Comparison of newer IOL power calculation methods for post-corneal refractive surgery eyes

Abstract

Objective

To compare the newer formulae, the optical coherence tomography based intraocular lens (IOL) power formula (OCT formula) and the Barrett True-K formula (True-K), to the methods on the ASCRS calculator in eyes with previous myopic LASIK/PRK.

Design

Prospective case series.

Participants

One-hundred and four eyes of 80 patients who had previous myopic LASIK/PRK and subsequent cataract surgery and IOL implantation.

Methods

Using the actual refraction following cataract surgery as target refraction, predicted IOL power for each method was calculated. The IOL prediction error (PE) was obtained by subtracting the predicted IOL power from the power of IOL implanted.

Main outcome measures

Arithmetic IOL PEs, variances of mean arithmetic IOL PE, median refractive PE and percent of eyes within 0.5 D and 1.0 D of refractive PE.

Results

OCT produced smaller variance of IOL PE than did Wang-Koch-Maloney, and Shammas (P<0.05). With the OCT, True-K No History, Wang-Koch-Maloney, Shammas, Haigis-L, and Average of these 5 formulas, respectively, the median refractive PEs were 0.35 D, 0.42 D, 0.51 D, 0.48 D, 0.39 D, and 0.35 D, and the % of eyes within 0.5 D of refractive PE were 68.3%, 58.7%, 50.0%, 52.9%, 55.8%, and 67.3%, and within 1.0 D of RPE, 92.3%, 90.4%, 86.9%, 88.5%, 90.4%, and 94.2%, respectively. The OCT formula had smaller refractive PE compared to Wang-Koch-Maloney and Shammas, and the Average approach produced significantly smaller refractive PE than did all methods except OCT (all P<0.05).

Conclusions

The OCT and True-K No History are promising formulas. The ASCRS IOL calculator has been updated to include the OCT and Barrett True K formulas.

Trial registration

Intraocular Lens Power Calculation After Laser Refractive Surgery Based on Optical Coherence Tomography (OCT IOL); Identifier: NCT00532051; www.ClinicalTrials.gov