Choice of intraocular lens calculation formula for cataract patients with prior pars plana vitrectomy

Abstract

Purpose: To determine the optimal intraocular lens (IOL) calculation formula for vitrectomized eyes with diverse surgical and biometric characteristics. Setting: Zhongshan Ophthalmic Center, Sun Yat-sen University, China. Design: Retrospective consecutive case-series study. Methods: This study included 974 vitrectomized eyes (974 patients) scheduled for phacoemulsification with IOL implantation. Eleven formulas were evaluated: Barrett Universal II(BUII), Emmetropia Verifying Optical, Hoffer-QST, Kane, Ladas Super Formula, Pearl-DGS, Radial Basis Function (RBF), Haigis, HofferQ, Holladay1, and SRK/T. Risk factors for prediction error (PE) exceeding 1D were determined using multiple logistic regression. Subgroup analyses were performed based on surgical history and biometric parameters. Results: The risk of hyperopic PE (>1D) was higher in patients with silicone oil tamponade (odds ratio [OR], 1.82) and longer axial length (AL) (OR, 1.55), while patients with previous scleral buckling (OR, 2.43) or ciliary sulcus IOL implantation (OR, 6.65) were more susceptible to myopic PE (<-1D). The Kane formula had the highest overall prediction accuracy, and also the best in silicone oil-filled eyes and the flat cornea subgroup. The BUII and RBF displayed the optimal performance in eyes with previous scleral buckle and steep cornea, respectively. In eyes with an AL ≥ 26mm, the Holladay1 with the nonlinear version of the Wang-Koch AL adjustment (Holladay1-WKn) showed the lowest absolute PE and highest percentage within ± 1.0D of PE. Conclusions: The Kane achieved the highest overall prediction accuracy in vitrectomized eyes. The optimal formula for eyes with previous scleral buckle, steep cornea, or long AL was BUII, RBF, and Holladay1-WKn, respectively.

Influence of Ocular Biometry Parameters on the Predictive Accuracy of IOL Power Formulas in Patients with High Myopia

“…The exclusion criteria of this study included a history of contact lens wearing, corneal abnormalities, pterygium, glaucoma, uveitis, zonular weakness, lens luxation, diabetic retinopathy, invalid ocular biometry, missing postoperative refractive information, and postoperative corrected distance visual acuity (CDVA) less than 20/40. We ruled out patients who had undergone pterygium surgery [ 21 ], corneal refractive surgery [ 22 ], implantable collamer lens (ICL) implantation [ 23 ], or vitrectomy surgery [ 24 ]. These cases were excluded to avoid preexisting surgery-induced changes in ocular anatomical and optical properties.…”