Prediction Accuracy of IOL Calculation Formulas in Combined Cataract Surgery and Trabeculectomy

Authors

  • Sara Geada Department of Ophthalmology, Unidade Local de Saúde de Coimbra, EPE, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal https://orcid.org/0000-0002-6851-6201
  • João Bernardes Department of Ophthalmology, Unidade Local de Saúde de Coimbra, EPE, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal; University Clinic of Ophthalmology, Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
  • Jorge Simão Department of Ophthalmology, Unidade Local de Saúde de Coimbra, EPE, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal; University Clinic of Ophthalmology, Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal
  • Marcelo Seara  Department of Ophthalmology, Unidade Local de Saúde de Coimbra, EPE, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal
  • Mário Soares  Department of Ophthalmology, Unidade Local de Saúde de Coimbra, EPE, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal
  • Sílvia Simão  Department of Ophthalmology, Unidade Local de Saúde de Coimbra, EPE, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal
  • Tatiana Queirós  Department of Ophthalmology, Unidade Local de Saúde de Coimbra, EPE, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal
  • Pedro Faria  Department of Ophthalmology, Unidade Local de Saúde de Coimbra, EPE, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal
  • Joaquim Murta Department of Ophthalmology, Unidade Local de Saúde de Coimbra, EPE, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal; University Clinic of Ophthalmology, Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal

DOI:

https://doi.org/10.48560/rspo.33168

Keywords:

Glaucoma, Lens Implantation, Intraocular, Phacoemulsification, Refractive Errors, Trabeculectomy

Abstract

INTRODUCTION: Information regarding the predictability of modern intraocular lens (IOL) calculation formulas in combined cataract surgery and trabeculectomy is lacking. This study aimed to evaluate the prediction error of the IOL calculation formulas incorporated in the European Society of Cataract & Refractive Surgeons (ESCRS) IOL calculator, as well as the Sanders Retzlaff Kraff/Theoretical (SRK/T) formula.
METHODS: Retrospective study included consecutive patients who underwent uneventful combined cataract surgery and trabeculectomy with monofocal IOL implantation. The following IOL calculation formulas were applied to predict the target spherical equivalent (SE) for the implanted IOL in each subject: Barrett Universal II, Cooke K6, EVO, Hill-RBF, Hoffer QST, Kane, PEARL DGS and SRK/T. Biometry was obtained using a swept-source optical biometer (IOL Master 700; Carl Zeiss). Prediction errors (PE), defined as the difference between postoperative and formula-predicted SE based on the IOL power implanted, were calculated at 3-6 months follow-up. Mean absolute error (MeanAE), median absolute error (MedAE) and the percentage of eyes within ±0.25 diopters (D), ±0.50D and ±1.00D of PE were determined.
RESULTS: A total of 41 eyes from 41 patients with a mean axial length (AL) of 23.39±0.82mm were included. The mean postoperative SE was -0.55±0.71D. The formula presenting the lowest MedAE was EVO (0.29D), followed by SRK/T (0.30D), Cooke K6 (0.32D), Kane (0.34D), Hoffer QST (0.35D), Hill-RBF (0.35D), PEARL GDS (0.38D), and finally Barrett Universal II (0.43D). The percentage of eyes within ±0.50D of PE was superior for Hill-RBF (65.9%), followed by Cooke K6 (64.1). For eyes within ±1.00D of PE, the formula showing a higher proportion was Hoffer QST (92.7%), followed by Kane (90.2%). Barrett Universal II was the formula with less percentage of eyes in all groups (29.3% for ±0.25D PE, 53.7% for ±0.50D PE, and 78.0% for ±1.00D PE).
CONCLUSION: Overall, all formulas evaluated showed a robust performance. The finding that none of the modern formulas exhibited a significant advantage when compared to SRK/T suggests that eyes undergoing combined cataract surgery and trabeculectomy should be evaluated as a singular subgroup in terms of IOL power calculation.

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Published

2025-07-01

How to Cite

Geada, S., Bernardes, J., Simão, J. ., Seara, M., Soares, M., Simão, S., … Murta, J. (2025). Prediction Accuracy of IOL Calculation Formulas in Combined Cataract Surgery and Trabeculectomy. Revista Sociedade Portuguesa De Oftalmologia, 49(2), 102–108. https://doi.org/10.48560/rspo.33168

Issue

Vol. 49 No. 2 (2025)

Section

Original Article

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