Influence of Posterior Corneal Asphericity on Refractive Error of SRK-T and Barrett Formulas for Lucidis IOL

Author(s):  
Mark Rabinovich ◽  
Ana Maria Aramburu Del Boz ◽  
Daniel Al-Khatib ◽  
Jean Pascal Genestier ◽  
Jerome Bovet

Abstract Purpose To evaluate the influence of posterior corneal asphericity on the refractive error using SRK-T and Barrett formulas for the intraocular lens (IOL) power calculation for Lucidis Extended Depth of Focus (EDOF) IOL. Setting This study was carried out at a tertiary ophthalmology center in Geneva, Switzerland. Design A retrospective study. Medical records from all enrolled patients were analyzed and the following information was extracted retrospectively, over 1 month following surgery. Methods We retrospectively reviewed 75 eyes that underwent cataract surgery and were implanted with a Lucidis EDOF IOL. We measured the posterior corneal asphericity (Q value), axial length (AL), and anterior chamber depth (ACD) and then calculated the IOL power using SRK-T and Barrett formulas. Results Seventy-five eyes were included, all of which had 1-month postoperative data. In the cohort, 32 eyes were from females (43%) and 43 from males (57%). The mean age of the study population was 73 ± 8.8 years. The mean AL was 23.5 ± 0.98 and the mean ACD was 3.13 ± 0.3. The mean posterior Q value was − 0.35 ± 0.2. In a regression analysis, we found a statistically significant relationship between the error in refraction prediction and the posterior Q value, irrespective of the formula used. The relationship between posterior corneal asphericity and the refraction prediction error was stronger for the Barrett II Universal formula than for the SRK-T formula. Conclusions Posterior corneal asphericity was correlated with the refractive error of calculation of both SRK-T and Barrett formulas, with a stronger correlation to the latter formula.

2019 ◽  
Vol 34 (2) ◽  
Author(s):  
Sidra Anwar, Atif Mansoor Ahmad, Irum Abbas, Zyeima Arif

Purpose: To compare post-operative mean refractive error with SandersRetzlaff-Kraff/theoretical (SRK-T) and Holladay 1 formulae for intraocular lens (IOL) power calculation in cataract patients with longer axial lengths. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Ophthalmology, Shaikh Zayed Hospital Lahore from 01 January 2017 01 January, 2018. Material and Methods: A total of 80 patients were selected from Ophthalmology Outdoor of Shaikh Zayed Hospital Lahore. The patients were randomly divided into two groups of 40 each by lottery method. IOL power calculation was done in group A using SRK-T formula and in group B using Holladay1 formula after keratomery and A-scan. All patients underwent phacoemulsification with foldable lens implantation. Post-operative refractive error was measured after one month and mean error was calculated and compared between the two groups. Results: Eighty cases were included in the study with a mean age of 55.8 ± 6.2 years. The mean axial length was 25.63 ± 0.78mm, and the mean keratometric power was 43.68 ± 1.1 D. The mean post-operative refractive error in group A (SRK/T) was +0.36D ± 0.33D and in group B (Holladay 1) it was +0.68 ± 0.43. The Mean Error in group A was +0.37D ± 0.31D as compared to +0.69D ± 0.44D in group B. Conclusion: SRK/T formula is superior to Holladay 1 formula for cases having longer axial lengths. Key words: Phacoemulsification, intraocular lens power, longer axial length, biometry.


2020 ◽  
pp. bjophthalmol-2020-316193
Author(s):  
Giacomo Savini ◽  
Marco Di Maita ◽  
Kenneth J Hoffer ◽  
Kristian Næser ◽  
Domenico Schiano-Lomoriello ◽  
...  

