Accuracy of theoretical IOL formulas for Panoptix intraocular lens according to axial length

Ayoung Choi,Hyunggoo Kwon,Sohee Jeon

doi:10.1038/s41598-021-86604-5

Abstract

The accuracy of intraocular lens (IOL) calculations is suboptimal for long or short eyes, which results in a low visual quality after multifocal IOL implantation. The purpose of the present study is to evaluate the accuracy of IOL formulas (Barrett Universal II, SRK/T, Holladay 1, Hoffer Q, and Haigis) for the Acrysof IQ Panoptix TFNT IOL (Alcon Laboratories, Inc, Fort Worth, Texas, United States) implantation based on the axial length (AXL) from a large cohort of 2018 cases and identify the factors that are associated with a high mean absolute error (MAE). The Barrett Universal II showed the lowest MAE in the normal AXL group (0.30 ± 0.23), whereas the Holladay 1 and Hoffer Q showed the lowest MAE in the short AXL group (0.32 ± 0.22 D and 0.32 ± 0.21 D, respectively). The Haigis showed the lowest MAE in the long AXL group (0.24 ± 0.19 D). The Barrett Universal II did not perform well in short AXL eyes with higher astigmatism (P = 0.013), wider white-to-white (WTW; P < 0.001), and shorter AXL (P = 0.016). Study results suggest that the Barrett Universal II performed best for the TFNT IOL in the overall study population, except for the eyes with short AXL, particularly when the eyes had higher astigmatism, wider WTW, and shorter AXL.

Highlights

Modern intraocular lens (IOL) formulas have significantly improved refractive outcomes after phacoemulsification and IOL implantation[1,2,3]
Among 2018 eyes, 260 eyes (12.9%) with axial length (AXL) ≤ 22.5 mm were classified in the short AXL group, 98 eyes (4.9%) with AXL ≥ 26.0 mm were classified in the long AXL group, and 1660 eyes (82.2%) with AXL between 22.5 and 26.0 mm were classified in the normal AXL group
The anterior chamber depth (ACD) was deeper, the lens thickness (LT) was thinner, the mean keratometric value was lower, the WTW corneal diameter was longer, and the total corneal irregular astigmatism (TCIA) was lower in the long AXL group followed by the normal AXL and short AXL

Summary

Introduction

Modern intraocular lens (IOL) formulas have significantly improved refractive outcomes after phacoemulsification and IOL implantation[1,2,3]. The clinical importance of postoperative refractive outcomes is most noted in patients with multifocal IOL (MIOL) implantation. Lawless et al.[6] reported a mean absolute error (MAE) of − 0.01 ± 0.22 D, and 100% of the eyes were within ± 0.50 D of the intended correction. The accuracy of modern IOL formulas has been verified as mentioned previously, most eyes in previous study population had an axial length (AXL) within the normal range. There are only limited data about the accuracy of IOL formulas for MIOLs, including the TFNT IOL, in eyes with extreme ocular metrics, such as high myopia and hyperopia. The purpose of the present study is to (1) evaluate the accuracy of IOL formulas for TFNT IOL implantation based on the AXL from a relatively large cohort of 2018 cases and (2) identify the factors that are associated with inaccurate outcomes

Objectives

Methods

Results

Conclusion