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Shruti Sudhakar, Darren Hill, Christopher Hill, Ingrid U Scott, Brett Ernst, Seth Pantanelli; Comparison of Preoperative Intraocular Lens Power Selection Methods to Intraoperative Aberrometry in Short Eyes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):921.
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© ARVO (1962-2015); The Authors (2016-present)
Lens selection algorithms work well for normally sized eyes, but for patients with short eyes (axial length ≤ 22mm), these equations are far less accurate. The purpose of this retrospective case series is to compare the accuracy of the Hoffer Q, SRK/T, and Holladay1 formulae to that of intraoperative aberrometry (Alcon ORA) with respect to predicting residual refractive error after cataract surgery in eyes with short axial length to reveal the best method for lens selection.
For all eyes with an axial length ≤ 22.0 mm that underwent cataract surgery by two surgeons between November 2014 to August 2015, predicted residual refractive error was calculated preoperatively using the Hoffer Q, SRK/T, and Holladay1 formulae and intraoperatively using the Alcon ORA aberrometer before IOL implantation. These predictions were used to select an intraocular lens (IOL) with a postoperative refractive target of emmetropia. Refraction was measured between 4 and 8 weeks postoperatively and compared to the preoperative and intraoperative prediction models for the selected IOL.
Eleven eyes of 11 patients were identified with an axial length ≤ 22.0 mm. Axial lengths ranged from 20.37 to 21.94 mm, with a mean of 21.59 mm. The mean numerical errors (MNE) associated with the Hoffer Q, SRK/T, and Holladay1 formulae and ORA were 0.036 +/-0.703 D, 0.239 +/- 0.731, 0.147 +/- 0.697 D, and 0.063 +/- 0.595, respectively (p-value > 0.05). Additionally, the mean absolute errors (MAE) were 0.586 +/- 0.343, 0.585 +/- 0.469, 0.519 +/- 0.456, and 0.440 +/- 0.371, respectively (p-value > 0.05). The proportion of patients within 0.5D of target refraction was 36.4%, 63.6%, 55.6%, and 63.6%, respectively (p-value > 0.05).
No significant difference was identified among the Hoffer Q, SRK/T, and Holladay1 formulae and intraoperative ORA measurements with respect to accuracy of predicting residual refractive error after cataract surgery in eyes with short axial length. More eyes are needed in order to increase the power of the current study.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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