RT Journal Article
SR Electronic
T1 Refractive accuracy in eyes undergoing combined cataract extraction and Descemet membrane endothelial keratoplasty
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP bjophthalmol-2020-317247
DO 10.1136/bjophthalmol-2020-317247
A1 Jack A Campbell
A1 John G Ladas
A1 Kendrick Wang
A1 Fasika Woreta
A1 Divya Srikumaran
YR 2021
UL http://bjo.bmj.com/content/early/2021/01/06/bjophthalmol-2020-317247.abstract
AB Purpose To evaluate the refractive accuracy of current intraocular lens (IOL) formulas and propose a modification in calculation of corneal power in eyes undergoing combined cataract extraction and Descemet membrane endothelial keratoplasty (DMEK).Design Retrospective cohort study.Methods Patients with Fuchs endothelial corneal dystrophy undergoing uncomplicated combined cataract surgery and DMEK at a single institution were included. The Hoffer Q, SRK/T, Holladay I, Barrett Universal II and Haigis formulas were compared. A modified corneal power was calculated using a thick lens equation based on anterior and posterior corneal radii and corneal thickness from Pentacam imaging. Error calculations were adjusted based on the difference in optical biometry and the modified corneal power. Mean absolute error (MAE) for each formula was compared between the corneal power modification and optical biometry corneal power.Results In 86 eyes, the mean error ranged from 0.90 D for the Barrett Universal II formula to −0.10 D for the Haigis formula, with 4 of 5 formulas resulting in a mean hyperopic error. The corneal power modification resulted in a significantly lower MAE for the Hoffer Q (0.82 D), Holladay I (0.85 D), SRK/T (0.85 D) and Barrett Universal II (0.90 D) formulas compared with optical biometry corneal power for the Hoffer Q (1.02 D; p<0.005), Holladay I (0.97 D; p<0.005), SRK/T (0.93 D; p<0.01) and Barrett Universal II (1.16 D; p<0.005) formulas.Conclusions All formulas except the Haigis formula resulted in a hyperopic error. The corneal power modification significantly reduced error in four out of five IOL formulas.