Abstract
In eyes with axial lengths greater than 25.0 mm, intraocular lens (IOL) power calculation formulas tend to suggest IOLs of insufficient power, leaving patients with postoperative hyperopia. This chapter describes the development and validation of a method for optimizing axial length to improve the accuracy of these formulas. In consecutive cases, refractive prediction errors with the Holladay 1, Haigis, SRK/T, and Hoffer Q formulas were evaluated. Eyes were then randomized into two groups, one to develop regression formulas to optimize axial length and one to validate the method. Two additional data sets were used for validation in this original study, as well as another data set that is yet unpublished. The method of optimizing axial length significantly reduced the mean numerical refractive prediction errors: (1) for IOLs > 5.00 diopters (D), from a range of +0.27 to +0.68 D to a range of −0.10 to −0.02 D, and (2) for IOLs ≤5.00 D, from a range of +1.13 to +1.87 D to a range of −0.21 to +0.01 D (all P < 0.05). Optimizing axial length also significantly reduced the percentage of eyes that would be left hyperopic in the two additional published data sets and in a more recent set of unpublished data. The unpublished data set also demonstrated better accuracy with optimized axial lengths in comparison to the Barrett Universal Formula. In conclusion, optimizing axial length with the proposed formulas in this chapter reduced the percentage of long eyes that would end up with an undesired hyperopic outcome.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Zaldivar R, Shultz MC, Davidorf JM, Holladay JT. Intraocular lens power calculations in patients with extreme myopia. J Cataract Refract Surg. 2000;26:668–74.
Maclaren RE, Sagoo MS, Restori M, Allan BDS. Biometry accuracy using zero- and negative-powered intraocular lenses. J Cataract Refract Surg. 2005;31:280–90.
Kohnen S, Brauweiler P. First results of cataract surgery and implantation of negative power intraocular lenses in highly myopic eyes. J Cataract Refract Surg. 1996;22:416–20.
Tsang CSL, Chong GSL, Tiu EPF, Ho CK. Intraocular lens power calculation formulas in Chinese eyes with high axial myopia. J Cataract Refract Surg. 2003;29:1358–64.
Pomberg ML, Miller KM. Preliminary efficacy and safety of zero diopter lens implantation in highly myopic eyes. Am J Ophthalmol. 2005;139:914–5.
Yalvac IS, Nurozler A, Unlu N, Cetinkaya F, Kasim R, Duman S. Calculation of intraocular lens power with the SRK II formula for axial high myopia. Eur J Ophthalmol. 1996;6:375–8.
Wang L, Shirayama M, Ma XJ, Kohnen T, Koch DD. Optimizing intraocular lens power calculations in eyes with axial lengths above 25.0 mm. J Cataract Refract Surg. 2011;37:2018–27.
Kora Y, Koike M, Suzuki Y, Inatomi M, Fukado Y, Ozawa T. Errors in IOL power calculations for axial high myopia. Ophthalmic Surg. 1991;22:78–81.
Barrett GD. An improved universal theoretical formula for intraocular lens power prediction. J Cataract Refract Surg. 1993;19:713–20.
Dubbelman M, Sicam VADP, van der Heijde GL. The shape of the anterior and posterior surface of the aging human cornea. Vision Res. 2006;46:993–1001.
Wang L, Mahmoud AM, Anderson BL, Koch DD, Roberts CJ. Total corneal power estimation: ray tracing method versus Gaussian optics formula. Invest Ophthalmol Vis Sci. 2011;52:1716–22.
Shirayama M, Wang L, Koch DD, Weikert MP. Comparison of accuracy of intraocular lens calculations using automated keratometry, a Placido-based corneal topographer, and a combined Placido-based and dual Scheimpflug corneal topographer. Cornea. 2010;29:1136–8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Japan
About this chapter
Cite this chapter
Feuerman, J., Wang, L., Barrett, R., Balakrishnan, S.A., Weikert, M.P., Koch, D.D. (2014). Intraocular Lens Power Calculations in Long Eyes. In: Bissen-Miyajima, H., Koch, D., Weikert, M. (eds) Cataract Surgery: Maximizing Outcomes Through Research. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54538-5_4
Download citation
DOI: https://doi.org/10.1007/978-4-431-54538-5_4
Published:
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-54537-8
Online ISBN: 978-4-431-54538-5
eBook Packages: MedicineMedicine (R0)