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[Intraocular lens power calculation and refractive change in pediatric cases]
Yukiko Kora1, Yayoi Kinohira, Makoto Inatomi
1Department of Ophthalmology, Hamamatsu Medical Center, 328 Tomitsuka-cho, Hamamatsu 432-8580, Japan.
Insights
The SRK formula best predicted refractive error in pediatric intraocular lens calculations, though accuracy remains a challenge for children. Predicting refractive changes in pediatric cases is also difficult.
Area of Science:
- Ophthalmology
- Pediatric ophthalmology
Context:
- Intraocular lens (IOL) implantation is a common procedure following cataract extraction in children.
- Accurate IOL power calculation is crucial for achieving optimal visual outcomes in pediatric patients.
Purpose:
- To evaluate the accuracy of existing intraocular lens power calculation formulas in pediatric cases.
- To assess the predictability of refractive changes in children following cataract surgery and IOL implantation.
Summary:
- The SRK formula demonstrated the highest accuracy (65% within +/- 1 D) for preoperative refractive prediction in pediatric patients.
- Formulas like SRK/T and Holladay showed reduced accuracy in younger children (<= 5 years) and those with shorter axial lengths (<= 22 mm).
- While mean refractive changes were similar across age groups over four years, some younger children (< = 10 years) experienced significant myopic shifts.
Impact:
- Current IOL power calculation formulas exhibit limitations in accuracy for pediatric populations.
- Predicting long-term refractive outcomes in children undergoing cataract surgery remains challenging, necessitating further research and potentially specialized formulas.
Purpose:
To evaluate the intraocular power calculation formula for children and the change of the refraction.
Subject And Methods:
We reviewed the medical records of 66 pediatric cases with intraocular lens (IOL) implantation after cataract extraction and results of questionnaire of the Japanese Association of Pediatric Ophthalmology and Japanese Society of Cataract and Refractive Surgery. We employed four IOL power calculation formulae(SRK, SRK II, SRK/T, Holladay) to evaluate the accuracy of preoperative prediction of refraction.
Results:
The best preoperative prediction was obtained by the SRK formula; the predictive refraction error within +/- 1 D was shown in 65% of patients. SRK/T and Holladay formulas were less accurate in patients aged 5 years old or younger. All formulae were less accurate in patients with axial length of 22 mm or shorter. There was no significant difference in the mean change in refraction over four years among three different age group (group 1: < = 5, group 2: 6 << = 10, group 3: 11 << = 15(years old(YO)). However, several patients aged 10(YO) or younger showed severe myopic changes during this period.
Conclusion:
The IOL power calculation fomulae show less accuracy on pediatric cases. It is also difficult to predict the change of refraction on pediatric cases.