Gender differences in refractive prediction in refractive lens exchange surgery

Area of Science:

• Ophthalmology
• Refractive Surgery
• Biomedical Engineering

Background:

• Refractive lens exchange (RLE) is a surgical procedure to correct refractive errors.
• Accurate intraocular lens (IOL) power calculation is crucial for achieving desired refractive outcomes.
• Existing IOL power calculation formulas may exhibit varying performance based on patient demographics and ocular biometry.

Purpose of the Study:

• To compare the refractive outcomes of RLE surgery using the Haigis and SRK/T IOL power calculation formulas.
• To investigate potential gender-based differences in refractive prediction error after RLE.

Main Methods:

• A cohort of 512 patients undergoing bilateral same-day RLE surgery was analyzed.
• IOL power was calculated using the Haigis formula, targeting emmetropia.
• Refractive prediction error (RPE) was assessed one month post-surgery and compared between Haigis and SRK/T formulas, with analysis of gender differences.

Main Results:

• The Haigis formula demonstrated a significantly lower absolute refractive prediction error (RPEAbs) than the SRK/T formula (0.16 D vs 0.32 D).
• No significant gender difference in RPEAbs was observed with the Haigis formula.
• The SRK/T formula showed a myopic shift in women and a hyperopic shift in men, correlated with differences in axial length, anterior chamber depth, and corneal curvature.

Conclusions:

• The Haigis formula generally provides superior refractive predictability in RLE surgery compared to the SRK/T formula.
• The SRK/T formula exhibits gender-specific refractive errors in RLE patients, influenced by ocular biometry variations between sexes.