Accuracy of intraocular lens power calculation in patients with endothelial dystrophy without edema

Purpose: To evaluate the accuracy of several intraocular lens (IOL) formulas for patients with endothelial dystrophy (ED) without edema treated with cataract surgery alone Setting: One academic, tertiary referral center. Design: Comparative retrospective cohort study. Methods: We assessed the predicted refractive results of ED patients who underwent cataract surgery and compared them to a matched control group. The accuracy of five different IOL formulas Haigis, Holladay 1, Barrett Universal II, SRK/T and Kane was evaluated and compared between the groups. The standard deviations of the prediction error of all formulas were compared. Results: The study included 221 eyes. Fifty (23%) eyes of patients with ED and 171 (77%) control eyes. There was no significant difference between the two groups in clinical and demographical characteristics (P>0.05). The postoperative spherical equivalent was -0.37 D in the ED group and -0.30 D in the control group (P=0.8). Overall, both groups had a comparable standard deviation of the prediction error (PE) and absolute PE (APE) in all formulas (p>0.05). In the ED group, APE was 0.34 D for Haigis, 0.32 D for Holladay1, 0.32 D for Barrett Universal II, 0.38 D for SRK/T and 0.32 D for Kane formulas. No statistically significant difference between formulas was found. Conclusion: The prediction accuracy of IOL power calculation in patients with ED was found comparable both between formulas and in comparison with healthy controls. This suggests that in patients with guttate without edema the IOL power calculations are as effective and accurate as in healthy eyes.