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TW Close, PA Russo; The Relative Accuracy of the Holladay 2 Versus the Holladay 1 Intraocular Lens Power Formula in Eyes With Atypical Parameters . Invest. Ophthalmol. Vis. Sci. 2002;43(13):418.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the predictive accuracy of post-operative refraction using the Holladay 2 versus the Holladay 1 IOL power formula in eyes with excessively flat or steep keratometry readings or excessively long or short axial lengths. Methods: This prospective analysis involved the selection of 18 pre-operative eyes with unusual corneal curvatures or axial lengths. Patients had average K values of less then 42.00 D or greater than 46.00 D. Alternatively, axial length measurements were less then 22.0 mm or greater than 26.0 mm. The implanted intraocular lens was then chosen based upon the Holladay 2 IOL power formula. Holladay 1 predictive data was also gathered for each eye. Uncomplicated cataract surgery with implantation of the same style intraocular lens was then performed. Post-operative refractions were taken on three occasions and an average spherical equivalent determined. Holladay 1 and 2 predicted post-operative refractions (spherical equivalent) were then compared to the actual post-operative refractions (spherical equivalent). Results: The mean absolute deviation (MAD) between the actual post-operative manifest refraction and predicted post-operative refraction was slightly higher for the Holladay 2 formula versus the Holladay 1 formula (0.487 D vs. 0.409 D). Using either formula, the predicted post-operative refraction was relatively hyperopic 44% of the time (MAD 0.56 D Holladay 2 and 0.37 D Holladay 1) and relatively myopic 56% of the time (MAD 0.43 D Holladay 2 and 0.44 D Holladay 1). Conclusion: Although the Holladay 2 formula is intended to provide clinically superior predictive accuracy for patients with extreme axial lengths or keratometry readings, this was not evident in the refractive outcomes of our patient population.
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