Intraocular lens power calculation formula in congenital cataracts: Are we using the correct formula for pediatric eyes?

Abstract

The major challenge these days in pediatric cataract surgery is not the technique of surgery or intraocular lens (IOL) used but the postoperative refractive error. Amblyopia occurring due to postoperative refractive error which the child has; destroys the benefit obtained by a near-perfect and timely surgery. Even if we settle the debate as to what should be the ideal postoperative target refraction, there is a postoperative surprise that is not explained by our conventional insights of an accurate power calculation in children. The role of IOL power calculation formulae in affecting the postoperative refractive error should not be underestimated. Therefore, which age-appropriate formula is to be used for children is unclear. This review is an update on major IOL power calculation formulas used in pediatric eyes. We have tried to define why we should not be using these formulas made for adult eyes and review the literature in this regard.

Response to comments on: Visual outcomes following cataract surgery with intraocular lens implantation in vitrectomized eyes among children

“…This finding only underlines the suboptimal accuracy of all IOL formulae in pediatric eyes and absence of clear guidelines. [ 2 ] The authors point out that our results could be biased due to the choice of IOL used. As this is a retrospective study involving several surgeons, difference in IOL models cannot be completely avoided.…”

“…This finding only underlines the suboptimal accuracy of all IOL formulae in pediatric eyes and absence of clear guidelines. [ 2 ]…”