Posterior Chamber Intraocular Lens Research Articles

Kongenitale Katarakt und Pseudophakie – Myopiekontrolle in einer ungewöhnlichen Ausgangssituation

Purpose. An effective reduction in the progression of myopia can be achieved by pharmacological administration of low-dose atropine eye drops, the fitting of multifocal and Ortho-K contact lenses or with specialized spectacle lenses. The case report describes the successful stabilization of myopia and visual acuity in a 14-year-old patient who had a posterior chamber IOL implanted at the age of 2 as a result of a congenital cataract. Material and Methods. A 14-year-old untreated patient with pseudophakia after congenital cataract, was fitted with multifocal rigid-gas permeable (RGP) contact lenses for high myopia, irregular astigmatism, anisometropia and nystagmus to increase visual acuity and prevent myopia progression. Results. With the fitted contact lenses, good lenses tolerance was achieved with a daily wearing time of 12 hours and an increase of visual acuity from spectacle-corrected visual acuity (20/160) to contact lens-corrected visual acuity (20/40) and stabilization of myopia over 3.5 years. With the contact lenses in combination with progressive spectacles, it was possible to achieve an additional increase in near vision and successful treatment of the patient. With her new quality of life, the patient can now complete school education independently and start an apprenticeship. Conclusion. Pseudophakic children with high myopia and astigmatism can also be successfully fitted with multifocal contact lenses with the aim of increasing visual acuity and stabilizing myopia.

Cat eyes - iris capture as unusual complication after phakic posterior chamber intraocular lens implantation

Cat eyes - iris capture as unusual complication after phakic posterior chamber intraocular lens implantation

Intraocular lens exchange or explantation post cataract surgery.

To report incidence, indications, and visual outcomes of intraocular lens (IOL) exchange/explantation surgery. Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1st January 2017 and 31st December 2022. The overall outcomes as well as comparison between the trainee versus experienced surgeons were analyzed. Out of 39 778 cataract surgeries (with no preexisting ocular co-morbidities) during a six-year period (2017-2022), 60 (0.15%) needed IOL exchange/explantation. Surgeons-under-training performed 36/60 cases (60%) while 24/60 (40%) were by experienced surgeons. The commonest indication was subluxated IOL in 26 (43.3%), followed by dislocated IOL in 20 (33.3%), postoperative refractive surprise in 7 (11.6%), IOL induced uveitis in five and broken haptic in two eyes. Twenty-four (40%) eyes had intraoperative complications during primary surgery. Posterior chamber IOL (PCIOL) was the commonest secondary IOL in 21 (35%) eyes, scleral fixated in 20 (31.6%), anterior chamber IOL (ACIOL) in 13 (21.6%), iris fixated IOL in three (5%) and three eyes (5%) were left aphakic. The mean time between primary and secondary surgery was 168d (168±338.8). Best corrected visual acuity (BCVA) of >20/60 was obtained in 43 eyes (71.66%), 20/80-20/200 in 14 (23.33%), 20/250 in two and hand movements in one. No statistically significant difference in visual outcome was noted at post-op one month between trainees versus experienced surgeons (UCVA 0.45±0.29 vs 0.53±0.32, P=0.20, BCVA 0.34±0.25 vs 0.37±0.26, P=0.69). IOL subluxation as the commonest indication and posterior capsular rupture is the commonest intraoperative risk factor. This complication can be effectively addressed with selection of the appropriate secondary IOL achieving good visual outcomes in over 70% of patients.

Client’s pre-operative expectations and outcome of cataract surgery at the Jos University Teaching Hospital, Jos, Plateau State, Nigeria

