser Refractive Corneal Surgery Eyes

Abstract

PurposeTo investigate the accuracy of the PEARL-DGS formula for intraocular lens (IOL) power calculation in post-myopic laser refractive corneal surgery eyes. DesignRetrospective case series MethodsA total of 139 eyes of 139 patients (mean axial length: 27.4 ± 2.1 mm), who had prior myopic laser refractive corneal surgery and subsequent cataract surgery using Tecnis ZCB00 from March 2018 to February 2023 were included. Refractive outcomes of five formulas (Barrett True K, Haigis-L, Hoffer-QST, PEARL-DGS, and Shammas-PL) were evaluated. Prediction error was defined as the difference between the measured and predicted postoperative refractive spherical equivalent using the IOL power actually implanted. Mean prediction error (MPE), median absolute prediction error (MedAE), mean absolute prediction error were calculated. ResultsWithout constant optimization, the PEARL-DGS resulted in a MPE of +0.05 ± 0.65 D, while the other formulas resulted in myopic shifts. The MedAEs of the formulas were 0.39, 0.53, 0.65, 0.85, and 1.11 D for the PEARL-DGS, Hoffer-QST, Barrett True K, Shammas-PL, and Haigis-L, respectively, in order of magnitude (P < 0.05). With constant optimization, there were no statistically significant differences in the MedAEs among the five formulas (P = 0.388). ConclusionsIn comparison to other IOL formulas, the PEARL-DGS resulted in better refractive outcomes after cataract surgery in post-myopic laser refractive corneal surgery eyes without constant optimization. We suggest that PEARL-DGS be considered as the first choice for IOL power calculation in these eyes when the clinicians do not have their optimized constants.