Effective Ocular Biometry and Intraocular Lens Power Calculation

2016 ◽  
Vol 10 (02) ◽  
pp. 94 ◽  
Author(s):  
Magdalena Turczynowska ◽  
Katarzyna Koźlik-Nowakowska ◽  
Magdalena Gaca-Wysocka ◽  
Andrzej Grzybowski ◽  
◽  
...  

Since the introduction of phacoemulsification, cataract surgery has evolved remarkably. The use of premium intraocular lenses (IOLs) (aspheric, toric, multifocal), refractive lens exchange and patients after refractive surgery procedures require extremely precise clinical measurements and IOL calculation formulas to achieve desired postoperative refraction. For many years, ultrasound biometry has been the standard for measurement of ocular parameters. The introduction of optical biometry (fast and non-invasive) has replaced ultrasound methods and is now considered as the clinical standard for ocular biometry. Recently, several modern optical instruments have been commercially launched and there are new methods available, including the empirical, analytical, numerical or combined methods to determine IOL power. The aim of this review is to present current techniques of ocular biometry and IOL power calculation formulas, which will contribute to achieve highly accurate refractive outcomes.

2020 ◽  
pp. 112067212096203
Author(s):  
David Carmona-González ◽  
Alfredo Castillo-Gómez ◽  
Carlos Palomino-Bautista ◽  
Marta Romero-Domínguez ◽  
María Ángeles Gutiérrez-Moreno

Purpose To compare the accuracy of 11 intraocular lens (IOL) power calculation formulas (SRK-T, Hoffer Q, Holladay I, Haigis, Holladay II, Olsen, Barrett Universal II, Hill-RBF, Ladas Super formula, EVO and Kane). Setting Private university hospital (QuironSalud, Madrid, Spain). Design Retrospective case series Methods Data were compiled from 481 eyes of 481 patients who had undergone uneventful cataract surgery with IOL insertion. Preoperative biometric measurements were made using an IOL Master® 700. Respective ULIB IOL constants ( http://ocusoft.de/ulib/c1.htm ) for each of 4 IOL models implanted were used to calculate the predictive refractive outcome for each formula. This was compared with the actual refractive outcome determined 3 months postoperatively. The primary outcome was mean absolute prediction error (MAE). The study sample was divided according to axial length (AL) into three groups of eyes: short (⩽22.00 mm), normal (22.00–25.00 mm) and long (⩾25.00 mm). Results The Barrett Universal II and Haigis formulas yielded the lowest MAEs over the entire AL range ( p < .01, except EVO) as well as in the long ( p < .01, all formulas) and normal ( p < .01, except Haigis, Holladay II, Olsen and LSF) eyes. In the short eyes, the lower MAEs were provided by Haigis and EVO ( p < .01 except Hoffer Q, SRK/T and Holladay I). Conclusions Barrett Universal II was the most accurate for IOL power calculation in the normal and long eyes. For short eyes, the formulas Haigis and EVO seem best at predicting refractive outcomes.


2021 ◽  
pp. 29-33
Author(s):  
Ehab M Ghoneim ◽  
Ahmed A Hassaan

There is no enough knowledge about the accuracy of intraocular lens (IOL) power calculation formulas in steep corneas. This study may be the first one that compares the accuracy of the SRK II formula with Holladay1, Hoffer Q and Haigis formulas in steep corneas. We reported a case of a 60-year-old female, with a cataract in the left eye and with a steep cornea. We used the modern formulas; Holladay1, Hoffer Q and Haigis. The result (+7.0D) was unexpected compared to the manifest refraction and to the IOL power calculated in the right eye using the same formulas which was (+17.0D). We implanted (+12.0D) Sensar 1-piece IOL depending on our clinical experience. The post-operative refraction was (+0.00/-1.75axis106). Postoperative, we used the patient data to find the best formula in this case. We found that the SRK II (A118) result was (+11.5D) and thus this formula was the most accurate in this case. Keywords: SRK II; Holladay1; Hoffer Q; Haigis


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 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Yichi Zhang ◽  
Xiao Ying Liang ◽  
Shu Liu ◽  
Jacky W. Y. Lee ◽  
Srinivasan Bhaskar ◽  
...  

