Abstract
Purpose :
To evaluate the accuracy of 11 modern intraocular lens calculation formulas in predicting the postoperative refraction error in eyes with cataract and FECD undergoing “Triple DMEK” (Descemet membrane endothelial keratoplasty combined with cataract surgery).
Methods :
This retrospective case series included 80 eyes of 80 patients (52 females, 28 males) with a mean age 67.08 ± 7.64 years (from 45 to 83 years old) having Descemet membrane endothelial keratoplasty combined with cataract surgery for Fuchs endothelial corneal dystrophy at the Department of Ophthalmology, Goethe University, Frankfurt, Germany between 2016 and 2023. Preoperative biometry measurements were obtained from IOLMaster 700 (Carl Zeiss Meditec). Evaluation of the measurements was performed by comparison of the mean prediction error and the mean and median absolute prediction error.
Results :
The median absolute error was lowest in Hill-Radial Basis Function (0.76 diopters) followed by Kane and Sanders-Retzlaff-Kraff/theoretical (0.80 diopters each), Hoffer QST (0.81 diopters), EVO and T2 (0,82 diopters each), Barrett Universal II and Pearl DGS (0.83 diopters each), Haigis (0.85 diopters) and Holladay 1 and Holladay 2 (0.88 diopters each). The lowest maximum absolute prediction error was obtained with Sanders-Retzlaff-Kraff/theoretical (3.97 diopters). The hyperopic shift was lowest in Holladay 1 formula with a mean prediction error of -0.41 diopters. Regarding eyes within ±0.5 diopters Hoffer QST (37.5%) performed best, followed by Haigis and Holladay 1 (36.3% each).
Conclusions :
Prediction of the postoperative refraction error in eyes that need both Descemet membrane endothelial keratoplasty (DMEK) and cataract surgery is still a challenge and not as accurate, as in healthy eyes without corneal pathologies. In our study, Hill-Radial Basis Function, Kane and Sanders-Retzlaff-Kraff/theoretical formula achieved the best results, although prediction with Holladay 1 formula showed the lowest hyperopic shift. This should be taken into account when calculating the IOL power in patients undergoing DMEK combined with cataract surgery.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.