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Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries
Published on: July 7, 2023
Accuracy of Contemporary Intraocular Lens Calculation Formulas Based on Swept-Source OCT Biometry in Eyes with
Ali Devebacak1, Müge Yılmaz1, Gül Arıkan1
1Dokuz Eylül University Faculty of Medicine, Department of Ophthalmology, İzmir, Türkiye.
Turkish Journal of Ophthalmology
|June 24, 2026
Summary
Barrett Universal II and Holladay II formulas offer superior refractive prediction accuracy in cataract surgery with capsular tension ring implantation. All formulas showed a slight hyperopic shift post-surgery.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Refractive Surgery
Background:
- Cataract surgery with capsular tension ring (CTR) implantation presents unique challenges for intraocular lens (IOL) power calculation.
- Accurate refractive outcomes are crucial for patient satisfaction after modern cataract surgery.
Purpose of the Study:
- To compare the refractive prediction accuracy of contemporary IOL calculation formulas using swept-source optical coherence tomography (OCT) biometry.
- To evaluate refractive prediction in eyes undergoing cataract surgery with CTR implantation.
- To assess for systematic postoperative refractive tendencies.
Main Methods:
- Retrospective study of 98 eyes (92 patients) undergoing phacoemulsification with in-the-bag IOL and CTR implantation.
- Preoperative biometry obtained using swept-source OCT (ARGOS, Alcon).
- Evaluated formulas: Barrett Universal II, Haigis, SRK/T, and Holladay II, analyzing mean prediction error, MAE, MedAE, and refractive outcomes within ±0.25, ±0.50, ±1.00 D.
Main Results:
- Barrett Universal II demonstrated the lowest Mean Absolute Error (MAE) and Median Absolute Error (MedAE) (0.36±0.34 D, 0.24 D).
- Holladay II also showed high accuracy (MAE 0.40±0.32 D, MedAE 0.30 D), performing similarly to Barrett Universal II.
- SRK/T and Haigis formulas exhibited higher MAE (0.45±0.37 D and 0.54±0.45 D, respectively).
- Barrett Universal II achieved the highest percentage of eyes within ±0.25 D (52.04%).
- All formulas indicated a mild hyperopic shift postoperatively.
Conclusions:
- Barrett Universal II and Holladay II formulas provide superior refractive prediction accuracy compared to Haigis and SRK/T in cataract surgery with CTR implantation.
- A consistent mild hyperopic shift was observed across all tested formulas.
- These findings are clinically significant for optimizing IOL power selection and target refraction in this patient cohort.