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Accuracy of common IOL power formulas in 611 eyes based on axial length and corneal power ranges
  1. Veronika Röggla1,
  2. Achim Langenbucher2,
  3. Christina Leydolt1,
  4. Daniel Schartmüller1,
  5. Luca Schwarzenbacher1,
  6. Claudette Abela-Formanek1,
  7. Rupert Menapace1
  1. 1 Department of Ophthalmology and Optometry, Medical University of Vienna, Austria
  2. 2 Institut Für Experimentelle Ophthalmologie, Saarland University, Saarbrucken, Germany
  1. Correspondence to Rupert Menapace, Ophthalmology, Medical University of Vienna, Spitalgasse 23, Wien 1090, Austria; rupert.menapace{at}


Aims To provide clinical guidance on the use of intraocular lens (IOL) power calculation formulas according to the biometric parameters.

Methods 611 eyes that underwent cataract surgery were retrospectively analysed in subgroups according to the axial length (AL) and corneal power (K). The predicted residual refractive error was calculated and compared to evaluate the accuracy of the following formulas: Haigis, Hoffer Q, Holladay 1 and SRK/T. Furthermore, the percentages of eyes with ≤±0.25, ≤±0.5 and 1 dioptres (D) of the prediction error were recorded.

Results The Haigis formula showed the highest percentage of cases with ≤0.5 D in eyes with a short AL and steep K (90%), average AL and steep cornea (73.2%) but also in long eyes with a flat and average K (65% and 72.7%, respectively). The Hoffer Q formula delivered the lowest median absolute error (MedAE) in short eyes with an average K (0.30 D) and Holladay 1 in short eyes with a steep K (Holladay 1 0.24 D). SRK/T presented the highest percentage of cases with ≤0.5 D in average long eyes with a flat and average K (80.5% and 68.1%, respectively) and the lowest MedAE in long eyes with an average K (0.29 D).

Conclusion Overall, the Haigis formula shows accurate results in most subgroups. However, attention must be paid to the axial eye length as well as the corneal power when choosing the appropriate formula to calculate an IOL power, especially in eyes with an unusual biometry.

  • Clinical Trial
  • Optics and Refraction
  • Treatment Surgery

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  • Contributors Concept and design of the study: CL, RM and VR. Data acquisition: DS, LS and CA-F. Data analysis/interpretation: VR and AL. Drafting the manuscript: CL, RM and VR. Critical revision of manuscript: CL, CA-F, DS and RM. Administrative, technical or material support: VR, DS, LS, CL, CA-F and RM. Supervision: CL and RM. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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