Abstract
PurposeWe assessed the accuracy of lens power calculation in highly myopic patients implanting plus and minus intraocular lenses (IOL).MethodsWe included 58 consecutive, myopic eyes with an axial length (AL) > 26.0 mm, undergoing phacoemulsification and IOL implantation following biometry using the IOLMaster 500. For lens power calculation, the Haigis formula was used in all cases. For comparison, refraction was back-calculated using the Barrett Universal II (Barrett), Holladay I, Hill-RBF (RBF) and SRK/T formulae.ResultsThe mean axial length was 30.17 ± 2.67 mm. Barrett (80%), Haigis (87%) and RBF (82%) showed comparable numbers of IOLs within 1 diopter (D) of target refraction. Visual acuity (BSCVA) improved (p < 0.001) from 0.60 ± 0.35 to 0.29 ± 0.29 logMAR (> 28-days postsurgery). The median absolute error (MedAE) of Barrett 0.49 D, Haigis 0.38, RBF 0.44 and SRK/T 0.44 did not differ. The MedAE of Haigis was significantly smaller than Holladay (0.75 D; p = 0.01). All median postoperative refractive errors (MedRE) differed significantly with the exception of Haigis to SRK/T (p = 0.6): Barrett − 0.33 D, Haigis 0.25, Holladay 0.63, RBF 0.04 and SRK/T 0.13. Barrett, Haigis, Holladay and RBF showed a tendency for higher MedAEs in their minus compared to plus IOLs, which only reached significance for SRK/T (p = 0.001). Barrett (p < 0.001) and RBF (p = 0.04) showed myopic, SRK/T (p = 002) a hyperopic shift in their minus IOLs.ConclusionsIn highly myopic patients, the accuracies of Barrett, Haigis and RBF were comparable with a tendency for higher MedAEs in minus IOLs. Barrett and RBF showed myopic, SRK/T a hyperopic shift in their minus IOLs.
Highlights
Deviation from target refraction is one of the most frequent indications for secondary intervention following the implantation of foldable intraocular lenses (IOL), excluding posterior capsule opacification [1]
In highly myopic patients, the accuracies of Barrett, Haigis and RBF were comparable with a tendency for higher median absolute error (MedAE) in minus IOLs
Mean axial length (AL) measured by IOL Master was 30.18 ± 2.67 mm
Summary
Deviation from target refraction is one of the most frequent indications for secondary intervention following the implantation of foldable intraocular lenses (IOL), excluding posterior capsule opacification [1]. In addition to postoperative anterior chamber depth and effective lens position (ELP), preoperative axial length (AL) measurement represents the most important error source for incorrect IOL power prediction, in myopic eyes [2, 3]. The unaided increase of visual acuity is a main target of cataract surgery, in case of clear lens exchange [4]. Partial coherence laser interferometry (PCI) yields AL measurements ten times more accurate than ultrasound [6]. It can be limited in cases of retinal detachment, fixation problems or dense cataract [7, 8]
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