The Accuracy Of Intraocular Lens Calculation Formula In Cataract With Short Axial Length

Objective To investigate the prediction of postoperative refractive state and its influencing factors in patients with short axial length(AL)cataracts by the 6 intraocular lens(IOL)calculation formulas(Holladay,Hoffer Q,SRK/T,Haigis,Barrett Universal II,Ladas Super Formular).Methods Prospective study.From January 2020 to September 2021,the patients who diagnosed with cataract and underwent surgery in the Department of Ophthalmology in the Affiliated Hospital of North China University of Science and Technology were selected.There were 67 patients(97 eyes)with short axial(AL≤22.0 mm,normal eye axis range of23.0 to 24.0 mm),37 people(37 eyes)met above criteria and 30 people(60 eyes)met above criteria,all of which were included in this study.A-scan ultrasound measured axial length(AL),anterior chamber depth(ACD),automatic refractometer measured keratometry(K).The refractive that one month after surgery was selected as the actual diopter,expressed by spherical equivalent.Calculating the mean refractive error(ME),mean absolute refractive error(MAE),median absolute error(MedAE)for Holladay,Hoffer-Q,SRK/T,Haigis,Barrett Universal II(BUII),Ladas Super Formular(Ladas).Comparing the prediction accuracy of each formula by comparing MedAE and MAE and comparing the difference between ME and zero(negative values indicate myopia drift,positive values indicate hyperopia drift)to analyzed refractive drift.Analysing the effect of AL,ACD and K on the prediction accuracy of each formula,and analysing differences in refractive error between the two eyes after surgery in patients underwent binocular cataract surgery.Making use with SPSS 26.0 statistical software for statistical analysis.The MedAE of different formulas were compared with the Friedman nonparametric test,and the pairwise comparison between groups was carried out by Bonferroni correction test level;the comparison between ME and 0 used one-sample t-test;the correlation between the prediction refractive error and AL,ACD,K was analyzed by Person correlation,and the influencing factors of the prediction error of each formula were used multiple linear regression;the proportion of prediction error of each formula is measured by chi-square test.The difference was considered to be of statistical significance in P<0.05.Results 1 The uncorrected visual acuity and best corrected visual acuity in one month after surgery were significantly improved compared with preoperative(P<0.05).2 BUII,Hoffer Q,Haigis showed myopia drift,Holladay,Ladas,SRK/T showed hyperopia drift.3The difference of MedAE in the six formulas was statistically significant(P<0.05),and the MedAE difference between BUII,Holladay and Hoffer Q was not statistically significant(P>0.05).4 AL(β=-0.319,P=0.002<0.05)and K(β=-0.374,P<0.001)can significantly negatively affected the refractive error of the SRK/T formula;ACD(β=0.542,P<0.001)can significantly positively affected the refractive error of the Haigis formula;BUII,Holladay,Hoffer Q,Ladas were less affected by AL,K,and ACD.5 In patients treated with cataract surgery in both eyes,there was significant correlation between the refractive errors of binocular with Haigis(r=0.395,P=0.031<0.05)and SRK/T(r=0.240,P=0.013<0.05).There was no significant correlation between the refractive errors of the binocular with Holladay,Hoffer Q,BUII,Ladas formulas(P>0.05).Conclusions For patients with AL≤22.0mm of cataract,the BUII and Hoffer Q formula provide better predictive accuracy,they are less affected by preoperative biometric parameters.Therefore,these two formulas can be used as the preferred formula for patients with short axial cataracts.Figure 2;Table 16;Reference 106...