Quantitative biometric cutoffs for the choice of the intraocular lens power calculation formula for a recently introduced nondiffractive extended depth-of-focus intraocular lens

Purpose This study aimed to analyze biometry values cutoffs for the choice of the best intraocular lens power calculation formula for AcrySof IQ Vivity intraocular lens. Methods The study was designed as interventional case series with 3 months of follow-up. Intraocular lens power calculation formulas included Barrett Universal II and SRK/T. The first was adopted for the intraocular lens power choice. The quantitative analysis focused on the identification of specific biometric cutoffs considering axial length, anterior chamber depth, and corneal powers. We included only the dominant eye in the statistical analysis. Results One hundred and eight eyes of 54 patients (23 males; mean age 62 ± 5 years) with no ocular diseases were included. Best-corrected visual acuity improved from 0.3 ± 0.2 to 0.0 ± 0.0 logMAR. All the eyes reached spectacles-free far and intermediate visions; a spherical addition of + 1.0D was necessary to adjust near vision. We identified significant quantitative cutoffs based on axial length and anterior chamber depth. Barrett Universal II resulted the best formula for eyes disclosing an axial length >25 mm, whereas SRK/T turned out to be the best choice for the eyes characterized by an anterior chamber depth <2.8 mm. Our analysis disclosed an overall sensitivity of 0.8 and a specificity of 0.7 ( p < 0.01). Conclusions Axial length and anterior chamber depth influence the choice of Barrett Universal II and SRK/T formulas. Quantitative biometric cutoffs may be useful to discriminate the best formula to be adopted.

Intraocular lens power calculation in virgin eyes: Accuracy of the Barrett Universal II formula and a Ray tracing software

Purpose To compare the accuracy of Sirius ray tracing software with the Barrett Universal II formula for intraocular lens power prediction in virgin eyes. Methods Retrospective case series including 86 eyes that have undergone uneventful cataract surgery with SN60WF implantation. The median absolute error, mean prediction error, variance, and the percentage of eyes within ± 0.25 D, ± 0.50 D, ± 0.75 D, and ± 1.00 D of the prediction error in refraction were calculated. The correlation of prediction error with different baseline parameters was investigated. Results No differences were found between the median absolute error of the Barrett Universal II formula (0.226 D) and the ray tracing software with different intraocular lens centerings; apex (0.331 D), limbus (0.345 D), and pupil (0.342 D) ( p = 0.084). The variance, from lowest to highest, was the Barrett Universal II (0.144 D2), ray tracing-limbus (0.285 D2), ray tracing-pupil (0.285 D2), and ray tracing-apex (0.287 D2) ( p = 0.027). The Barrett Universal II formula showed a higher percentage of eyes within ± 0.25 D (56.98%), ± 0.50 D (82.56%), and ± 0.75 D (93.02%) compared to ray tracing software ( p < 0.01). A significant correlation between the prediction error of the Barrett Universal II formula and corneal diameter (r = 0.322, p = 0.002) and pupil diameter (r = 0.230, p = 0.033) was found. Also, a positive correlation between the prediction error of Sirius ray tracing and axial length ( p < 0.001) and pupil diameter ( p = 0.01) was found. Conclusion There is a trend of the Barrett Universal II formula to be more accurate than Sirius ray tracing software for intraocular lens power calculation in virgin eyes. This should be confirmed in future prospective comparative studies.

Accuracy of intraocular lens power calculation formulas in a steep cornea: A case report

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