Background/aimsTo compare the accuracy of 13 formulas for intraocular lens (IOL) power calculation in cataract surgery.MethodsIn this retrospective interventional case series, optical biometry measurements were entered into these formulas: Barrett Universal II (BUII) with and without anterior chamber depth (ACD) as a predictor, EVO 2.0 with and without ACD as a predictor, Haigis, Hoffer Q, Holladay 1, Holladay 2AL, Kane, Næser 2, Pearl-DGS, RBF 2.0, SRK/T, T2 and VRF. The mean prediction error (PE), median absolute error (MedAE), mean absolute error and percentage of eyes with a PE within ±0.25, ±0.50, ±0.75 and ±1.00 diopters (D) were calculated.ResultsTwo hundred consecutive eyes were enrolled. With all formulas, the mean PE was zero. The BUII with no ACD had the lowest standard deviation (±0.343 D), followed by the T2 (0.347 D), Kane (0.348 D), EVO 2.0 with no ACD (0.348 D) and BUII with ACD (0.353 D) formulas. The difference among the MedAEs of all formulas was statistically significant (p<0.0001); the lowest values were achieved with the Kane (0.214 D), RBF 2.0 (0.215 D), BUII with and without ACD (0.218 D) and SRK/T (0.223 D). A percentage ranging from 80% to 88.5% of eyes showed a PE within ±0.50 D and all formulas achieved more than 50% of eyes with a PE within ±0.25 D.ConclusionAll investigated formulas achieved good results; there was a tendency towards better outcomes with newer formulas. Traditional formulas can still be considered an accurate option.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Kei Iijima ◽  
Kazutaka Kamiya ◽  
Yoshihiko Iida ◽  
Nobuyuki Shoji

Purpose. To compare the predictability of intraocular lens (IOL) power calculation using the Barrett Universal II and the SRK/T formulas, according to the keratometry. Methods. We retrospectively reviewed the clinical charts of 335 consecutive eyes undergoing standard cataract surgery. IOL power calculations were performed using the Barrett Universal II and the SRK/T formulas. We compared the prediction error, the absolute error, and the percentages within ±0.25, ±0.5, and ±1.0 D of the targeted refraction, 1 month postoperatively, and also investigated the relationship of these outcomes with the keratometric readings, using the two formulas. Results. The prediction error using the SRK/T formula was significantly more myopic than that using the Barrett Universal II formula (the paired t-test, p<0.001). The absolute error using the SRK/T formula was significantly larger than that using the Barrett Universal II formula (p=0.006). We found a significant correlation between the prediction error and the keratometric readings using the SRK/T formula (Pearson correlation coefficient, r = −0.522, p<0.001), but there was no significant correlation between them using the Barrett Universal II formula (r = −0.031, p=0.576). Conclusions. The Barrett Universal II formula provides a better predictability of IOL power calculation and is less susceptible to the effect of the corneal shape, than the SRK/T formula. The Barrett Universal formula, instead of the SRK/T formula, may be clinically helpful for improving the refractive accuracy, especially in eyes with steep or flat corneas.


2021 ◽  
Author(s):  
Beatriz Gargallo-Martinez ◽  
Amanda Ortiz-Gomariz ◽  
Ana Maria Gomez-Ramirez ◽  
Angel Ramon Gutiérrez-Ortega ◽  
Jose Javier Garcia-Medina

Abstract Fuchs endothelial dystrophy (FED) is a bilateral, asymmetric, progressive corneal endothelium disorder that causes corneal edema. Resolution of corneal edema is only possible by corneal transplantation. Cataract surgery is a common surgery that replaces the natural lens of the eye by an artificial intraocular lens (IOL). The IOL-power calculation depends mainly on the anterior corneal keratometry and the axial length. In patients with FED, anterior keratometry may be affected by corneal edema and calculations may be less accurate. Therefore, the aim of this study is to establish the theorical postoperative refractive error due to corneal edema resolution after Descemet stripping endothelial keratoplasty combined with cataract surgery and IOL implantation. For this, anterior keratometry was measure preoperatively with edematous cornea and postoperatively after corneal edema resolution. Both keratometries were compared and used to calculate the respective theorical IOL-powers. The difference between target IOLs was used to establish the theorical refractive error due to corneal edema resolution. The results showed that corneal edema resolution induces a change in anterior keratometry, which affects IOL-power calculations and causes a hyperopic shift. The patients with moderate-to-severe preoperative corneal edema had higher theorical refractive error so their target selection should be adjusted for additional − 0.50D.


