Comparison of the prediction accuracy of 13 formulas in long eyes

Abstract

Purpose: To investigate the accuracy of modern intraocular lens (IOL) power calculation formulas in eyes with axial length (AL) ≥ 26.00 mm.

Methods: A total of 193 eyes with one type of lens were analysed. An IOL Master 700 (Carl Zeiss Meditec, Jena, Germany) was used for optical biometry. Thirteen formulas and their modifications were evaluated: Barrett Universal II, Haigis, Hoffer QST, Holladay 1 MWK, Holladay 1 NLR, Holladay 2 NLR, Kane, Naeser 2, SRK/T, SRK/T MWK, T2, VRF and VRF-G. The User Group for Laser Interference Biometry lens constants were used for IOL power calculation. The mean prediction error (PE) and its standard deviation (SD), the median absolute error (MedAE), the mean absolute error (MAE) and the percentage of eyes with PEs within ± 0.25 D, ± 0.50 D and < ± 1.00 D were calculated.

Results: The modern formulas (Barrett Universal II, Hoffer QST, Kane, Naeser 2 and VRF-G) produced the smallest MedAE among all methods (0.30 D, 0.30 D, 0.30 D, 0.29 D and 0.28 D, respectively). The percentage of eyes with a PE within ± 0.50 D ranged from 67.48% to 74.85% for SRK/T and Hoffer QST, Naeser 2 and VRF-G, respectively.

Conclusions: Dunn's post hoc test of the absolute errors revealed statistically significant differences (P < 0.05) between some of the newer formulas (Naeser 2 and VRF-G) and the remaining ones. From a clinical perspective the Hoffer QST, Naeser 2 and VRF-G formulas were more accurate predictors of postoperative refraction with the largest proportion of eyes within ± 0.50 D.

Keywords: Calculation; Formulas; IOL power; IOLMaster; Long eyes.