This study aims to evaluate the accuracy of intraocular lens (IOL) power calculation formulas-including Kane, Emmetropia Verifying Optical (EVO) 2.0, SRK/T, Hoffer Q, Haigis standard, Haigis optimized, Holladay 1, Olsen, Barrett Universal II-in primary angle-closure glaucoma (PACG) eyes undergoing cataract surgery combined with goniosynechialysis (GSL). Preoperative biometric data were obtained using the OA-2000. The preoperative anterior chamber depth (ACD) was categorized into two subgroups: < 2.50mm and 2.50 to 3.50mm. The predictive accuracy of the formulas was assessed using the mean prediction error (PE), mean absolute error (MAE), median absolute error (MedAE), and proportions of eyes within ± 0.25D, ± 0.50D, ± 0.75D, and ± 1.00D. Differences in absolute error among the various formulas were examined utilizing the Friedman test. In the case of a significant result, post hoc analysis was conducted employing the Wilcoxon test with Bonferroni correction. A total of 141 eyes of 141 PACG patients were included in the analysis. The standard deviations of the PE, ranked from lowest to highest, were as follows: Holladay 1 (0.67), Kane (0.69), EVO 2.0 (0.71), SRK/T (0.71), Hoffer Q (0.72), Haigis standard (0.74), Haigis optimized (0.76), Olsen (0.77), Barrett Universal II (0.79). Statistically significant differences in absolute refractive errors among the formulas were observed (P = 0.001). Kane formula demonstrated the lowest MedAE (0.34), and the highest percentages of eyes within ± 0.25D (35.46%) and ± 1.00D (89.36%), while EVO 2.0 had the highest percentages within ± 0.50D (65.25%). In the ACD < 2.50mm subgroup, MedAE differed significantly among formulas (P = 0.001). The Holladay 1 formula had the lowest MedAE (0.33), followed by Kane (0.34), EVO 2.0 (0.37). In the 2.50 ≤ ACD < 3.50mm subgroup, refractive errors showed no statistically significant differences. Additionally, the percentages within ± 0.25D, ± 0.50D, ± 0.75D, and ± 1.00D demonstrated no significant differences in both subgroups (all P > 0.05). Among the nine formulas, Kane, Holladay 1, and EVO 2.0 demonstrated superior refractive outcomes in PACG eyes.
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