2020 ◽  
Vol 17 (2) ◽  
pp. 233-242
Author(s):  
Juanita Noeline Chui ◽  
Keith Ong

Purpose: Achieving the desired post-operative refraction in cataract surgery requires accurate calculations for intraocular lens (IOL) power. Latest-generation formulae use anterior-chamber depth (ACD)—the distance from the corneal apex to the anterior surface of the lens—as one of the parameters to predict the post-operative IOL position within the eye, termed the effective lens position (ELP). Significant discrepancies between predicted and actual ELP result in refractive surprise. This study aims to improve the predictability of ELP. We hypothesise that predictions based on the distance from the corneal apex to the mid-sagittal plane of the cataractous lens would more accurately reflect the position of the principal plane of the non-angulated IOL within the capsular bag. Accordingly, we propose that predictions derived from ACD + ½LT (length thickness) would be superior to those from ACD alone. Design: Retrospective cohort study, comparing ELP predictions derived from ACD to aproposed prediction parameter. Method: This retrospective study includes data from 162 consecutive cataract surgery cases, with posterior-chamber IOL (AlconSN60WF) implantation. Pre- and postoperative biometric measurements were made using the IOLMaster700 (ZEISS, Jena, Germany). The accuracy and reliability of ELP predictions derived from ACD and ACD + ½LT were compared using software-aided analyses. Results: An overall reduction in average ELP prediction error (PEELP) was achieved using the proposed parameter (root-mean-square-error [RMSE] = 0.50 mm), compared to ACD (RMSE = 1.57 mm). The mean percentage PEELP, comparing between eyes of different axial lengths, was 9.88% ± 3.48% and −34.9% ± 4.79% for predictions derived from ACD + ½LT and ACD, respectively. A 44.10% ± 5.22% mean of differences was observed (p < 0.001). Conclusion: ACD + ½LT predicts ELP with greater accuracy and reliability than ACD alone; its use in IOL power calculation formulae may improve refractive outcomes.


2020 ◽  
Vol 13 (4) ◽  
pp. 15-20
Author(s):  
Dmitrii Fedorovich Belov ◽  
Vadim Petrovich Nikolaenko

Aim to compare intraocular lens (IOL) power calculation before and after different types glaucoma procedures. Material and methods.Into the study, 115 patients were included, divided into 3 groups: group 1 patients, in whom sinustrabeculectomy was performed (n= 86); group 2 patients with implanted Ex-PRESS shunt (n= 19), group 3 patients after Ahmed glaucoma valve implantation (n= 10). For each patient before surgery optical biometry (IOL-Master 500) was performed and IOL power calculation using Barrett Universal II Formula (target refraction emmetropia). Baseline data were compared with corresponding examinations results obtained in 6 months after glaucoma procedure, to evaluate its effect on main biometric parameters of the eye and the IOL calculation accuracy. Results.Despite significant changes of optical and anatomic indices, mean values of target refraction before and after glaucoma surgery did not differ significantly: 0.00 0.03 versus 0.03 0.52 D (p= 0.628), 0.00 0.1 versus 0.19 0.61 D (p= 0.173), 0.04 0.08 versus 0.11 0.42 D (p= 0.269) for groups, respectively. However, there was a pronounced trend to the increase of target refraction data scattering. Conclusion.Glaucoma procedures cause changes of biometrical parameters of the eye, which leads to decrease in accuracy of IOL calculation. Consequently, when choosing intraocular lens, it is recommended to use measurement results obtained after glaucoma surgery. Keywords:intraocular lens; IOL power calculation; glaucoma; sinustrabeculectomy; Ex-PRESS shunt; Ahmed glaucoma valve; biometry; phacoemulsification; axial length; anterior chamber depth; keratometry.


2021 ◽  
pp. 112067212199472
Author(s):  
Gabor Nemeth ◽  
Adam Kemeny-Beke ◽  
Laszlo Modis

Purpose: To assess the accuracy of the intraocular lens (IOL) power calculation based on three methods using artificial intelligence (AI) and one formula using no AI. Methods: During cataract surgery on 114 eyes, one type of IOL was implanted, calculated with the Hill-RBF 2.0 method. The theoretical postoperative refractions were calculated using the Kane and the Pearl-DGS methods and a vergence based formula (Barrett Universal II, BUII). The differences between the manifest and objective postoperative refractions and the predicted refractions were calculated. The percentage of eyes within ±0.5 D and ±1.0 D prediction error (PE), the mean, and the median absolute errors (MAE and MedAE) were also determined. Results: The mean age of the patients was 69.48 years; the axial length was between 21.19 and 25.39 mm. The number of eyes within ±0.5/±1.0 D PE was 96/108 (84.21%/94.73%) using the Hill-RBF 2.0 method, 92/107 (80.70%/93.85%) with the Kane method, 91/107 (79.82%/93.85%) with the Pearl-DGS method, and 91/106 (79.82%/92.98%) with the BUII formula, using subjective refraction. With objective refractometric data, PEs were within ±0.5 D in 88 (77.19%), 83 (72.80%), 82 (71.92%), and 80 (70.17%) cases (Hill-RBF, Kane, Pearl-DGS, BUII, respectively). MAE and MedAE were also best with the Hill-RBF 2.0 method (0.3 D; 0.18 D). Conclusion: Better accuracy of PE might be obtained by the Hill-RBF 2.0 method compared with BUII. The Kane and Pearl-DGS methods showed similar accuracy when compared with BUII.