Objectives: A cataract is an opacity of the natural crystalline lens that causes vision loss. It is the most common cause of blindness worldwide, accounting for 39% of the 42 million blind people in the world. The optimum outcome from a cataract surgery can be achieved if post-operative subjective outcomes meet pre-operative expectations. It is expressed in different ways including patient satisfaction. This study evaluated clients’ pre-operative expectations and the outcome of cataract surgery at Jos University Teaching Hospital. Materials and Methods: A quasi-experimental, prospective hospital-based study that consecutively recruited 109 participants aged 18 years and above for 6 months. Data regarding the sociodemographic characteristics, pre-operative visual function, and expected post-operative outcome were collected preoperatively, and the subjective outcome and level of patient satisfaction were also assessed 6 weeks after surgery using a visual function index questionnaire. Data were analysed using the Statistical Package for the Social Sciences’ version 23. Frequencies and percentages were determined for categorical variables; mean and standard deviation, median, and interquartile range were calculated for continuous variables. Correlation was used to measure the relationship between overall satisfaction and expected or achieved visual function. A significant level was determined at P < 0.05. Results: A total of 109 participants were seen in this study, of which 60 (55%) were males. The mean age of participants in the study was 64.5 ± 11.1 years. The median (interquartile range) expected and actual post-operative outcome scores were 100 (80–100) and 98 (75–100), respectively. The majority of the participants, 86 (78.9%), were satisfied with the outcome of cataract surgery, and the predictors of satisfaction were insertion of posterior chamber intraocular lens, absence of complications, and absence of ocular comorbidities. We found a significant strong positive correlation between subjective outcome and satisfaction (r = 0.538, P ≤ 0.0001). Conclusion: The majority of the clients were satisfied with the outcome of their surgeries which meets the high expected outcomes from the clients pre-operative. Adequate counselling, training, and retraining of surgeons are key to improving and maintaining satisfaction with the outcome of cataract surgery.

Three-point transscleral suture fixation of a foldable three-looped haptics one-piece posterior chamber intraocular lens implantation

A 73-year-old male patient was suffering from aphakia due to ocular trauma. Capsular implantation of a posterior chamber intraocular lens (PCIOL) was impossible in the absence of capsular support. Three-point transscleral suture fixation was used. The technique was performed under retrobulbar anesthesia. A three-looped haptics one-piece foldable PCIOL was suspended in the eye with one haptic at 6 o’clock and tied by a cow-hitch knot, and the haptics at 2 o’clock and 10 o’clock were threaded by another suture. The patient was followed up for 6 months postoperatively, and the postoperative logarithm of the minimum angle of resolution at the final follow-up was 0.3. The intraocular lens remained well positioned and stable. No complications, such as suture loosening, hypotony, chronic inflammation, or retinal detachment, were observed during the postsurgery follow-up period.

Cataract as the First Manifestation of Insulin Dependent Diabetes Mellitus

An 8-year-old girl presented with blurry vision. Examination revealed impaired visual acuity (VA) in both eyes and significant lamellar and posterior subcapsular cataracts requiring surgery. Preoperative laboratory tests indicated elevated urine and blood glucose levels, leading to a diagnosis of insulin-dependent diabetes mellitus by a paediatric endocrinologist. She began insulin treatment and underwent lens aspiration with posterior chamber intraocular lens implantation. Postoperatively, her VA improved to 20/30 in the right eye and 20/60 in the left eye.

Evaluation of refractive surgery with posterior chamber intraocular lenses in patients with high myopia treated in an Ophthalmologic Center of the city of Rosario, years 2019-2022

Introduction: Myopia is an ametropia that is highly prevalent and causes loss of visual acuity, characterized by having diopters greater than -5.00. The implantation of a posterior chamber intraocular lens represents a treatment option for those patients who cannot undergo the Excimer Laser technique.Objective: To describe the results achieved with the placement of posterior chamber intraocular lenses in patients with high myopia treated in an ophthalmologic center in the city of Rosario between the years of 2019-2022.Materials and Methods: Quantitative, descriptive, observational, retrospective, retrospective, cross-sectional, non-probabilistic study by convenience. Conducted at Centro Oftalmología Global, a private center specialized in ocular pathologies, located at Bv. Oroño 1003 in the city of Rosario - Santa Fe. Data were collected by review of medical records. The data obtained were entered into a Microsoft Excel database. The data were tabulated for presentation and analysis. Summary measures of central tendency (arithmetic mean, median and mode) and dispersion (standard deviation) and descriptive statistical techniques (frequency distributions, averages and percentages) were used.Results: A total of 38 medical records were studied, of which n=23 (60.5%) were female and n=15 (39.5%) were male. The mean age was 31.2 (SD ±2.84 years; min. 24 and max. 35). The age group with the highest frequency was 30 and 35 with 25 patients (65.8%). Of the total, n=21 (55.3%) were patients with high myopia and n=17 (45.7%) with high myopia and astigmatism. Of n=38, 44.7% presented preoperative visual acuity less than 1/10 and 26.3% of 1/10. Refractometry showed results between -3.00 to -20.00 diopters of sphere and -1.00 to -6.00 diopters of cylinder.Conclusion: It was possible to assess that 86.8% of the patients who underwent refractive surgery were able to achieve an optimal visual quality (10/10) after LCI placement, and of the total number of patients (n=38) studied, only 5 (13.2%) presented complications in the postoperative period

