Comparison of the Accuracy of IOL Power Calculation Formulas for Pediatric Eyes in Children of Different Ages

Abstract

Purpose. This study aims to compare the accuracy of five intraocular lens (IOL) power calculation formulas (SRK/T, Hoffer Q, Holladay 1, Haigis, and Holladay 2) for pediatric eyes in children of different ages. Methods. In this prospective study, patients who received cataract surgery and IOL implantation in the capsular bag were enrolled. We compared the calculation accuracy of 5 formulas at 1 month postoperatively and performed subgroup analysis with the patients divided into three groups according to their ages at the time of surgery as follows: group 1 (age ≤ 2 years, 35 eyes), group 2 (2 years < age < 5 years, 38 eyes), and group 3 (age > 5 years, 29 eyes). Results. 75 patients (102 eyes) were enrolled in this study. The Haigis formula got the smallest PE among all formulas in all three groups. With regard to APE, there were no statistical differences among the formulas except group 2, with the SRK/T formula a little smaller, the Holladay 2 formula a little larger in group 1, and the Haigis formula a little smaller in group 3. In group 2, the Haigis formula had the lowest APE (0.87 ± 0.61 D), while the Holladay 2 formula had the largest (1.71 ± 1.20 D, p<0.001), followed by the Holladay 1 formula (1.51 ± 1.07 D, p=0.002). On comparing the percentage of APE within 0.5 D and 1.0 D obtained with 5 formulas in each group, there were no statistical differences. The SRK/T formula and the Holladay 1 formula showed the highest percentage (40.00% and 60.00%) in group 1. While the Haigis formula got the highest percentage in less than 0.5 D (34.21%) and less than 1 D (60.53%) in group 2. In group 3, the Holladay 2 formula and the Haigis formula got the highest percentage less than 0.5 D (58.62%) and less than 1 D (79.31%). The multiple linear regression indicated that the age at the time of surgery was a significant factor affecting the accuracy of APE; after removing the age, AL was the only factor that affected the accuracy of APE. Conclusion. The SRK/T and the Holladay 1 formulas were relatively accurate in patients younger than 2 years old, while the Haigis formula performed better in patients older than 2.

Accuracy of the SRK/T Formula in Pediatric Cataract Surgery

“…Kou et al reported that SRK/T formula had smaller APE in each group (1.13 ± 1.27 D, 1.018 ± 0.70 D, and 0.80 ± 0.70 D respectively). 23 The smallest APE was found in group ≥5 years, while the present study found that APE in group ≥7 years was higher (1.42 ± 1.19 D). Kou et al did not analyze the difference among these groups, but Chang et al reported that prediction errors were not significantly associated with different ages in most formulas, including SRK/T.…”

“…Kou et al did not analyze the difference among these groups, but Chang et al reported that prediction errors were not significantly associated with different ages in most formulas, including SRK/T. 23 , 24 Lee et al stated that age at IOL implantation has significant correlation with PE calculated by SRK/II, SRK/T, and Hoffer-Q formula. 25 The discordance between the present study results and several previous studies can be attributed to age distribution.…”

Accuracy of Intraocular Lens Power Calculation Formulas in Pediatric Cataract Patients: A Systematic Review and Meta-Analysis

“…The multiple linear regression analyses from previous studies have demonstrated that age is significantly associated with postoperative refractive error (21,32,35,39). The current metaanalysis included pediatric patients aged 1.1-216 months, which covers the whole period of the eye development pf a child.…”

“…Table 1 summarizes the descriptive characteristics of the included studies. A total of 1,647 eyes from 12 studies were enrolled in our meta-analysis (20,21,(30)(31)(32)(33)(34)(35)(36)(37)(38)(39). Five of the studies were conducted in the United States, three in China, three in other Asian countries, and one in Canada.…”

Commentary review: challenges of intraocular lens implantation for congenital cataract infants

“…We found in patients younger than 2 years old or with an AL≤21 mm, SRK/T formulas were relatively accurate, while Barrett and Haigis formulas were better in patients older than 2 or with an AL>21 mm. Later, we made further research to compare the accuracy of five IOL power calculation formulas (SRK/T, Holladay 1, Holladay 2, Hoffer Q and Haigis) for pediatric eyes in children of different ages, finding that SRK/T and Holladay 1 formulas were relatively accurate in patients younger than 2 years old, while the Haigis formula performed better in patients older than 2 [42] . In the study of O'Gallagher et al [43] , SRK/T was also the most accurate formula in predicting postoperative refraction for patients younger than 8 years old.…”