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Risk Factors for Postoperative Refractive Error in New-Generation Intraocular Lens Calculation Formulas.

Shohei Nishida1, Yasuya Inomata1, Akira Hirata2

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Clinical Ophthalmology (Auckland, N.Z.)
|August 19, 2024
PubMed
Summary

Comparing intraocular lens (IOL) calculation formulas, lens thickness (LT) emerged as a significant factor for refractive error, particularly with the Barrett Universal II (BU II) and PEARL-DGS formulas. Axial length and anterior chamber depth were also factors for the SRK/T formula.

Keywords:
cataractlens thicknesslogistic modelsrefractive surgical procedures

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Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Computational Science

Background:

  • Accurate intraocular lens (IOL) power calculation is crucial for achieving desired refractive outcomes after cataract surgery.
  • Traditional formulas like SRK/T have limitations, prompting the development of newer generation formulas and AI-driven approaches.
  • Understanding factors influencing postoperative refractive error (PE) is essential for refining IOL calculation methods.

Purpose of the Study:

  • To compare the accuracy of three IOL calculation formulas: SRK/T, Barrett Universal II (BU II), and PEARL-DGS (PEARL).
  • To identify factors contributing to postoperative refractive error (PE) across these formulas.

Main Methods:

  • A retrospective study of 205 patients (205 eyes) undergoing cataract surgery.
  • Calculation and comparison of PE for SRK/T, BU II, and PEARL formulas.
  • Multivariate logistic regression analysis to identify factors associated with PE > ±0.50 D, including axial length (AL), keratometry (K), anterior chamber depth (ACD), lens thickness (LT), and white-to-white (WTW).

Main Results:

  • Mean PE (ME) for SRK/T, BU II, and PEARL were 0.11 ± 0.52 D, 0.11 ± 0.50 D, and 0.21 ± 0.50 D, respectively.
  • No significant differences were found in median absolute error (MedAE) or the percentage of PE within ±0.50 D among the formulas.
  • Multivariate analysis identified AL, ACD, and LT as significant factors for SRK/T; sex and LT for BU II; and LT for PEARL.

Conclusions:

  • Lens thickness (LT) was identified as a significant risk factor for refractive error, especially for the BU II and PEARL formulas.
  • Axial length (AL) was not a significant factor for PE in the BU II and PEARL formulas, unlike the SRK/T formula.