Related Experiment Video
Updated: Aug 14, 2026
05:14
Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter
Published on: September 16, 2025
Evaluation of Intraocular Lens Power Calculation Formulas for Highly Myopic Eyes: A Systematic Review and Network
Magí Vilaltella1,2, Tonet Serés-Noriega3, Pau Cid-Bertomeu4
1Department of Medicine and Surgery, Faculty of Medicine, University of Lleida, Carrer de Montserrat Roig, 2, 25008 Lleida, Spain.
Journal of Clinical Medicine
|August 13, 2026
Summary
The Kane and Holladay 1 formula, with axial length adjustment, demonstrated the most consistent accuracy for intraocular lens power calculations in highly myopic eyes. Other formulas like Hill-RBF 3.0 and EVO also showed high precision.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Optics
Background:
- Accurate intraocular lens (IOL) power calculation is crucial for visual outcomes.
- The optimal IOL formula for highly myopic eyes (axial length > 26 mm) is not definitively established.
- Existing formulas may have limitations in predicting refractive outcomes for these specific eyes.
Purpose of the Study:
- To systematically review and perform a network meta-analysis of IOL power calculation formulas.
- To compare and rank the accuracy of various IOL formulas in eyes with axial lengths exceeding 26 mm.
- To identify the most reliable formulas for pre-operative IOL power selection in high myopia.
Main Methods:
- Conducted a comprehensive literature search across major databases (PubMed, Cochrane, Scopus, Web of Science).
- Performed a network meta-analysis comparing IOL formulas based on refractive prediction error percentages (<0.25, <0.50, <1.00 diopters).
- Utilized Surface Under the Cumulative Ranking Curve (SUCRA) values for formula ranking and generated forest plots against Barrett Universal II.
Main Results:
- Ten studies were included in the analysis.
- Kane and Holladay 1 (with Wang-Koch adjustment) ranked highly across all prediction error thresholds.
- Hill-RBF 3.0, EVO, and Barrett Universal II showed top-three performance at specific error thresholds (<0.25, <0.50, <1.00 D, respectively).
Conclusions:
- The Kane and Holladay 1 formula (with Wang-Koch adjustment) exhibited the most consistent performance in highly myopic eyes.
- Hill-RBF 3.0, EVO, and Barrett Universal II are precise and reliable alternatives for IOL power calculation in this population.
- Further validation may refine formula selection for optimal outcomes in high myopia.
Related Concept Videos
01:16Focusing of Light in the Eye
Light rays enter the eye through the cornea, a transparent dome-shaped tissue that is the eye's outermost layer. The cornea bends or refracts, light rays traveling to the pupil. The shape of the cornea determines how much of the light is bent and whether the image will be focused correctly on the retina at the back of the eye. Once the light has passed through both refraction layers, it converges into a single focal point onto a small area. This is where photoreceptors start transforming...
01:27Open Angle Glaucoma: Treatment
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:25Glaucoma: Overview
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...