Use of various keratometry data (ring and zone) in trifocal IOL calculation

Abstract

Purpose. To compare the results of trifocal IOL calculation using various corneal tomographic data (ring and zone). Methods. This retrospective study involved 46 patients (46 eyes), underwent cataract surgery with trifocal IOL implantation (AcrySof IQ PanOptix). The calculation was performed using Tomey OA-2000 according to 2 formulas (Barrett II Universal, Olsen). Keratometry values included Km (the average of two main meridians of a cornea) provided by Pentacam HR Power Distribution Apex map, which describes total corneal refractive power (TCRP) with diameter of 3.0, 4.0 and 5.0 mm on a ring and zone. Mean (MAE) and median (MedAE) predicted postoperative refraction errors were assessed after surgery. Results. Mean Km value on 3 mm zone and ring was: 42.75±1,46 D and 42,91±1,43 D, respectively (p<0,0001). Mean Km on 4 mm zone and ring was: 42.6±1.5 D and 43.3 ± 1.5 D, respectively (p <0.005). Mean Km value on 5 mm zone and ring was: 43,09±1,5 D and 43,55±1,48 D, respectively (p<0,0001). Calculations using the Barrett II Universal formula revealed significant difference between MAE and MedAE of the predicted postoperative refraction on 5mm zone and ring (p=0.045). When using the Olsen formula in the calculations, significant difference was revealed using the Km data with a diameter of 3 mm and 5 mm (p=0.001 и p=0.009, respectively). The calculation on 3 mm ring was more accurate than for 3 mm zone. With a 5 mm diameter, the calculation is more accurate according to the zone data. Conclusion. Mean Km value on Power Distribution Apex map according to ring is significantly greater then according to zone. 1) The calculation of the trifocal IOL based on the TCRP zone data is reliably more accurate than the ring data according to both formulas (Barrett II Universal and Olsen) with a diameter of 5 mm. 2) According to the Olsen formula with a diameter of 3 mm, the calculation of the optical power of trifocal IOL based on TCRP ring data is more accurate. Key words: IOL calculation, Trifocal IOL, corneal topography