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Intraocular Lens Power Calculation Formulas in Children-A Systematic Review
Wiktor Stopyra1,2, Andrzej Grzybowski3,4
1MW-Med Eye Centre, 31-416 Krakow, Poland.
Insights
The Barrett Universal II formula is most accurate for pediatric intraocular lens power calculation. Holladay 1 also provides good outcomes, but formula choice remains debated for pediatric cataract surgery.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Pediatric Surgery
Background:
- Accurate intraocular lens (IOL) power calculation is critical for successful phacoemulsification, especially in pediatric cases.
- Various formulas exist for IOL power calculation, each with varying degrees of accuracy.
Purpose of the Study:
- To evaluate and compare the accuracy of commonly used IOL power calculation formulas in pediatric eyes.
- To identify the most reliable formula for IOL power selection in children undergoing cataract surgery.
Main Methods:
- A systematic literature review of studies published between 2019 and 2024 was conducted.
- Searches included databases like PubMed, Crossref, and Google Scholar using keywords related to IOL power calculation and pediatric cataract surgery.
- Fourteen recent, peer-reviewed papers with large sample sizes were analyzed.
Main Results:
- Formulas were assessed based on mean absolute error (MAE) and the percentage of predictions within ±0.5 D and ±1.0 D.
- Hoffer Q showed the best MAE most frequently, followed closely by SRK/T and Barrett Universal II.
- Barrett Universal II demonstrated the best results for predictions within ±1.0 D, with Holladay 1 also performing well.
Conclusions:
- The Barrett Universal II formula appears to be the most accurate for pediatric IOL power calculation.
- The Holladay 1 formula also offers very good postoperative outcomes.
- Consensus on the optimal formula for pediatric IOL power calculation is still lacking.
Abstract:
Objectives: The selection of an appropriate formula for intraocular lens power calculation is crucial in phacoemulsification, particularly in pediatric patients. The most commonly used formulas are described and their accuracy evaluated in this study. Methods: This review includes papers evaluating the accuracy of intraocular lens power calculation formulas for children's eyes published from 2019-2024. The articles were identified by a literature search of medical and other databases (Pubmed/MEDLINE, Crossref, Google Scholar) using the combination of the following key words: "IOL power calculation formula", "pediatric cataract", "congenital cataract", "pediatric intraocular lens implantation", "lens power estimation", "IOL power selection", "phacoemulsification", "Hoffer Q", "Holladay 1", "SRK/T", "Barrett Universal II", "Hill-RBF", and "Kane". A total of 14 of the most recent peer-reviewed papers in English with the maximum sample sizes and the greatest number of compared formulas were considered. Results: The outcomes of mean absolute error and percentage of predictions within ±0.5 D and ±1.0 D were used to assess the accuracy of the formulas. In terms of MAE, Hoffer Q yielded the best result most often, just ahead of SRK/T and Barrett Universal II, which, together with Holladay 1, most often yielded the second-best outcomes. Considering patients with PE within ±1.0 D, Barrett Universal II most often gave the best results and Holladay 1 most often gave the second-best. Conclusions: Barrett Universal II seems to be the most accurate formula for intraocular lens calculation for children's eyes. Very good postoperative outcomes can also be achieved using the Holladay 1 formula. However, there is still no agreement in terms of formula choice.
