Intraocular Lens Power Calculation for Eyes with an Axial Length Greater Than 26.0 Mm: Comparison of Formulas and Methods

Purpose: To evaluate and compare the accuracy of formulas and methods for calculating the intraocular lens (IOL) power for eyes with an axial length (AL) greater than 26.0 mm.

Setting: Ein-Tal Eye Center, Tel-Aviv, Israel.

Design: Retrospective case series.

Methods: The postoperative refraction results in myopic eyes with an AL over 26.0 mm were compared with the predicted refractions calculated using standard formulas (Holladay 1, SRK/T, Hoffer Q, and Haigis) with optical IOL constants, User Group for Laser Interference Biometry constants, and an AL-adjustment method and using new-generation formulas (Barrett Universal II, Holladay 2, and Olsen).

Results: In 76 (71.7%) of 106 eyes, the IOL was 6.0 diopters (D) or more (Group A) and in 30 eyes (28.3%) was less than 6.0 D (Group B). In Group A, the SRK/T, Hoffer Q, Haigis, Barrett Universal II, Holladay 2, and Olsen methods met the benchmark criteria of having a prediction error of ±0.5 D in at least 71.0% of eyes and ±1.0 D in 93.0% of eyes. In Group B, only the Barrett Universal II formula and the Holladay 1 and Haigis formulas using the AL-adjusted method met those criteria.

Conclusion: When selecting IOLs for high and extreme myopia, choosing appropriate formulas and methods can yield accurate refractive results that meet benchmark criteria.

Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.