Scientific correspondence
Accuracy of intraocular lens power calculation in paediatric
cataract surgery
C Tromansa b, P M Haighc, S Biswasa, I C Lloyda b
a Department of
Paediatric Ophthalmology, Royal Eye Hospital, Manchester, UK, b University Department of Ophthalmology, Royal
Eye Hospital, Manchester, UK, c Royal Shrewsbury Hospital, Shrewsbury, UK
Correspondence to: Mr Lloyd chrislloyd{at}wilmslow1.demon.co.uk
Accepted for publication 27 February 2001
AIMS
To determine the
accuracy of intraocular lens (IOL) power calculation in a group of
pseudophakic children.
METHODSA
retrospective analysis of biometric and refractive data was performed
on 52 eyes of 40 infants and children, who successfully underwent
cataract extraction and IOL implantation. The following parameters were
included: age at the time of surgery, keratometry, axial length,
estimated refraction, and the power of IOL implanted. The postoperative
refractive outcome was taken as the spherical equivalent of the
refraction at 3 months after surgery. The prediction error was taken as
the absolute difference between the estimated and actual postoperative
refraction. The data were analysed to assess the effects of age at the
time of surgery, keratometry, and axial length on the accuracy of
calculation of IOL power.
RESULTSFor the
overall group the mean and median prediction errors were 1.40 D and
0.84 D (SD 1.60). The mean and median prediction errors in eyes with
axial lengths 
20 mm were 1.07 D and 0.71 D (SD 0.98) and in
eyes <20 mm were 2.63 D and 2.61 D (SD 2.65). The mean and median
prediction errors in eyes in children aged 36 months were 1.06 D and
0.68 D (SD 1.02) and in children aged <36 months was 2.56 D and 2.29 D
(SD 2.50). The differences between the prediction errors for both axial
length and age were statistically significant (p<0.05).
CONCLUSIONSFor the
overall group IOL power calculation is satisfactory. In eyes with axial
lengths less than 20 mm and in children less than 36 months of age
larger errors can arise. This study demonstrates the need for an IOL
formula specifically designed for paediatric use.
© 2001 by British Journal of Ophthalmology
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