Focusing on issues about phacoemulsification lens extraction combined with goniosynechialysis

Angle closure is a basic pathological process in primary angle-closure glaucoma. Unlike filtration anti-glaucoma surgery, goniosynechialysis is a treatment for the cause of primary angle-closure glaucoma by reconstructing the physiological aqueous outflow pathway. In the past 10 years, phacoemulsification lens extraction with posterior chamber intraocular lens implantation in combination with goniosynechialysis for the treatment of primary angle-closure glaucoma has become a hot topic of clinical research and discussion. This article points out the issues that need to be paid attention to in the clinical practice of the combined surgery, including the relationship between phacoemulsification surgery and goniosynechialysis, the effectiveness and influencing factors of the combined surgery, and how to avoid the postoperative re-adhesion of the angle, in order to provide reference and guidance for better goniosynechialysis.

Adjustable flanged technique for secondary implantation of four-point scleral‑fixated posterior chamber intraocular lenses using two parallel 6−0 polyglactin sutures

ObjectiveTo assess the efficacy and safety of using the adjustable flanged technique for secondary implantation of four-point scleral‑fixated posterior chamber intraocular lenses with two parallel 6−0 polyglactin sutures.MethodsTwo parallel 6−0 polyglactin sutures were passed separately through the two haptics on the horizontal line of the 4-haptic IOL. The four externalized sutures were then trimmed and cauterized to form flanges. The best corrected visual acuity, intraocular pressure, and complications in all patients were observed and recorded.ResultsThe flanged technique using two parallel 6−0 polyglactin sutures was applied to 14 aphakic eyes. The average preoperative best corrected visual acuity was 1.00 ± 0.88 LogMAR (Snellen 20/200), which improved to 0.42 ± 0.38 LogMAR (Snellen 20/48) at the final follow-up (P = 0.004). None of the patients experienced vitreous hemorrhage, low intraocular pressure, or issues with exposed or broken sutures.ConclusionThe simplicity of the technique, along with its ability to accommodate adjustments post-implantation, allows for optimal positioning and reduces risks like IOL tilt or dislocation. Overall, this is a promising approach to secondary IOL implantation, with potential benefits for both patient outcomes and surgical efficiency.

Clinical Effect Analysis of Posterior Chamber Intraocular Lens Implantation for Correcting High Myopia and Astigmatism

Objective: To explore the corrective effect of posterior chamber intraocular lens implantation with phakic eyes in the treatment of high myopia and astigmatism. Methods: From May 2023, the hospital began to collect the case data of diagnosis and treatment of high myopia and astigmatism. By May 2024, 310 cases were included, all of which were treated with posterior chamber intraocular lens implantation. The visual acuity, astigmatism and axial position of the intraocular lens were observed before and after treatment. Results: At different time points after the operation, the patient’s vision was significantly improved compared with that before the operation (P < 0.05), and the vision level was equal to or greater than the best-corrected vision before the operation. At different time points after the operation, the average rotation of the intraocular lens was less than 5 degrees. Astigmatism was significantly lower than that before the operation (P < 0.05). After the operation, the intraocular pressure increased in 11 cases, accounting for 3.55%, with no adverse complications such as lens turbidity, glare and obvious halo occurring. Conclusion: The posterior chamber intraocular lens implantation with phakic eyes has an ideal correction effect in the treatment of high myopia and astigmatism, which can effectively improve the vision level of patients and reduce the degree of astigmatism, and has high effectiveness and safety.

