Influence of Patient Age on Intraocular Lens Power Prediction Error

To examine whether intraocular lens (IOL) power prediction error (PE) after cataract surgery differs according to patient age.

Prospective cohort study.

We consecutively enrolled 75 eyes of 75 patients 59 years of age or younger, and 150 eyes of 150 patients in each of 3 age groups (60-69, 70-79, and 80-89 years), for whom phacoemulsification and implantation of a single-piece acrylic IOL was planned. The IOL power was calculated using the optimized SRK/T formula. Objective refraction was measured using an autorefractometer at approximately 3 months postoperatively, and the mean arithmetic PE and median absolute PE were compared among age groups.

The mean preoperative refractive error predicted by the SRK/T formula was similar among age groups (P = .4179). The mean postoperative spherical equivalent was significantly more myopic in younger patients (P < .0001). Mean PE was -0.24 diopters (D) in those ≤59 years of age, -0.17 D in those 60-69 years of age, -0.11 D in those 70-79 years of age, and -0.05 D in those 80-89 years of age; the mean PE was less myopic in older patients (P = .0008). The median absolute PE did not differ significantly among groups (P = .6192). Mean PE was positively correlated with age (P < .0001). Multiple regression analysis revealed that age, preoperative axial length, average corneal curvature, and anterior chamber depth were independent predictors of the age-related difference in PE.

PE was less myopic by approximately 0.06 D per decade as age increased, suggesting that patient age should be considered when selecting IOL power.