Accuracy of the refractive prediction determined by multiple currently available intraocular lens power calculation formulas in small eyes

PURPOSE: To observe the refractive outcomes of cataract surgery in small adult eyes, and to investigate the accuracy of different intraocular lens (IOL) power prediction formulas.DESIGN: Retrospective interventional case series.METHODS: We included consecutive small eyes undergoing uneventful phacoemulsification cataract surgery with a single highly powerful IOL (Acrysof SA60AT) implanted in the capsular bag (range of powers +35.0 to +40.0 diopters [D]), at the Cataract Centre for Moorfields Eye Hospital. Exclusion criteria were combined or previous intraocular surgical procedures, and any type of intraoperative complications. Main outcome measures were mean prediction errors with Hoffer Q, Holladay 1, Holladay 2, Haigis, SRK-T, and SRK-II IOL power prediction formulas and proportions of eyes achieving absolute errors within the dioptric ranges of 0.5, 1.0, and 2.0 D of target and emmetropia, respectively. The ANOVA test was used to compare the refractive results among various formulas.RESULTS: Twenty-eight eyes were studied; the mean numerical error was 0.22 +/- 1.22 D and the mean absolute error was 0.95 +/- 0.78 D with the adopted Hoffer Q formula; 39%, 61%, and 89% of the eyes had a final refraction within 0.5 D, 1.0 D, and 2.0 D of target, respectively. None of the latest-generation formulas significantly outperformed the others (P = .245).CONCLUSIONS: The Hoffer Q formula led to good or fair refractive outcomes in less than two thirds of the cases. With Holladay 1 and 2 and Haigis formulas, outcomes would have not been significantly different. The SRK formulas yielded less accurate predictions. Possible reasons are discussed. (C) 2015 Elsevier Inc. All rights reserve

Cataract surgery in small adult eyes

Aim To evaluate the clinical outcomes of phacoemulsification cataract surgery in microphthalmos.Methods Retrospective consecutive case series of eyes with axial length <20.9 mm, and requiring a high intraocular lens (IOL) power (>= 30 or >= 35 dioptres for anterior or posterior chamber fixation, respectively), with no history of previous ocular surgery, and undergoing planned phacoemulsification cataract surgery with IOL implantation at Moorfields Eye Hospital was investigated to observe the incidence of intraoperative and postoperative complications.Results During a 5-year study period, 47 of 22 093 eyes were treated in two locations (0.21%). Thirty-nine eyes met the study inclusion criteria. No serious intraoperative adverse events were recorded. Severe postoperative complications (retinal detachment and chronic postoperative uveitis) occurred in two cases. The postoperative corrected distance visual acuity (CDVA) was logMAR 0.30 or better in 24 eyes (62%), and only three eyes obtained worse vision. The overall ocular comorbitidy rate was 53%; 10 microphthalmic eyes (26%) presented with associated congenital or hereditary pathology, and had worse visual outcomes (p<0.0001).Conclusions Microphthalmic eyes requiring high IOL power are rare, and their presence is often associated with other ocular congenital or acquired disorders. Overall, the clinical outcomes were satisfactory and the surgical procedure affected by a low complication rate