Manual Sutureless (MSICS) Cataract Surgery and Corneal Astigmatism

The most frequent preventable cause of blindness worldwide is cataracts. Manual Small Incision Cataract Surgery (MSICS) is still very much in use, even though cataract surgery is always changing. The resurgence of MSICS can be attributed to its low cost and safety, as it primarily uses easily sterilizable equipments and does not require sophisticated technology. This study aims to assess corneal astigmatism and manual sutureless (MSICS) cataract surgery after a month of follow-up. Forty individuals with cataract diagnoses were enrolled in this prospective study. During the procedure, a posterior chamber intraocular lens (IOL) implantation was done in addition to a superior manual minor incision under local anesthesia. The findings indicated that 15% or so of the patients experienced astigmatism following surgery. Also the findings revealed that sphere and cylinder refraction was significantly influenced by surgery. The means of sphere refraction before and after surgery were 3.93±6.37 and 0.93±0.98 D, while the corresponding means for cylinder refraction were 1.37±1.08 and 1.94±1.18 D. The results showed that means preoperative and postoperative Keratometry of cornea (K1) were 43.09±1.21 and 43.37±1.42 mm, while the corresponding means of Keratometry (K2) were 43.97±1.35 and 44.49±1.59 mm. The study concluded that the length of the superior incision (6.0 mm) may have contributed to the higher mean SIA than reported in other studies. However, more research is required to determine the impact of incision size on surgically produced astigmatism.

Outcome of Cataract Surgery among Eye Camp Patients of Eastern Nepal

Background: Outreach camp is helpful for reducing the prevalence of blindness due to cataracts and refractive error. The objective was to evaluate the visual outcome of cataract surgery among camp patients operated at a high volume center of Eastern Nepal. Materials and Methods: Descriptive cross sectional study design was used. The comprehensive eye screening program was conducted and those having cataracts were referred to base hospital for cataract surgery, patients were reexamined at the base hospital again and a small incision cataract surgery with posterior chamber intraocular lens was implanted at Biratnagar Eye Hospital, Biratnagar and Sagarmatha Choudhary Eye Hospital, Lahan. The pre-operative vision was taken during screening and post-operative vision was taken after one-month by performing refraction by trained personnel. Data were extracted from the hospital record; analysis was done using SPSS version 17.0. Descriptive analysis by using frequency, parent age and association was done by using Chi square test with a P-value <0.05 considered as significant. Results: A total of 1426 camp patients were operated. Among them 1113 (78%) were visited after one month post operative follow up at the campsite. There were 744 (52%) female and bilateral affected eyes were 735(52%). Pre-operative presenting visual acuity was <3/60 (37%), which was reduced to (0.2%) after one month follows up of cataract surgery. There was a significant association in pre-operative VA with aided one month to follow up VA. Conclusion: The outcome of the cataract surgery of camp patients operated at base hospitals was good in high-volume hospitals. Follow up after one month was good practice to provide services and measure the outcome of cataract surgery.

A study of contrast sensitivity in eyes with hydrophobic and hydrophilic acrylic foldable posterior chamber intraocular lens

A study of contrast sensitivity in eyes with hydrophobic and hydrophilic acrylic foldable posterior chamber intraocular lens

Improving the quality of visualization in phacoemulsification in the “triple procedure”

The so-called “triple procedure,” including penetrating keratoplasty in combination with cataract removal and posterior chamber IOL implantation, is the preferred treatment method for patients with combined pathology of the cornea and lens. Methods to reduce intraoperative complications and ensure rapid visual rehabilitation in patients with concomitant conditions are of particular importance when planning such surgeries. In this article, we describe a clinical case of a triple procedure, which involves a lamellar dissection of the damaged cornea of the recipient followed by exposure of the residual corneal stroma to a 40% glucose solution in combination with a viscoelastic, which allowed for optical clearing of the stroma and improved visualization of the anterior chamber structures for phacoemulsification with posterior chamber IOL implantation. This approach represents a safer alternative to the “cataract stage” of surgery, performed under “open sky” conditions.

A Comparison of Functional Endothelial Changes between Phacoemulsification with PCIOL and Manual Small Incision Cataract Surgery with PCIOL

