Comparison of intraocular lens power formulas for negative diopter intraocular lens implantation for high myopia

Purpose: To compare the accuracy of intraocular lens (IOL) power calculation formulas for myopic eyes requiring negative diopter-powered IOLs. Design: Retrospective case series. Setting: Kim's Eye Hospital, College of Medicine, Konyang University, Seoul, South Korea and Yeouido St. Mary Hospital, Seoul, South Korea. Methods: 61 eyes that underwent phacoemulsification with implantation of a negative power IOL were investigated. The trueness, precision, and accuracy of IOL power calculation were assessed for the Barrett Universal II (BUII), EVO 2.0, Haigis, Hoffer QST, Holladay 1, and SRK/T formulas using the Eyetemis online tool. The analysis was performed using (1) the ULIB IOL constants and (2) after constant optimization. Results: With ULIB constants, the Haigis, Holladay 1, and SRK/T resulted in a hyperopic mean prediction error (PE) >1.00 diopter (D), which was significantly different from zero (adjusted P < .05). The mean PE of the remaining formulas was closer to zero. The absolute PE was significantly higher with the Holladay 1 and SRK/T (adjusted P < .05) with respect to the remaining formulas. After constant optimization, the outcomes of traditional formulas improved and no statistically significant differences were found among any of the formulas in trueness, precision, and accuracy. The percentage of eyes with an absolute PE within 0.50 D was low (<50%) even after constant optimization. Conclusions: With ULIB constants, the BUII, EVO 2.0, and Hoffer QST were more accurate than traditional formulas in eyes with negative diopter IOLs. The results of IOL power calculation in these eyes remain poor even after constant optimization.