The purpose of this study was to compare the accuracy of several intraocular (IOL) lens power calculation formulas in long eyes. This was a single-site retrospective consecutive case series that reviewed patients with axial lengths (AL) > 28.0 mm who underwent phacoemulsification. The Wang–Koch (WK) adjustment and Cooke-modified axial length (CMAL) adjustment were applied to Holladay 1 and SRK/T. The median absolute error (MedAE) and the percentage of eyes with prediction errors ±0.25 diopters (D), ±0.50 D, ±0.75 D, and ±1.00 D were used to analyze the formula’s accuracy. This study comprised a total of 35 eyes from 25 patients. The Kane formula had the lowest MedAE of all the formulas, but all were comparable except Holladay 1, which had a significantly lower prediction accuracy with either AL adjustment. The SRK/T formula with the CMAL adjustment had the highest accuracy in predicting the formula outcome within ±0.50 D. The newer formulas (BU-II, EVO, Hill-RBF version 3.0, and Kane) were all equally predictable in long eyes. The SRK/T formula with the CMAL adjustment was comparable to these newer formulas with better outcomes than the WK adjustment. The Holladay 1 with either AL adjustment had the lowest predictive accuracy.

We thank Cioni et al. for their suggestions and comments [...]

(1) Background: Glaucoma is a leading cause of irreversible blindness worldwide. Unfortunately, no noticeable symptoms exist until mid- to late-stage glaucoma, leading to substantial costs to the patient and the healthcare system. (2) Methods: The Student Sight Savers Program, an initiative started at Johns Hopkins University, was designed to meet the needs of community screening for glaucoma. Several medical students at the Rocky Vista University in Saint George, Utah, were trained, and screened patients at local fairs and gathering places using a modified version of this program. Patients found to have elevated pressure (>21 mmHg) or other ocular abnormalities were referred for an ophthalmological examination. (3) Results: Individuals from medically underserved areas/populations (MUA/Ps) were nearly three times as likely to have elevated intraocular pressure as individuals not in underserved areas (p = 0.0141). A further analysis demonstrates that medical students can help reduce medical costs for patients and the healthcare system by providing referrals to ophthalmologists and reaching populations that are not usually screened for glaucoma. (4) Conclusions: Allowing medical students to perform community-based glaucoma screening events in MUA/Ps using handheld tonometers may decrease the cost burden associated with late diagnosis, and raise awareness about glaucoma, especially in underserved populations.