Intraocular surgery e.g., cataract surgery with PCIOL implantation is one of the leading causes of corneal endothelial injury and change in the functionality of the cornea. This observational study was conducted in the Department of Ophthalmology of Combined Military Hospital (CMH), Dhaka Cantonment, Dhaka, Bangladesh, between January and July of 2016, to assess and compare functional changes in cornea (i.e., endothelial thickness) after phacoemulsification with posterior chamber intraocular lens (PCIOL) implantation and manual small incision cataract surgery (MSICS) with PCIOL implantation. A total of 80 patients of age-related cataract were randomly selected based on inclusion and exclusion criteria. All patients underwent complete ophthalmic evaluation pre- and post-operatively (at day 1, after 1 week and 3 months) specifically for observation of the endothelial changes in cornea. Specular microscopy was done to assess corneal endothelial change. The mean central corneal thickness was increased at day 1 (564.71±22.45μ vs. 555.10±40.57μ), after 1 week (539.43±22.16μ vs. 535.08±38.87μ) and 3 months (523.49±21.29μ vs. 520.05±33.68μ) after phacoemulsification and MSICS from their preoperative value (508.72±23.96μ vs. 503.62±32.06μ) respectively. However, the differences were not statistically significant between two groups (P>0.05). The mean percentage of central corneal thickness change at day1, after 1 week and after 3 months following cataract surgery were found 11.01±6.30% and 10.22±26.54% at day 1, 6.04±7.52% and 6.25±21.24% after 1 week, 2.90±11.14% and 3.26±5.05% after 3 months in phacoemulsification and MSICS cases respectively. However, no statistically significant difference was observed in percentage of central corneal thickness change of both groups (P>0.05). To summarize, an increased central corneal thickness was observed after phacoemulsification and SICS from their preoperative values. Mugda Med Coll J. 2024; 7(1): 14-18

Capsular bag distension syndrome with sulcus IOL acting as a seal

Capsular bag distension syndrome (CBDS) is a rare complication following cataract surgery with posterior chamber intraocular lens (IOL) implantation. We describe the case of a 68-year-old female who developed early-onset CBDS of her left eye after manual small-incision cataract surgery with implantation of posterior chamber IOL in the sulcus (Excel PMMA IOL (polymethyl methacrylate), Manufactured by Excel Optics (P) Limited, Chennai). The patient had an uneventful cataract surgery performed by a resident in training. Her immediate postoperative uncorrected vision was 20/40, but it decreased to finger counting 1 m on postoperative day 7, for which she presented back to hospital. Slit-lamp examination revealed a quiet anterior chamber without any cells–flare with IOL in the sulcus with a relatively smaller capsulorhexis of about 5 mm, and IOL optic was covering the capsulorhexis in a symmetric fashion, thus causing a block. Distension of capsular bag was further confirmed by Anterion anterior segment optical coherence tomography (Heidelberg Engineering Technology, Germany), which showed a confined hyperechogenic fluid trapped between the IOL and the posterior capsule. She was diagnosed with CBDS secondary to retention of turbid fluid. Phased treatment was done; neodymium-doped yttrium aluminum garnet capsulotomy was tried in the first attempt, but failed as the posterior capsule was far too behind. This was followed by anterior chamber wash with redialing of the lens in the bag, which thereby improved vision to 20/20 (best corrected visual acuity) at 1-week postoperatively. Even with IOL in the sulcus, the postoperative CBDS may rarely happen at any point of time with a small capsulorrhexis and an intumescent mature cataract. Immense cortex wash should always be kept in mind in such a case, as the liquefied cortex is sometimes stuck at the equator and a little more duration of irrigation is required in such scenarios. Hence, complete clearance of turbid fluid of intumescent mature cataract variety also holds due importance similar to the need of removing viscoelastic substance to prevent CBDS.

Intraoperative challenges and outcomes of pediatric cataract surgery following glaucoma filtering surgery.

To analyze the intraoperative challenges of cataract surgery in children, following glaucoma filtering surgery. This was a retrospective study to analyze intra-op challenges and outcomes of pediatric cataract surgery in post-glaucoma filtration surgery eyes, between January 2007 and December 2019. We included 20 eyes of 16 children. The most common glaucoma surgery performed was trabeculectomy and trabeculotomy (14 eyes). The median age at the time of cataract surgery was 74.5months. The most common cataract surgery performed was lens aspiration with posterior chamber intraocular lens implantation (LA + PCIOL) (9/20). The most common intraoperative challenge faced was difficulty in capsulorrhexis (ten eyes), followed by extension of primary posterior capsulotomy (six eyes). At the final follow up eight eyes had improvement in visual acuity, five eyes had stable visual acuity and five eyes had a drop in visual acuity. In 12/20 eyes IOL was implanted, nine eyes in-the-bag and three eyes had in ciliary sulcus. None of the IOLs in the bag had decentration of IOL. The median postoperative IOP (p = 0.12) and median number of postoperative AGM (p = 0.13) at 2years remained stable compared to the preoperative values. The IOP remained well controlled in 4 eyes without anti-glaucoma medications and in 14 eyes with anti-glaucoma medications and none needed additional surgery for IOP control. Two eyes developed retinal detachment postoperatively. Cataract surgery in pediatric eyes with prior glaucoma surgeries, have challenges with capsulorrhexis and IOL stability. The visual outcomes were reasonably good so was the IOP control.

