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Intraocular Lens Power Calculation after Refractive Surgery: A Comparative Analysis of Accuracy and Predictability.
To compare the accuracy of intraocular lens (IOL) power calculation using conventional regression formulae or the American Society of Cataract and Refractive Surgery (ASCRS) IOL power calculator for previous corneal refractive surgery.
We retrospectively reviewed 96 eyes from 68 patients that had undergone cataract surgery after keratorefractive surgeries. We calculated the formula with two approaches: IOL powers using the ASCRS IOL power calculator and IOL powers using conventional formulae with previous refractive data (Camellin, Jarade, Savini, and clinical history method) or without prior data (0, 2 and, 4 mm total mean power in topography, Wang-Koch-Maloney, Shammas, Seitz, and Maloney). Two conventional IOL formulae (the SRK/T and the Hoffer Q) were calculated with the single K and double K methods. Mean arithmetic refractive error and mean absolute error were calculated at the first postoperative month.
In conventional formulae, the Jarade method or the Seitz method, applied in the Hoffer Q formula with the single K or double K method, have the lowest prediction errors. The least prediction error was found in the Shammas-PL method in the ASCRS group. There was no statistically significant difference between the 10 lowest mean absolute error conventional methods, the Shammas-PL method and the Barrett True-K method calculated with using the ASCRS calculator, without using preoperative data.
The Shammas-PL formula and the Barrett True-K formula, calculated with the ASCRS calculator, without using history, were methods comparable to the 10 most accurate conventional formulae. Other methods using the ASCRS calculator show a myopic tendency.
Kang BS
,Han JM
,Oh JY
,Kim MK
,Wee WR
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Comparison of intraocular lens power prediction by American Society of Cataract and Refractive Surgery formulas and Barrett True-K TK in eyes with prior laser refractive surgery.
To evaluate the prediction accuracy of various intraocular lens (IOL) power calculation formulas on American Society of Cataract and Refractive Surgery (ASCRS) calculator and Barrett True-K total keratometry (TK) in eyes with previous laser refractive surgery for myopia.
This retrospective study included eyes with history of myopic laser refractive surgery, which have undergone clear or cataractous lens extraction by phacoemulsification followed by IOL implantation. Those who underwent uneventful crystalline lens extraction were included. Eyes with any complication of refractive surgery or those with eventful lens extraction procedure and those who were lost to follow-up were excluded. Formulas compared were Wang-Koch-Maloney, Shammas, Haigis-L, Barrett True-K no-history formula, ASCRS average power, ASCRS maximum power on the ASCRS post-refractive calculator and the IOLMaster 700 Barrett True-K TK. Prediction error was calculated as the difference between the implanted IOL power and the predicted power by various formulae available on ASCRS online calculator.
Forty post-myopic laser-refractive surgery eyes of 26 patients were included. Friedman's test revealed that Shammas formula, Barrett True-K, and ASCRS maximum power were significantly different from all other formulas (P < 0.00001 for each). Median absolute error (MedAE) was the least for Shammas and Barrett True-K TK formulas (0.28 [0.14, 0.36] and 0.28 [0.21, 0.39], respectively) and the highest for Wang-Koch-Maloney (1.29 [0.97, 1.61]). Shammas formula had the least variance (0.14), while Wang-Koch-Maloney formula had the maximum variance (2.66).
In post-myopic laser refractive surgery eyes, Shammas formula and Barrett True-K TK no-history formula on ASCRS calculator are more accurate in predicting IOL powers.
Shetty N
,Sathe P
,Aishwarya
,Francis M
,Shetty R
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Comparison of intraocular lens power calculation methods after myopic laser refractive surgery without previous refractive surgery data.
To compare the accuracy of intraocular lens (IOL) power calculation methods for post-myopic excimer laser surgery patients without previous refractive surgery data using the Holladay IOL Consultant Program and the American Society of Cataract and Refractive Surgery (ASCRS) IOL Power Calculator.
Wang Vision Cataract and LASIK Center, Nashville, Tennessee, USA.
Case series.
Eight methods were used to calculate IOL power: Holladay 2 partial coherence interferometry (PCI)-K, Holladay 2 FlatK, Wang-Koch-Maloney, Shammas No-History, Haigis-L, ASCRS-Average, ASCRS-Min, and ASCRS-Max. The optimum IOL power corresponding to the target refraction was back-calculated using the stable post-cataract surgery refraction and implanted IOL power. Using the optimum IOL power, the predicted IOL power error and the resultant refractive error with each method were calculated and compared.
