Seeking Perfection in the Shortest Eyes: Intraocular Lens Power Calculation in Eyes with Axial Length Inferior to 21 mm

Authors

  • Bruno Barbosa Ribeiro Serviço de Oftalmologia, Centro Hospitalar Universitário de Santo António, Porto, Portugal https://orcid.org/0000-0002-8079-9101
  • João Heitor Marques Serviço de Oftalmologia, Centro Hospitalar Universitário de Santo António, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal https://orcid.org/0000-0001-6487-7950
  • Ana Carolina Abreu Serviço de Oftalmologia, Centro Hospitalar Universitário de Santo António, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
  • Silvia Monteiro Serviço de Oftalmologia, Centro Hospitalar Universitário de Santo António, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal https://orcid.org/0000-0001-5264-0833
  • Pedro Menéres Serviço de Oftalmologia, Centro Hospitalar Universitário de Santo António, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal https://orcid.org/0000-0002-1989-3465
  • Maria do Céu Pinto Serviço de Oftalmologia, Centro Hospitalar Universitário de Santo António, Porto, Portugal https://orcid.org/0000-0003-2396-952X

DOI:

https://doi.org/10.48560/rspo.33203

Keywords:

Axial Length, Eye/anatomy & histology, Lens Implantation, Intraocular, Lenses, Intraocular

Abstract

INTRODUCTION: Cataract surgery has evolved towards perfection. However, intraocular lens (IOL) calculation accuracy is diminished in short eyes. The main purpose of this study was to compare the accuracy of 11 IOL calculation formulas in refractive outcomes for uneventful cataract surgery in short eyes with axial length (AL) equal or inferior to 21.0 mm.
METHODS: Retrospective analysis of patients submitted to uneventful phacoemulsification at a tertiary hospital between January 2020 and June 2023. Prediction error (PE) was calculated as the difference between the subjective refraction spherical equivalent (SE) and the targeted SE of each formula. Absolute error (AE) was the absolute value of the PE. For each calculation formula and IOL, PE was zeroed by subtracting the mean PE of each formula. According to IOL power we defined 2 groups: group 1 (IOL power below 30 D) and group 2 (IOL power above 30 D). We analyzed the total of spherical IOLs and the 2 subgroups separately.
RESULTS: We included 87 eyes of 55 patients, with an AL of 20.48 ± 0.55 (range 18.06-21.00) mm. Group 2 included Acrysof® SN60AT IOLs and group 1 included Clareon® CNA0T0 IOLs. Unzeroed mean PE was lowest for Pearl DGS in group 2 (-0.03 ± 0.66 D) and Kane in group 1 (0.05 ± 0.55 D). After zeroing the PE, Pearl DGS was the most accurate (mean AE (MAE) 0.40 D) in all IOLs (as well as in group 2), while Kane exhibited lowest error in group 1. The MAE was significantly higher for Haigis (p=0.045) and Barrett Universal II formulas (p=0.036) in group 2. Although the Hill-RBF showed good results in group 1, it showed disappointing results in group 2 (MAE 0.37 versus MAE 0.56 D, respectively).
CONCLUSION: Pearl DGS showed the lowest error in group 2, while Kane formula showed excellent results in eyes from group 1. Hill-RBF showed good results in IOLs under 30.0 D. Haigis and Barrett Universal II showed disappointing results. The application of modern methods and formulas for IOL calculation will obtain even more accurate results.

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Published

2024-08-17

How to Cite

Barbosa Ribeiro, B., Marques, J. H., Abreu, A. C., Monteiro, S. ., Menéres, P., & Pinto, M. do C. (2024). Seeking Perfection in the Shortest Eyes: Intraocular Lens Power Calculation in Eyes with Axial Length Inferior to 21 mm. Revista Sociedade Portuguesa De Oftalmologia. https://doi.org/10.48560/rspo.33203

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