Purpose: To compare the prediction accuracy of algorithmic intraocular lens (IOL) power calculation formula selection method using conventional formulas (Haigis, Hoffer Q, Holladay 1, SRK/T and/or Barrett Universal II) based on keratometry (K), anterior chamber depth (ACD) and axial length (AL).Methods: A total of 1653 patients (1653 eyes) implanted with Tecnis ZCB00 IOL during cataract surgery were enrolled in this study. Intraocular lens (IOL) power calculation formulas with a small absolute value in the sum of the area under the curve measured by K, ACD and AL subgroup were selected to calculate IOL power in the relevant biometry subgroup. The median absolute error (MedAE) calculated by the Haigis, Hoffer Q, Holladay 1, SRK/T and Barrett Universal II formulas individually was compared to that calculated by the algorithmic selection method using four formulas, Haigis, Hoffer Q, Holladay 1 and SRK/T, or five formulas when Barrett is included.Results: The MedAE was 0.27 D in the Haigis, 0.30 D in the Hoffer Q, 0.27 D in the Holladay 1, 0.29 D in the SRK/T and 0.26 D in the Barrett Universal II formulas. The MedAEs determined by the algorithmic selection method using four (019 D) and five (0.21 D) formulas were significantly lower than those by the conventional IOL power calculation formulas.Conclusions: The IOL power calculation formula selection method by biometry subgroup combined with biometric parameters K, ACD and AL may offer a more superior postoperative refractive error prediction in cataract surgery.
1 October 2015 in American Journal of Ophthalmology
Purpose: To evaluate the accuracy of IOL power calculation using adjusted corneal power according to the posterior/anterior corneal curvature radii ratio. Methods: Nine hundred twenty-eight eyes from 928 reference subjects and 158 eyes from 158 cataract patients who underwent phacoemulsification surgery were enrolled. Adjusted corneal power of cataract patients was calculated using the fictitious refractive index that was obtained from the geometric mean posterior/anterior corneal curvature radii ratio of reference subjects and adjusted anterior and predicted posterior corneal curvature radii from conventional keratometry (K) using the posterior/anterior corneal curvature radii ratio. The median absolute error (MedAE) based on the adjusted corneal power was compared with that based on conventional K in the Haigis and SRK/T formulae. Results: The geometric mean posterior/anterior corneal curvature radii ratio was 0.808, and the fictitious refractive index of the cornea for a single Scheimpflug camera was 1.3275. The mean difference between adjusted corneal power and conventional K was 0.05 diopter (D). The MedAE based on adjusted corneal power (0.31 D in the Haigis formula and 0.32 D in the SRK/T formula) was significantly smaller than that based on conventional K (0.41 D and 0.40 D, respectively; P < 0.001 and P < 0.001, respectively). The percentage of eyes with refractive prediction error within ± 0.50 D calculated using adjusted corneal power (74.7%) was significantly greater than that obtained using conventional K (62.7%) in the Haigis formula (P = 0.029). Conclusions: IOL power calculation using adjusted corneal power according to the posterior/anterior corneal curvature radii ratio provided more accurate refractive outcomes than calculation using conventional K.