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Prediction of aphakic refractive error in children
R C Arffa1, P B Donzis, K S Morgan
1Department of Ophthalmology, University of Pittsburgh, Pennsylvania.
Insights
Accurate optical correction formulas for pediatric aphakic eyes are crucial. New analysis shows specific formulas like Hoffer-Colenbrander and Binkhorst are more reliable than Sanders-Retzlaff-Kraff for children, improving refractive predictions.
Area of Science:
- Ophthalmology
- Pediatric Optometry
Background:
- Optical correction formulas for aphakic eyes are primarily validated in adults.
- Pediatric aphakic eyes present unique optical challenges due to shorter axial lengths.
Purpose of the Study:
- To evaluate the accuracy of existing aphakic optical correction formulas in pediatric patients.
- To identify the most reliable formulas for predicting refractive needs in young aphakic individuals.
Main Methods:
- Retrospective analysis of 17 pediatric aphakic patients.
- Comparison of the Sanders-Retzlaff-Kraff (SRK) formula against theoretical (Hoffer-Colenbrander, Binkhorst), percentage change (Donzis-Kastl-Gordon), and derived linear regression (LIN) formulas.
Main Results:
- The SRK formula consistently underestimated aphakic correction in pediatric eyes.
- Hoffer-Colenbrander, Binkhorst, Donzis-Kastl-Gordon, and LIN formulas demonstrated significantly higher accuracy.
- No significant differences were found between the more accurate formulas.
Conclusions:
- Standard formulas like SRK may be inadequate for pediatric aphakic eye correction.
- Formulas such as Hoffer-Colenbrander, Binkhorst, and LIN offer improved prediction accuracy for pediatric aphakia.
- Accurate formula selection can enhance outcomes for epikeratophakia or intraocular lens power prediction in children.
Abstract:
Formulas created to predict the optical requirements of the aphakic eye have been tested mainly in adult eyes. The accuracy of these formulas in shorter pediatric aphakic eyes was examined using retrospective analysis of 17 aphakic pediatric patients. The Sanders-Retzlaff-Kraff contact lens formula, used previously to predict required lens powers for epikeratophakia, consistently underestimated the required aphakic correction in the shorter eyes, which may have been responsible in part for the large undercorrections obtained previously in patients under one year of age. The Hoffer-Colenbrander and Binkhorst theoretical formulas, Donzis-Kastl-Gordon percentage change formula, and a linear regression formula derived from the present data (LIN), were significantly more accurate. The differences between these formulas were not significant. The use of one of these formulas should facilitate prediction of required epikeratophakia lenticule power or intraocular lens power in young children.