Refractive predictive errors using Barrett II, Hoffer-Q, and SRKT formulae for pediatric IOL implantation

Or Shmueli; Nur Azem; Ana Navarrete; Milka Matanis-Suidan; Ran David; Hadas Mechoulam; Irene Anteby

doi:10.1007/s00417-024-06401-4

Refractive predictive errors using Barrett II, Hoffer-Q, and SRKT formulae for pediatric IOL implantation

Graefes Arch Clin Exp Ophthalmol. 2024 Feb 15. doi: 10.1007/s00417-024-06401-4. Online ahead of print.

Authors

Or Shmueli¹, Nur Azem¹, Ana Navarrete¹, Milka Matanis-Suidan¹, Ran David¹, Hadas Mechoulam¹, Irene Anteby²

Affiliations

¹ Department of Ophthalmology, Hadassah Medical Center, The Hebrew University of Jerusalem, 9112001, Ein-Karem, Jerusalem, Israel.
² Department of Ophthalmology, Hadassah Medical Center, The Hebrew University of Jerusalem, 9112001, Ein-Karem, Jerusalem, Israel. irenea@mail.huji.ac.il.

PMID: 38358526
DOI: 10.1007/s00417-024-06401-4

Abstract

Purpose: To compare the accuracy of the Barrett II universal (BU II) formula, Hoffer-Q, and SRKT formulae following lensectomy and IOL implantation in a large pediatric cohort.

Methods: Retrospective study of children who underwent lensectomy and IOL implantation between 2015 and 2023 at Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Results: One hundred and fifty-one eyes of 104 children aged 6.0 ± 3.9 years were included. The mean prediction error (PE) was - 0.08 ± 1.54 diopters (D) with BU II, 0.24 ± 1.46 D with Hoffer-Q, and 0.71 ± 1.92 D with SRKT (P = 0.10). In eyes with axial length (AL) < 22 mm, BU II and Hoffer-Q had a smaller PE than SRKT (P = 0.024). In eyes with AL ≥ 22 mm, BU II had a smaller PE than Hoffer-Q (P = 0.048). In children 24 months or older at surgery, BU II had a smaller PE than SRKT and Hoffer-Q (P = 0.012). However, in younger children, no difference was found between the formulae (P = 0.61). For mean k-values ≥ 44.5 D, BU II and Hoffer-Q had a smaller PE than SRKT (P = 0.002). An absolute prediction error < 1.0 D was obtained with BU II in 66% of eyes and SRKT in 35% (P = 0.01).

Conclusions: The BU II formula performed well with a small prediction error. No significant difference in PE was detected overall between the formulae. However, only BU II demonstrated a stable prediction error at varying axial lengths, K-readings, and ages. As the biometric parameters of the developing eye change with growth, the BU II formula offers a reliable and stable option for pediatric IOL calculation.

Keywords: Accuracy; Barrett Universal II formula; Children; Intra-ocular lens power calculation; Pediatric cataract; Predictive error.