Comparison of IOL formula accuracy for eyes with prior scleral buckle surgery.

Abstract

Purpose: To compare intraocular lens (IOL) formula prediction accuracy for patients with previous scleral buckling surgery.

Setting: Single academic center in Los Angeles, California.

Design: Retrospective study.

Methods: Patients who had cataract extraction following scleral buckle surgery from 2014 to 2024 were included. The spherical equivalent prediction error (SEQ-PE) from Barrett Universal II (BUII), Hoffer QST, Holladay 1, Kane, RBF 3.0, and SRK/T was evaluated. The Wang-Koch adjusted (WKA) axial lengths were used for eyes >25.0 mm for the Holladay 1 and SRK/T formulas. Analysis was done with Eyetemis, an online software designed to compare the accuracy, precision, and trueness of the SEQ-PE.

Results: 79 eyes from 77 patients were included. The 6 formulas showed similar accuracy, with no statistically significant differences for pairwise comparisons of the absolute SEQ-PE, which ranged between 0.33 D (±0.52 D) for the Holladay 1 and 0.42 D (±0.56 D) for the RBF 3.0 formulas, and for pairwise comparisons of the precision of SEQ-PE, except for the comparison between BUII and Hoffer QST. There was no significant difference in the absolute SEQ-PE within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D. Comparing the trueness of the SEQ-PE, BUII and Hoffer QST were hyperopic while Holladay 1 and SRK/T were myopic.

Conclusions: The formulas compared had similar accuracy of the absolute and precision SEQ-PE for eyes with scleral buckles. There was variability in the trueness of the 6 formulas, however. Therefore, surgeons should consider these trends for IOL selection in eyes with scleral buckles.