Can We Use the Fellow Eye Biometric Data to Predict IOL Power?

Area of Science:

• Ophthalmology
• Biometry
• Refractive Surgery

Background:

• Accurate biometry is crucial for successful intraocular lens (IOL) implantation.
• Understanding interocular symmetry in ocular measurements is essential for predictable refractive outcomes.
• Population-based data provides a robust foundation for clinical decision-making.

Purpose of the Study:

• To investigate the correlation between right (RE) and left (LE) eye keratometry (K) and axial length (AL) in a population-based sample.
• To assess the prevalence of significant interocular differences in K and AL.
• To evaluate the implications of these differences for intraocular lens (IOL) power calculations.

Main Methods:

• Retrospective analysis of partial coherence interferometry data from 4516 eyes of 2258 patients.
• Inclusion of subjects with a wide age range (18-96 years).
• Statistical correlation and comparison of K and AL measurements between RE and LE.

Main Results:

• Average K showed a statistically significant difference between RE (44.01 ± 1.50 D) and LE (44.04 ± 1.53 D) (p = 0.0075).
• Average AL also showed a statistically significant difference between RE (23.89 ± 1.77 mm) and LE (23.84 ± 1.68 mm) (p = 0.0018).
• 4.5% of patients had K differences ≥ 1 D, and 19.2% had AL differences ≥ 0.4 mm, both potentially leading to ~1 D IOL power discrepancies.

Conclusions:

• Clinicians must be aware of potential interocular biometric differences when calculating IOL power.
• Validation of measurements using the fellow eye is recommended.
• Symmetric biometric findings are crucial for reliable outcomes in the second eye, especially for post-cataract refractive error management.