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J Cataract Refract Surg. 2019 May;45(5):576-581. doi: 10.1016/j.jcrs.2018.11.029. Epub 2019 Feb 21.

Intraocular lens power calculation in eyes with keratoconus.

Author information

1
IRCCS Fondazione Bietti, Rome, Italy. Electronic address: giacomo.savini@alice.it.
2
Eye Clinic, Department of Neurosciences, and Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy.
3
Stein Eye Institute, University of California, Los Angeles, California, USA; St. Mary's Eye Center, Santa Monica, California, USA.
4
Department of Ophthalmology, Ospedale di Stato della, Repubblica di San Marino.
5
Department of Ophthalmology, Santa Maria delle Croci Hospital, Ravenna, Italy.
6
IRCCS Fondazione Bietti, Rome, Italy.

Abstract

PURPOSE:

To assess the refractive accuracy of different formulas for intraocular lens (IOL) power calculation in eyes with keratoconus.

SETTING:

IRCCS Fondazione Bietti, Rome, Italy.

DESIGN:

Multicenter retrospective interventional study.

METHODS:

A consecutive series of eyes with keratoconus that had cataract surgery were evaluated. Keratometry, anterior chamber depth, and axial length were measured preoperatively with optical biometry; IOL power was calculated with the Barrett Universal II, Haigis, Hoffer Q, Holladay 1, and SRK/T formulas. Subjective refraction was assessed at 1 month. The mean prediction error (PE), median absolute error (MedAE) and percentage of eyes with a PE within ±0.50 diopters (D), ±0.75 D, and ±1.00 D were calculated.

RESULTS:

The final spherical equivalent was -0.52 D ±1.61 (SD). In the whole sample (41 eyes), the mean PE was positive (hyperopic surprise) with all formulas; the lowest PE (0.91 D) and MedAE (0.62 D) were obtained with the SRK/T formula. In stage I eyes (n = 21), the MedAE ranged between 0.43 and 0.91 D; the SRK/T formula achieved the lowest MedAE and the highest rate of eyes with a PE within ±0.50 (61.9%). In stage II eyes (n = 13), the MedAE ranged between 0.75 D and 1.50 D; the SRK/T formula achieved the lowest MedAE and the highest rate of eyes with a PE within ±0.50 (30.8%). In stage III eyes (n = 7), the MedAE was higher than 2.50 D with all formulas.

CONCLUSIONS:

In keratoconus eyes, all formulas led to a hyperopic refractive outcome. The SRK/T was the most accurate formula. The results were worse in advanced stages of the disease.

PMID:
30799180
DOI:
10.1016/j.jcrs.2018.11.029

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