Accuracy of Intraocular Lens Power Calculation Formulas in Myopic Eyes with Target Refractions of Emmetropia and Intentional Myopia

Daiki Sakai,1– 3 Yasuhiko Hirami,1,2 Makoto Nakamura,3 Yasuo Kurimoto1,2 1Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan; 2Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Japan; 3Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, JapanCorrespondence: Daiki SakaiDepartment of Ophthalmology, Kobe City Eye Hospital, 2-1-8 Minatojima Minamimachi, Chuo-ku, Kobe-shi, Hyogo, 650-0047, JapanTel +81-78-381-9876Fax +81-78-381-9910Email dsakai1027@gmail.comPurpose: To compare the accuracy of the intraocular lens (IOL) power calculation formulas for predicting the postoperative refraction in eyes with a target of emmetropia or intentional myopia.Patients and Methods: This is a retrospective study conducted at Kobe City Eye Hospital, Kobe, Japan. Fifty eyes of 50 patients with axial myopia who underwent uncomplicated phacoemulsification and single-type IOL implantation for a target of emmetropia (plano to − 0.5 D) or intentional myopia (− 2.0 D to − 3.0 D) were selected. Preoperative ocular biometry was performed using IOLMaster700 in all eyes. Refractive prediction errors of 6 IOL formulas integrated into IOLMaster700 were compared between eyes with a target of emmetropia and intentional myopia.Results: The mean numerical errors of SRK/T (Sanders, Retzlaff, and Kraft/theoretical), Holladay 1, Hoffer Q, and Holladay 2 significantly differed between the two groups (p < 0.001, p = 0.008, 0.02, and 0.007, respectively). The values for mean numerical errors in eyes with a target of intentional myopia were smaller, showing relatively myopic outcome, as compared with those in eyes with a target of emmetropia. In eyes with a target of emmetropia, the mean numerical errors of Holladay 1 (p < 0.001, 95% confidence interval [CI]: 0.32 to 0.63), Hoffer Q (p = 0.001, 95% CI: 0.12 to 0.42), and Barrett Universal II (p = 0.007, 95% CI: 0.06 to 0.35) were significantly different from zero (hyperopic trend). Furthermore, in eyes with a target of intentional myopia, the mean numerical error of SRK/T (p = 0.001, 95% CI: − 0.61 to − 0.17) and Holladay 2 (p = 0.023, 95% CI: − 0.43 to − 0.04) were significantly different from zero (myopic trend).Conclusion: In patients with axial myopia, some IOL formulas may show a myopic trend in the refractive outcome when targeting intentional myopia as compared to emmetropia.Keywords: cataract surgery, postoperative refraction, intentional myopia, axial myopia, IOLMaster70