Purpose.To evaluate and compare the accuracy of different intraocular lens (IOL) power calculation formulas for eyes with an axial length (AL) greater than 26.00 mm.Methods.This study reviewed 407 eyes of 219 patients with AL longer than 26.0 mm. The refractive prediction errors of IOL power calculation formulas (SRK/T, Haigis, Holladay, Hoffer Q, and Barrett Universal II) using User Group for Laser Interference Biometry (ULIB) constants were evaluated and compared.Results.One hundred seventy-one eyes were enrolled. The Barrett Universal II formula had the lowest mean absolute error (MAE) and SRK/T and Haigis had similar MAE, and the statistical highest MAE were seen with the Holladay and Hoffer Q formulas. The interquartile range of the Barrett Universal II formula was also the lowest among all the formulas. The Barrett Universal II formulas yielded the highest percentage of eyes within ±1.0 D and ±0.5 D of the target refraction in this study (97.24% and 79.56%, resp.).Conclusions.Barrett Universal II formula produced the lowest predictive error and the least variable predictive error compared with the SRK/T, Haigis, Holladay, and Hoffer Q formulas. For high myopic eyes, the Barrett Universal II formula may be a more suitable choice.


2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Hannah Muniz Castro ◽  
Audrey X. Tai ◽  
Samuel J. Sampson ◽  
Matthew Wade ◽  
Marjan Farid ◽  
...  

Purpose. To compare the preoperative measurements of the anterior chamber depth (ACD) by the IOLMaster and Catalys; additionally, to compare the accuracy of the IOL power calculated by the Barrett Universal II formula using the two different measurements. Setting. University of California, Irvine, Gavin Herbert Eye Institute in Irvine, California. Design. Retrospective comparative study. Methods. This study included 144 eyes of 90 patients with a mean age of 72.0 years (range 40.8 to 92.1 years) that underwent femtosecond laser-assisted cataract surgery using Catalys. Preoperative measurements of ACD were taken by the IOLMaster and Catalys. Manifest refraction and refractive spherical equivalent were measured 1 month postoperatively. Expected refractive results were compared with actual postoperative refractive results. Results. The correlation between the ACD values from the two devices was good (r = 0.80). The Catalys ACD measurements yielded a larger ACD compared to the IOLMaster, with a mean difference of 0.22 mm (P<0.0001). The correlation between the postoperative and predicted RSE of the implanted IOL power was excellent (r = 0.96). There was no statistically significant difference between the mean absolute error derived from the IOLMaster, 0.37 diopter (D) ± 0.34 (SD), and the Catalys, 0.37 ± 0.35 D (P=0.50). Conclusions. The Catalys biometry yielded a significantly larger ACD value than the IOLMaster. This difference in ACD value, however, did not reflect in a statistically significant difference in IOL power calculation and refractive prediction error using the Barrett Universal II Formula.


2014 ◽  
Vol 6 (1) ◽  
pp. 56-64 ◽  
Author(s):  
Purushottam Joshi ◽  
Raman Mehta ◽  
Suma Ganesh

