Improving effective lens position prediction for secondary intraocular lens implantation in pediatric aphakic eyes.

PURPOSE: To improve the accuracy of refractive prediction for pediatric secondary sulcus intraocular lens (IOL) implantation by optimizing the effective lens position (ELP) prediction within the SRK/T formula.

SETTING

Zhongshan Ophthalmic Center, Guangzhou, China.

DESIGN

Retrospective consecutive case-series.

METHODS

The value of sulcus-ELP was identified by linear regression formula with utilizing back-calculated ELP. The obtained sulcus-ELP was subsequently incorporated into the original SRK/T formula, then creating the sulcus-SRK/T formula. The prediction accuracy of sulcus-SRK/T formula was compared with six formulas. Main outcome measures included prediction error (PE), mean error (ME), median absolute error (MedAE), and the percentage of eyes with prediction error within ±0.50 diopters (D) and ±1.00 D.

RESULTS

This study included 86 pediatric patients (131 eyes) who underwent secondary ciliary sulcus IOL implantation. With the modified formula, the percentages of eyes achieving the prediction error (PE) within ±0.50 D and ±1.00 D were 25.6% and 53.9%, respectively, significantly higher than those of other formulas. The mean error (ME) of the modified formula was 0.46±1.39 D, and the modified formula showed lower median absolute error (MedAE) (0.95 D, P < .05) than other formulas.

CONCLUSIONS

By optimizing ELP prediction of the SRK/T formula, the prediction accuracy of pediatric secondary sulcus IOL implantation has been improved. The sulcus-SRK/T formula is a worthwhile choice and requires further external validation to confirm its effectiveness.