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. 2025 Jan 16;25(1):21.
doi: 10.1186/s12886-024-03793-z.

Intraocular lens calculation formula selection for short eyes: based on axial length and anterior chamber depth

Ruoxi Gao #  1 , Jiaqing Zhang #  1 , Xiaotong Han  1 , Yiguo Huang  2 , Ruoxuan Huang  2 , Jinfeng Ye  2 , Ling Wen  2 , Xiaozhang Qiu  1 , Xiaoyun Chen  1 , Xuhua Tan  3 , Lixia Luo  4
Affiliations

Intraocular lens calculation formula selection for short eyes: based on axial length and anterior chamber depth

Ruoxi Gao et al. BMC Ophthalmol. .

Abstract

Purpose: To evaluate the predictive accuracy of 11 intraocular lens (IOL) calculation formulas in eyes with an axial length (AL) less than 22.00 mm.

Methods: New-generation formulas (Barrett Universal II [BUII], Emmetropia Verifying Optical [EVO] 2.0, Hill-Radial Basis Function [Hill-RBF] 3.0, Hoffer QST, K6, Kane, Pearl-DGS) and traditional formulas (Haigis, Hoffer Q, Holladay 1 and SRK/T) were evaluated for predictive accuracy. Subgroup analyses were performed based on AL and anterior chamber depth (ACD).

Results: The study enrolled a total of 184 eyes from 184 patients. The BUII, Hoffer QST, Hoffer Q, Holladay 1, and SRK/T showed myopic shifts (-0.49 to -0.18 diopters [D], P < 0.05), whereas K6 displayed a hyperopic shift (0.11 D, P = 0.03). The Kane exhibited no systematic bias (-0.07 D), and yielded lower mean absolute error (MAE) (0.48 D, P < 0.05) and root mean square absolute error (RMSAE) (0.65 D, P < 0.01). For eyes with an AL ≤ 21.5 mm and an ACD > 2.5 mm, the Pearl-DGS displayed the smallest MAE (0.43 D) and lowest RMSAE (0.57 D), while other new-generation formulas showed relatively worse performance (MAE: 0.46 to 0.67 D; RMSAE: 0.60 to 0.84 D).

Conclusion: The Kane formula showed the highest accuracy in short eyes, whereas the Pearl-DGS had superior performance in eyes with a relatively shorter AL and deeper ACD.

Clinical trial number: Not applicable.

Keywords: Anterior chamber depth; Axial length; IOL calculation; Short eyes.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This retrospective study was approved by the Institutional Review Board of Zhongshan Ophthalmic Center and adhered to the tenets of the Declaration of Helsinki. Informed consent was waived, as only medical records were involved. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Box plots showing the absolute prediction error of intraocular lens calculation formulas. Orange boxes represent the second quartile, and blue boxes represent the third quartile *P < 0.05, **P < 0.01 BUII = Barrett Universal II formula; EVO 2.0 = Emmetropia Verifying Optical formula version 2.0; Hill-RBF 3.0 = Hill-Radial Basis Function formula version 3.0
Fig. 2
Fig. 2
Stacked histogram showing percentage of eyes within ± 0.25 diopters (D), ± 0.50 D, ± 0.75 D, ± 1.0 D, and > 1.0 D range of prediction error. BUII = Barrett Universal II formula; EVO 2.0 = Emmetropia Verifying Optical formula version 2.0; Hill-RBF 3.0 = Hill-Radial Basis Function formula version 3.0
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