The effect of patient age on some new and older IOL power calculation formulas

Ruti Sella; Olga Reitblat; Kathryn M Durnford; Jeff H Pettey; Randall J Olson; Tara E Hahn; Ashlie A Bernhisel; Natalie A Afshari

doi:10.1111/aos.16621

The effect of patient age on some new and older IOL power calculation formulas

Acta Ophthalmol. 2023 Dec 28. doi: 10.1111/aos.16621. Online ahead of print.

Authors

Ruti Sella^{1

2

3

4}, Olga Reitblat^{1

2}, Kathryn M Durnford⁵, Jeff H Pettey⁶, Randall J Olson⁶, Tara E Hahn⁶, Ashlie A Bernhisel^{3

4

6}, Natalie A Afshari⁴

Affiliations

¹ Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel.
² Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
³ Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA.
⁴ Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California, USA.
⁵ University of Utah School of Medicine, Salt Lake City, Utah, USA.
⁶ Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.

PMID: 38155407
DOI: 10.1111/aos.16621

Abstract

Purpose: To assess the accuracy of intraocular lens (IOL) power calculation in different age groups using various IOL calculation formulas.

Methods: Data from 421 eyes of 421 patients ≥60 years old (ages: 60-69, n = 131; 70-74, n = 105; 75-84, n = 158 and ≥85, n = 27), who underwent uneventful cataract surgery with SN60WF IOL implantation at John A. Moran Eye Center, Salt Lake City, USA, were retrospectively obtained. The SD of the prediction error (PE), median and mean absolute PEs and the percentage of eyes within ±0.25, ±0.50, ±0.75 and ±1.00 D were calculated after constant optimizations for the following formulas: Barrett Universal II (BUII), Emmetropia Verifying Optical (EVO) 2.0, Haigis, Hoffer Q, Hoffer QST, Holladay 1, Kane, Radial Basis Function (RBF) 3.0 and SRK/T. Results were compared between the different age groups.

Results: Predictability rates within 0.25D were lower for the eldest age group compared with the other groups using the EVO 2.0 (33% vs. 37%-53%, p = 0.045), Kane (26% vs. 35%-50%, p = 0.034) and SRK/T (22% vs. 31%-49%, p = 0.002). Higher median absolute refractive errors for all formulas were observed in the oldest group [range: 0.39 D (Haigis, Hoffer QSR)-0.48 D (Kane)], followed by the youngest group [range: 0.30 D (RBF 3.0)-0.39 D (Holladay 1, SRK/T)] but did not reach statistical significance. No significant differences between the groups in the distribution parameter were seen.

Conclusion: Current IOL power calculation formulas may have variable accuracy for different age groups. This should be taken into account when planning cataract surgery to improve refractive outcomes.

Keywords: IOL power calculation different ages; IOL power calculation in the elderly; IOL predictability; heteroscedastic statistical method; intraocular lens power calculation.