Intraocular Lens Power Calculation Formulas-A Systematic Review

Overview

Journal Ophthalmol Ther

Specialty Ophthalmology

Date 2023 Sep 12

PMID 37698825

Authors

Wiktor Stopyra

Achim Langenbucher

Andrzej Grzybowski

Affiliations

Soon will be listed here.

Abstract

Purpose: The proper choice of an intraocular lens (IOL) power calculation formula is an important aspect of phacoemulsification. In this study, the formulas most commonly used today are described and their accuracy is evaluated.

Methods: This review includes papers evaluating the accuracy of IOL power calculation formulas published during the period from January 2015 to December 2022. The articles were identified by a literature search of medical and other databases (PubMed/MEDLINE, Crossref, Web of Science, SciELO, Google Scholar, and Cochrane Library) using the terms "IOL formulas," "Barrett Universal II," "Kane," "Hill-RBF," "Olsen," "PEARL-DGS," "EVO," "Haigis," "SRK/T," and "Hoffer Q." Twenty-nine of the most recent peer-reviewed papers in English with the largest samples and largest number of formulas compared were considered.

Results: Outcomes of mean absolute error and percentage of predictions within ±0.5 D and ±1.0 D were used to evaluate the accuracy of the formulas. In most studies, Barrett achieved the smallest mean absolute error and PEARL-DGS the highest percentage of patients with ±0.5 D in short eyes, while Kane obtained the highest percentage of patients with ±0.5 D in long eyes.

Conclusions: The third- and fourth-generation formulas are gradually being replaced by more accurate ones. The Barrett Universal II among vergence formulas and Kane and PEARL-DGS among artificial intelligence-based formulas are currently most often reported as the most precise.

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References

Kane J, Melles R . Intraocular lens formula comparison in axial hyperopia with a high-power intraocular lens of 30 or more diopters. J Cataract Refract Surg. 2020; 46(9):1236-1239. DOI: 10.1097/j.jcrs.0000000000000235. View

Nemeth G, Modis Jr L . Accuracy of the Hill-radial basis function method and the Barrett Universal II formula. Eur J Ophthalmol. 2020; 31(2):566-571. DOI: 10.1177/1120672120902952. View

Lee A, Qazi M, Pepose J . Biometry and intraocular lens power calculation. Curr Opin Ophthalmol. 2007; 19(1):13-7. DOI: 10.1097/ICU.0b013e3282f1c5ad. View

Wang L, Koch D . Intraocular Lens Power Calculations in Eyes with Previous Corneal Refractive Surgery: Review and Expert Opinion. Ophthalmology. 2020; 128(11):e121-e131. DOI: 10.1016/j.ophtha.2020.06.054. View

Rosa N, Cione F, Pepe A, Musto S, De Bernardo M . An Advanced Lens Measurement Approach (ALMA) in post refractive surgery IOL power calculation with unknown preoperative parameters. PLoS One. 2020; 15(8):e0237990. PMC: 7447029. DOI: 10.1371/journal.pone.0237990. View

Chen C, Xu X, Miao Y, Zheng G, Sun Y, Xu X . Accuracy of Intraocular Lens Power Formulas Involving 148 Eyes with Long Axial Lengths: A Retrospective Chart-Review Study. J Ophthalmol. 2016; 2015:976847. PMC: 4697084. DOI: 10.1155/2015/976847. View

Luo Y, Li H, Gao L, Du J, Chen W, Gao Y . Comparing the accuracy of new intraocular lens power calculation formulae in short eyes after cataract surgery: a systematic review and meta-analysis. Int Ophthalmol. 2022; 42(6):1939-1956. DOI: 10.1007/s10792-021-02191-4. View

Du X, Yang Z, Guo Y, Li S, Wang X, Sheng Y . Analysis of risk factors for dry eye disease and effect of diquafosol sodium ophthalmic solution on the tear film after vitrectomy in patients with type 2 diabetes mellitus: a preliminary study. Int Ophthalmol. 2022; 43(6):1849-1859. DOI: 10.1007/s10792-022-02584-z. View

Wang Q, Jiang W, Lin T, Wu X, Lin H, Chen W . Meta-analysis of accuracy of intraocular lens power calculation formulas in short eyes. Clin Exp Ophthalmol. 2017; 46(4):356-363. DOI: 10.1111/ceo.13058. View

10.

Wang Q, Jiang W, Lin T, Zhu Y, Chen C, Lin H . Accuracy of intraocular lens power calculation formulas in long eyes: a systematic review and meta-analysis. Clin Exp Ophthalmol. 2018; 46(7):738-749. DOI: 10.1111/ceo.13184. View

12.

Liu J, Wang L, Chai F, Han Y, Qian S, Koch D . Comparison of intraocular lens power calculation formulas in Chinese eyes with axial myopia. J Cataract Refract Surg. 2019; 45(6):725-731. DOI: 10.1016/j.jcrs.2019.01.018. View

13.

Rocha-de-Lossada C, Colmenero-Reina E, Flikier D, Castro-Alonso F, Rodriguez-Raton A, Garcia-Madrona J . Intraocular lens power calculation formula accuracy: Comparison of 12 formulas for a trifocal hydrophilic intraocular lens. Eur J Ophthalmol. 2020; 31(6):2981-2988. DOI: 10.1177/1120672120980690. View

14.

Carmona-Gonzalez D, Castillo-Gomez A, Palomino-Bautista C, Romero-Dominguez M, Gutierrez-Moreno M . Comparison of the accuracy of 11 intraocular lens power calculation formulas. Eur J Ophthalmol. 2020; 31(5):2370-2376. DOI: 10.1177/1120672120962030. View

15.

Darcy K, Gunn D, Tavassoli S, Sparrow J, Kane J . Assessment of the accuracy of new and updated intraocular lens power calculation formulas in 10 930 eyes from the UK National Health Service. J Cataract Refract Surg. 2020; 46(1):2-7. DOI: 10.1016/j.jcrs.2019.08.014. View

16.

Voytsekhivskyy O, Hoffer K, Savini G, Tutchenko L, Hipolito-Fernandes D . Clinical Accuracy of 18 IOL Power Formulas in 241 Short Eyes. Curr Eye Res. 2021; 46(12):1832-1843. DOI: 10.1080/02713683.2021.1933056. View

17.

Carmona Gonzalez D, Palomino Bautista C . Accuracy of a new intraocular lens power calculation method based on artificial intelligence. Eye (Lond). 2020; 35(2):517-522. PMC: 8026960. DOI: 10.1038/s41433-020-0883-3. View

18.

Lin L, Xu M, Mo E, Huang S, Qi X, Gu S . Accuracy of Newer Generation IOL Power Calculation Formulas in Eyes With High Axial Myopia. J Refract Surg. 2021; 37(11):754-758. DOI: 10.3928/1081597X-20210712-08. View

19.

Shammas H . Reply : Predicted vs measured posterior corneal astigmatism for toric intraocular lens calculations. J Cataract Refract Surg. 2022; 48(10):1228-1229. DOI: 10.1097/j.jcrs.0000000000001048. View

20.

Hoffer K, Savini G . Update on Intraocular Lens Power Calculation Study Protocols: The Better Way to Design and Report Clinical Trials. Ophthalmology. 2020; 128(11):e115-e120. DOI: 10.1016/j.ophtha.2020.07.005. View

21.

Cooke D, Cooke T . Comparison of 9 intraocular lens power calculation formulas. J Cataract Refract Surg. 2016; 42(8):1157-64. DOI: 10.1016/j.jcrs.2016.06.029. View