Accuracy of 3 new methods for intraocular lens power selection

Abstract

PURPOSE: To evaluate the accuracy of 3 new methods for intraocular lens (IOL) power selection (Hill-Radial Basis Function [Hill-RBF] method, FullMonte method, and the Ladas Super Formula) compared with that of the Holladay 1 and Barrett Universal II formulas. SETTING: Ophthalmology Department, Alfred Hospital, Melbourne, Australia. DESIGN: Retrospective case series. METHODS: Patients who had uneventful cataract surgery with insertion of the Acrysof IQ SN60WF IOL over 5 years were included in the study. Data obtained from the electronic medical record and the IOLMaster device were entered into the respective calculators using self-designed computer programs. Using optimized lens constants, the predicted refractive outcome using each of the 5 methods/formulas was calculated and compared with the actual refractive outcome to give the prediction error. Eyes were separated into subgroups based on axial length as follows: short (≤22.0 mm), medium (>22.0 to <24.5 mm), medium-long (≥24.5 to <26.0 mm), and long (≥26.0 mm). RESULTS: The study comprised 3122 eyes of 3122 patients. A statistically significant difference in the mean absolute prediction error (MAE) between the 5 methods for IOL power calculation was found (P < .001), with the Barrett Universal II formula being the most accurate. The Ladas Super Formula had the third lowest MAE, the Hill-RBF the fourth lowest MAE, and the FullMonte the highest MAE of the 5 methods assessed. CONCLUSION: New methods for predicting the postoperative refraction failed to yield more accurate results than current formulas.