Comparison of intraocular lens formula accuracy for eyes with prior scleral buckle surgery

To compare intraocular lens (IOL) formula prediction accuracy for patients with previous scleral buckling surgery.

Single academic center in Los Angeles, California.

Retrospective study.

Patients who had cataract extraction after scleral buckle surgery from 2014 to 2024 were included. The spherical equivalent prediction error (SEQ-PE) from Barrett Universal II (BUII), Hoffer QST, Holladay 1, Kane, Radial Basis Function (RBF) 3.0, and SRK/T was evaluated. The Wang-Koch-adjusted axial lengths were used for eyes >25.0 mm for the Holladay 1 and SRK/T formulas. Analysis was performed with Eyetemis, an online software designed to compare the accuracy, precision, and trueness of the SEQ-PE.

79 eyes from 77 patients were included. The 6 formulas showed similar accuracy, with no statistically significant differences for pairwise comparisons of the absolute SEQ-PE, which ranged between 0.33 diopters (D) (±0.52 D) for the Holladay 1 and 0.42 D (±0.56 D) for the RBF 3.0 formulas, and for pairwise comparisons of the precision of SEQ-PE, except for the comparison between BUII and Hoffer QST. There was no significant difference in the absolute SEQ-PE within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D. Comparing the trueness of the SEQ-PE, BUII and Hoffer QST were hyperopic, while Holladay 1 and SRK/T were myopic.

The formulas compared had similar accuracy of the absolute and precision SEQ-PE for eyes with scleral buckles. There was variability in the trueness of the 6 formulas, however. Therefore, surgeons should consider these trends for IOL selection in eyes with scleral buckles.