Introduction: Selection of an appropriately-powered IOL is a complex issue, especially in eyes with an axial length of less than 20 mm in pediatric cataract. Objective: To assess the accuracy of IOL power calculation formulae in pediatric cataracts in eyes with an axial length of less than 20 mm. Materials and methods: The records of children less than 15 years old with congenital cataract who had undergone primary IOL implantation were analyzed. Main outcome measures: The variables studied were axial length, keratometric values and the prediction error. The data were analyzed for prediction error determination using the SRK II, SRK T, Holladay 1 and Hoffer Q IOL power calculation formulae. The formula that gave the best prediction error was identified. Results: Twenty-eight eyes of 19 children were included in the study. The absolute prediction error was found to be 1.84 ± 2.09 diopters (D) with SRK II, 2.93±3.55D with SRK T, 3.63±4.06D with Holladay 1, and 4.83±5.02D with Hoffer Q. The number of eyes with the absolute prediction error within 0.5 D was 6 (21.42%) with SRK II, 4 (14.28%) with SRK T, 1 (3.57%) with Holladay 1, and 3 (10.71%) with Hoffer Q. The absolute prediction error with SRK II formula was significantly better than that with other formulae (P < .001). The axial length influenced the absolute prediction error with Hoffer Q formula (P = 0.04). The mean keratometry influenced the prediction error with SRK T formula (P = 0.02), Holladay 1 formula (P = 0.02) and Hoffer Q formula (P = 0.02). Conclusion: Although the absolute prediction error tends to remain high with all the present IOL power calculation formulae, SRK II was the most predictable formula in this study. DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10773 Nepal J Ophthalmol 2014; 6 (2): 56-64


2020 ◽  
Author(s):  
Ping-Jun Chang ◽  
Zhangliang Li ◽  
Fan Zhang ◽  
Lei Lin ◽  
Jiaojiao Kou ◽  
...  

Purpose: To compare the accuracy of refractive outcomes in children undergoing secondary in-the-bag or cilliary sulcus IOL implantation, using aphakic refraction (AR)-based formulae and biometry-based formulae. Methods: In this retrospective study, 39 eyes of the in-the-bag IOL group and the other 26 eyes of the sulcus-implanted IOL group. Holladay 1, Hoffer Q, SRK/T and SRK II formulae were employed depending on the biometric data, while Hug and Khan formulae were used based on preoperative aphakic refraction. The prediction error (PE) and the absolute value of predicted error (APE) were compared between the two groups and formulae. Results: In the in-the-bag IOL group, non-significant differences of APE were found among the 6 formulae, while the Holladay 1, Hoffer Q, SRK/T and SRK II all demonstrated a significant hyperopic shift of median PE value compared to the Hug formula and Holladay 1 and SRK II also showed a significant hyperopic shift of PE compared to the Khan . Higher percentages of eyes with PE less than 1 D were found using Hoffer Q and SRK/T. In the sulcus-implanted group, the Holladay 1, Hoffer Q and SRK/T had a significantly smaller median value of APE than the Hug and Khan formulae, and the SRK II had a significantly smaller median value of APE than the Hug formula, while Holladay 1 had the lowest value of APE. Higher percentages of eyes within PE less than 1 D were found using Holladay 1, Hoffer Q and SRK/T, while the highest was SRK/T. Significantly larger hyperopic shifts of median PE value using all the 6 formulae were found in eyes with sulcus-implanted IOL than with in-the-bag implanted IOL . In in-the-bag implanted IOL group, the Hug and Khan formulae had significantly smaller APE values when compared with the sulcus-implanted IOL group. Conclusions: whether IOL was in the bag or sulcus implantation, almost all the formulae showed hyperopic shift, SRK/T showed the best accuracy. Biometry-based formulae were superior to AR-based formulae in accuracy of IOL power calculation, especially when IOL was implanted in the sulcus. In-the-bag IOL implantation should always be with higher priorities, especially when using AR-based formulae in IOL power calculation.


2015 ◽  
Vol 09 (01) ◽  
pp. 13
Author(s):  
Nino Hirnschall ◽  
Oliver Findl ◽  
◽  

Since the introduction of optical biometry and modern intraocular lens (IOL) power calculation formulae, the refractive outcome after cataract surgery improved significantly. This is necessary, as patient demand for spectacle independence is increasing. However, especially when it comes to short and long eyes, all formulae have their difficulties in predicting the effective lens position – and, therefore, the post-operative refractive outcome. This review summarises the development of IOL power calculation formulae, explains their basics and presents some alternative calculation methods.


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