The Holladay 2 FlatK method was most accurate for IOL power calculation, followed by the Holladay 2 PCI-K, ASCRS-Min, Wang-Koch-Maloney, ASCRS-Average, Shammas No-History, Haigis-L, and ASCRS-Max. Statistically significant differences were observed between Holladay 2 FlatK and Holladay 2 PCI-K (P<.05), Wang-Koch-Maloney and ASCRS-Average (P<.05), and Haigis-L and ASCRS-Max (P<.01). No statistically significant differences were observed between the Holladay 2 PCI-K, ASCRS-Min, and Wang-Koch-Maloney or between the ASCRS-Average, Shammas No-History, and Haigis-L (both P>.05).
The Holladay 2 FlatK method provided the most accurate IOL power in eyes without previous myopic laser surgery data. If the Holladay IOL Consultant Program is unavailable, the ASCRS methods can be used; the ASCRS-Min represents the most accurate method.
Yang R
,Yeh A
,George MR
,Rahman M
,Boerman H
,Wang M
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Comparison of Newer Intraocular Lens Power Calculation Methods for Eyes after Corneal Refractive Surgery.
To compare the newer formulae, the optical coherence tomography (OCT)-based intraocular lens (IOL) power formula (OCT formula) and the Barrett True-K formula (True-K), with the methods on the American Society of Cataract and Refractive Surgery (ASCRS) calculator in eyes with previous myopic LASIK/photorefractive keratectomy (PRK).
Prospective case series.
A total of 104 eyes of 80 patients who had previous myopic LASIK/PRK and subsequent cataract surgery and IOL implantation.
By using the actual refraction after cataract surgery as target refraction, predicted IOL power for each method was calculated. The IOL prediction error (PE) was obtained by subtracting the predicted IOL power from the power of the IOL implanted.
Arithmetic IOL PEs, variances of mean arithmetic IOL PE, median refractive PE, and percent of eyes within 0.5 diopters (D) and 1.0 D of refractive PE.
Optical coherence tomography produced smaller variance of IOL PE than did Wang-Koch-Maloney (WKM) and Shammas (P < 0.05). With the OCT, True-K No History, WKM, Shammas, Haigis-L, and Average of these 5 formulas, the median refractive PEs were 0.35 D, 0.42 D, 0.51 D, 0.48 D, 0.39 D, and 0.35 D, respectively, the percentage of eyes within 0.5 D of refractive PE were 68.3%, 58.7%, 50.0%, 52.9%, 55.8%, and 67.3%, respectively, and the percentage of eyes within 1.0 D of refractive PE were 92.3%, 90.4%, 86.9%, 88.5%, 90.4%, and 94.2%, respectively. The OCT formula had smaller refractive PE compared with the WKM and Shammas, and the Average approach produced significantly smaller refractive PE than all methods except OCT (all P < 0.05).
The OCT and True-K No History are promising formulas. The ASCRS IOL calculator has been updated to include the OCT and Barrett True K formulas.
Intraocular Lens Power Calculation After Laser Refractive Surgery Based on Optical Coherence Tomography (OCT IOL); Identifier: NCT00532051; www.ClinicalTrials.gov.
Wang L
,Tang M
,Huang D
,Weikert MP
,Koch DD
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Accuracy of the Barrett True-K formula for intraocular lens power prediction after laser in situ keratomileusis or photorefractive keratectomy for myopia.
To compare the accuracy of the Barrett True-K formula with other methods available on the American Society of Cataract and Refractive Surgery (ASCRS) post-refractive surgery intraocular lens (IOL) power calculator for the prediction of IOL power after previous myopic laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK).
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, and private practice, Mesa, Arizona, USA.
Retrospective case series.
The accuracy of the Barrett True-K formula was compared with the Adjusted Atlas (4.0 mm zone), Masket, modified-Masket, Wang-Koch-Maloney, Shammas, and Haigis-L methods to calculate IOL power. A separate analysis of 2 no-history methods (Shammas and Haigis-L) was performed and compared with the Barrett True-K no-history option.
Eighty-eight eyes were available for analysis. The Barrett True-K formula had a significantly smaller median absolute refraction prediction error than all other formulas except the Masket, smaller variances compared with the Wang-Koch-Maloney, Shammas, and Haigis-L, and a greater percentage of eyes within ±0.50 diopter (D) of predicted error in refraction compared with the Adjusted Atlas, Masket, and modified Masket methods (all P < .05). In eyes with no historical data, the Barrett True-K no-history formula had a significantly smaller median absolute refraction prediction error and a greater percentage of eyes within ±0.50 D of the predicted error in refraction than the Shammas and the Haigis-L formulas (both P < .05).
The Barrett True-K formula was either equal to or better than alternative methods available on the ASCRS online calculator for predicting IOL power in eyes with previous myopic LASIK or PRK.
Abulafia A
,Hill WE
,Koch DD
,Wang L
,Barrett GD
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