Granulomatosis with polyangiitis, complicated by ocular adnexa lesion and vascular changes in retina and choroid (literature review with a clinical case)

Granulomatosis with polyangiitis (GPA) is manifested as ocular pathology in almost a third of patients, which can either be detected at the onset of the disease or occur in the late stages. The pathological process involves the orbit, sclera, episclera, cornea, conjunctiva, eyelids, nasolacrimal system, optic nerve, retina and choroid. Lesion of eye and its surrounding structures determines the severity of the pathological process, the patient’s quality of life and prognosis. The article presents a clinical case of a 38-year-old man with an unfavorable course of GPA, lesion to upper and lower respiratory tract, kidneys, and musculoskeletal system. The authors consider ocular manifestations in the context of a systemic disease. An ophthalmological examination of the patient revealed changes in sclera and choroid, which had not previously been described in detail in the literature. The patient underwent cataract phacoemulsification in the right eye with implantation of a posterior chamber intraocular lens. The dynamics of clinical manifestations of eye lesion in the near future is positive, but in the long term it remains doubtful due to pronounced changes in the orbit and adnexa of the eye against the background of ongoing small vessels vasculitis. Early consultation with an ophthalmologist and optical coherence tomography in patients with GPA are necessary at any stage of the disease. The clinical case is presented with consideration to the CARE 2021 recommendations.

A Glistening Intraocular Lens: A Case Report

Introduction Cataract surgery with a posterior chamber intraocular lens (PCIOL) is one of the most performed surgeries in North America. A common complication of cataract surgery is the development of post-surgical opacities on the posterior lens capsule, known as posterior capsule opacification (PCO). When visually significant, PCO is treated with a YAG laser. Less commonly however, opacities can form within the lens implant itself known as lens glistening. Case Presentation An 86-year-old male patient with a history of macular retinoschisis and vitreoretinal traction in both eyes presented to the eye clinic with complaints of visual disturbance in the left eye over the course of 4 months. Clinical examination and diagnostic testing revealed stable retinal disease with new findings of PCIOLs with lens glistening, left eye greater than right eye. The patient was referred to the cataract surgeon and the decision was made to manage the lens glistening conservatively. Discussion Lens glistening can be managed with observation or intraocular lens (IOL) exchange depending on its impact on the patient’s quality of life or the degree to which the opacities preclude examination of the fundus.

Comparison of Hill-RBF 3.0 with Barrett Universal II, SRK/T, Hoffer Q, Haigis, and Holladay 1 to predict the accuracy of post-cataract surgery refractive outcomes in Indian eyes.

To compare Hill-RBF 3.0 with Barrett Universal II (BU II), SRK/T, Hoffer Q, Haigis, and Holladay 1 in predicting the accuracy of post-cataract surgery refractive outcomes in Indian eyes. In this prospective, comparative, observational study, consecutive patients with uncomplicated age-related cataracts undergoing uneventful phacoemulsification with posterior chamber intraocular lens (IOL) implantation were included. The mean absolute errors (MAEs) and median absolute errors were used to determine the accuracy of predicted postoperative target refractions. A total of 219 eyes of 173 patients were enrolled. Based on the axial lengths (AL), the patients were classified into: AL <22 mm (short), 22-24.5 mm (normal), and >24.5 mm (long). BU II exhibited the lowest MAE for normal ALs (0.2683 ± 0.2790 D) as well as for the entire population (0.2764 ± 0.2764 D). For the short ALs, Hill RBF 3.0 exhibited the lowest MAE (0.3268 ± 0.3268 D), while for the long ALs, SRK/T showed the lowest MAE (0.2823 ± 0.2642 D). BU II exhibited the highest percentage of eyes of 57.5%, 95.4%, and 98.6% within ±0.25, ±0.75, and ±1.0 D of postoperative target refractions respectively, whereas Hill RBF 3.0 had the highest percentages of eyes (88.1%) within ±0.5 D of postoperative target refraction. Hill-RBF 3.0 exhibited the least MAE for patients with short ALs, while BU II showed the least MAE for normal ALs as well as for the entire population and SRK/T for long ALs. This study is likely to aid surgeons in selecting the most appropriate IOL power formula, which thereby improves the refractive outcomes with utmost accuracy.