Accuracy of theoretical IOL formulas for Panoptix intraocular lens according to axial length

Abstract

The accuracy of intraocular lens (IOL) calculations is suboptimal for long or short eyes, which results in a low visual quality after multifocal IOL implantation. The purpose of the present study is to evaluate the accuracy of IOL formulas (Barrett Universal II, SRK/T, Holladay 1, Hoffer Q, and Haigis) for the Acrysof IQ Panoptix TFNT IOL (Alcon Laboratories, Inc, Fort Worth, Texas, United States) implantation based on the axial length (AXL) from a large cohort of 2018 cases and identify the factors that are associated with a high mean absolute error (MAE). The Barrett Universal II showed the lowest MAE in the normal AXL group (0.30 ± 0.23), whereas the Holladay 1 and Hoffer Q showed the lowest MAE in the short AXL group (0.32 ± 0.22 D and 0.32 ± 0.21 D, respectively). The Haigis showed the lowest MAE in the long AXL group (0.24 ± 0.19 D). The Barrett Universal II did not perform well in short AXL eyes with higher astigmatism (P = 0.013), wider white-to-white (WTW; P < 0.001), and shorter AXL (P = 0.016). Study results suggest that the Barrett Universal II performed best for the TFNT IOL in the overall study population, except for the eyes with short AXL, particularly when the eyes had higher astigmatism, wider WTW, and shorter AXL.

Evaluation of Refractive Accuracy of ORA and the Factors Impacting Residual Astigmatism in Patients Implanted with Trifocal IOLs During Cataract Surgery: A Retrospective Observational Study

“…It has been previously reported that among power calculation formulas, the Barrett Universal II formula performed the best for TFNT IOLs in the overall study population, except for eyes with a short axial length, particularly when they had higher astigmatism, wider white-to-white corneal diameter, and shorter axial length. 20 Another study reported that RPE tended to be within ±0.25 D for most eyes analyzed using the Haigis formula and within ±0.50 D for all eyes analyzed using the Barrett Universal II formula among eyes with an axial length between 22.0 mm and 24.5 mm. 21 …”

“…It has been previously reported that among power calculation formulas, the Barrett Universal II formula performed the best for TFNT IOLs in the overall study population, except for eyes with a short axial length, particularly when they had higher astigmatism, wider white-to-white corneal diameter, and shorter axial length. 20 Another study reported that RPE tended to be within ±0.25 D for most eyes analyzed using the Haigis formula and within ±0.50 D for all eyes analyzed using the Barrett Universal II formula among eyes with an axial length between 22.0 mm and 24.5 mm. 21 In this study, we estimated the preoperative RPE for 180 eyes using three well-known IOL power formulas, including the third-generation SRK/T formula and the fourth-generation Barrett Universal II and Haigis formulas, and compared them with the intraoperative prediction of ORA to determine the most suitable method for IOL power selection in eyes with TFNT lenses.…”

Risk Factor for Transient Hyperopic Refractive Outcome at Acute Postoperative Period After Panoptix Intraocular Lens Implantation

“…Results also suggest that the large WTW diameter in short eyes was associated with a greater prediction error when using the Barrett Universal II formula, which is one of the most accurate IOL formulas available thus far. 11 This led us to two potential reasons why the SE during the acute postoperative period was more hyperopic than expected: (1) a real prediction error or (2) a transient hyperopic state. The distinction between these two possibilities is critical when the surgery of the other eye has to be planned immediately, as many surgeons determine the target diopter of fellow eye according to the refractive outcome of the operative eye.…”

“…16 The accuracy of the modern IOL formula when using a TFNT IOL is favorable. 11 Although the absolute refractive difference between that measured on postoperative day 1 and postoperative month 6 was as small as 0.08 D, the largest amount of the refractive difference was 1.53 D. Because even a small amount of postoperative refractive error can significantly affect visual outcome and patient satisfaction, it would be helpful to discriminate those patients at risk of a transient hyperopic state. This analysis was limited to TFNT IOLs; therefore, the results could not be extended to other types of IOLs.…”

“… 9 We found in previous studies that the modern theoretical IOL formulas predicted myopic refractive outcomes after TFNL IOL implantation in hyperopic eyes, particularly when there was deviation from standard ocular parameters, such as a large white-to-white (WTW) corneal diameter in eyes with short AL. 11 In addition to those cases that resulted in an inaccurate prediction of postoperative refraction, there are a certain proportion of patients who experience transient hyperopia during the acute postoperative period and then return to the targeted refraction over the long term. It is important to distinguish patients with transient hyperopia from patients with inaccurate IOL calculation when deciding on the target refractive power of the other eye.…”