2016 ◽  
Vol 14 (4) ◽  
Author(s):  
Vijaya Pai ◽  
Divya Shastri ◽  
Asha Kamath

Aim: To compare accuracy of intraocular lens power (IOL) calculation using Partial coherence Interferometry based Carl Zeiss IOL master 500 and Immersion ultrasound (Alcon Ocuscan RXP). Methods: A prospective randomized study of patients who underwent clear corneal phacoemulsification with foldable (IOL) by a single surgeon, during the period September 2010 to 2012. Group A included those patients in whom IOL power calculation using Immersion ultrasound (Ocuscan RXP) was used. Group B included those patients in whom IOL power calculation using Partial coherence Interferometry based Zeiss IOL master was used. SRK T formula was used to calculate the IOL power in both the groups. Postoperative final refraction was done at 6 weeks. Unaided visual acuity and best corrected visual acuity was assessed. Postoperative refractive error was compared with predicted refractive error with each biometry method. Statistical analysis was done using SPSS 16.5. Continuous variables expressed as mean (standard deviation). P < 0.05 was considered significant.Results: There were 50 patients in Group A, 44 patients in Group B. Axial length of the patients varied from 22-26mm in both the groups. The postoperative refraction using Ocuscan, 88% had refractive error ≤± 0.5 D, 94% had ≤±1.00D, and 100% had ≤±2.0D of emmetropia. Using Zeiss IOL Master 72.7% had ≤± 0.5 D, 100% had ≤±1.00D of refractive error. Difference in absolute postoperative refractive error using Ocuscan vs. IOL Master was not statistically significant. Conclusion: In our study both ultrasound Ocuscan and IOL master were accurate in calculating intraocular lens power and achieving postoperative refraction closer to emmetropia. 


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jun Zhang ◽  
Jie Shao ◽  
Li Zheng ◽  
Ye Shen ◽  
Xia Zhao

Abstract Background Intraocular lens (IOL) calculation using traditional formulas for post-corneal refractive surgery eyes can yield inaccurate results. This study aimed to compare the clinical accuracy of the newly developed Zhang & Zheng (ZZ) formula with previously reported IOL formulas. Study design Retrospective study. Methods Post-corneal refractive surgery eyes were assessed for IOL power using the ZZ, Haigis-L, Shammas, Barrett True-K (no history), and ray tracing (C.S.O Sirius) IOL formulas, and their accuracy was compared. No pre-refractive surgery information was used in the calculations. Results This study included 38 eyes in 26 patients. ZZ IOL yielded a lower arithmetic IOL prediction error (PE) compared with ray tracing (P = 0.04), whereas the other formulas had values like that of ZZ IOL (P > 0.05). The arithmetic IOL PE for the ZZ IOL formula was not significantly different from zero (P = 0.96). ZZ IOL yielded a lower absolute IOL PE compared with Shammas (P < 0.01), Haigis-L (P = 0.02), Barrett true K (P = 0.03), and ray tracing (P < 0.01). The variance of the mean arithmetic IOL PE for ZZ IOL was significantly smaller than those of Shammas (P < 0.01), Haigis-L (P = 0.03), Barrett True K (P = 0.02), and ray tracing (P < 0.01). The percentages of eyes within ± 0.5 D of the target refraction with the ZZ IOL, Shammas, Haigis-L, Barrett True-K, and ray-tracing formulas were 86.8 %, 45.5 %, 66.7 %, 73.7 %, and 50.0 %, respectively (P < 0.05 for Shammas and ray tracing vs. ZZ IOL). Conclusions The ZZ IOL formula might offer superior outcomes for IOL power calculation for post-corneal refractive surgery eyes without prior refractive data.


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