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Accuracy of intraocular lens power calculations in paediatric eyes
Jianbing Li1, Zhenzhen Liu1, Ruixin Wang1
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Insights
For pediatric cataract surgery, Hoffer Q and Holladay 1 intraocular lens (IOL) power calculation formulas offer the best refractive prediction. SRK II was found to be the least predictable formula in this study.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Cataract Surgery
Background:
- Accurate refractive prediction is crucial for pediatric cataract surgery outcomes.
- Current intraocular lens (IOL) power calculation formulas lack consensus for pediatric use.
- Evaluating IOL formula predictability in children is essential for optimizing visual results.
Purpose of the Study:
- To assess the refractive predictability of six different IOL power calculation formulas in pediatric cataract cases.
- To compare the accuracy of SRK II, SRK/T, Hoffer Q, Holladay 1, T2, and Super formulas in predicting postoperative refraction.
- To identify the most reliable IOL formula for pediatric intraocular lens implantation.
Main Methods:
- Retrospective case series analysis of 377 pediatric eyes (<13 years) undergoing primary IOL implantation.
- Comparison of prediction errors between postoperative refraction and predicted refraction using six IOL formulas.
- Statistical analysis of mean absolute error, median absolute error, and percentage of eyes within specific refractive error margins.
Main Results:
- All formulas exhibited a hyperopic refractive error on average.
- SRK II demonstrated significantly higher absolute errors compared to other formulas (P < .001).
- Hoffer Q and Holladay 1 formulas provided the lowest absolute errors, closely followed by the Super formula.
- Age at surgery was identified as an independent factor influencing refractive surprise across all formulas.
Conclusions:
- SRK II is the least predictable IOL power calculation formula for pediatric cataract surgery.
- Hoffer Q and Holladay 1 formulas offer the best refractive predictability in the pediatric population.
- Age-related factors significantly impact refractive outcomes in pediatric IOL calculations.
Importance:
There is no clear consensus on which intraocular lens (IOL) power calculation formula provides the best refractive prediction in the paediatric population.
Background:
To evaluate the predictability of desired postoperative refractive outcomes by using six IOL formulas in paediatric cataract cases.
Design:
Retrospective case series.
Participants:
A total of 377 eyes in 377 paediatric patients (<13 years of age) who received primary IOL implants in the capsular bag.
Methods:
This study utilized formulas, namely, SRK II, SRK/T, Hoffer Q, Holladay 1, T2 and Super formula. Prediction errors were calculated based on the difference between the postoperative refraction and the refraction predicted by each formula.
Main Outcome Measures:
The mean prediction error, mean absolute error, median absolute error, percentages of eyes within the prediction errors of ±0.50 D, ±1.00 D and ± 2.00 D.
Results:
The mean axial length was 22.48 ± 1.91 mm (<22.0 mm for 161 eyes). The average age at surgery was 55.21 ± 28.01 months (<24 months for 37 eyes). The mean prediction error was positive (hyperopic error) with all formulas. Compared to the other IOL power formulas, SRK II showed significantly higher absolute errors (P < .001). Hoffer Q and Holladay 1 generated the least absolute error, followed closely by Super formula. Multiple logistic analyses indicated that age at time of surgery was an independent factor significantly contributing to the refractive surprise using all formulas.
Conclusions And Relevance:
SRK II was the least predictable formula in this study. HofferQ and Holladay 1 yielded the best predictive values.
