ESCRS - PO436 - Use Of The Holladay Report In Third-Generation Formulas For Intraocular Lens Calculations With Elevated Keratometry

Use Of The Holladay Report In Third-Generation Formulas For Intraocular Lens Calculations With Elevated Keratometry

Published 2024 - 42nd Congress of the ESCRS

Reference: PO436 | Type: Poster | DOI: 10.82333/7shb-0184

Authors: Anne Samilet León Valle* 1

1Segmento anterior,Hospital Fundación Nuestra Señora de la Luz,Ciudad de México,Mexico

Purpose

General Objective: To determine the accuracy in intraocular lens calculation using keratometry with the Holladay Equivalent vs. simulated anterior curvature keratometry of Pentacam® AXL and IOL Master 700.

 

Specific Objectives:

  1. Measure the absolute predictive error in each formula using the keratometric measurements of each system.
  2. Determine the median of the absolute predictive error using the keratometric measurements of each system.
  3. Stratify the accuracy of the absolute error.
  4. Compare the results of the three different methods.
 

Setting

The use of third-generation formulas considers biometric measurements such as axial length and keratometry. Choosing the best instrument for measurement becomes crucial. The Holladay Report gains significance in obtaining measurements by taking into account both anterior and posterior corneal curvatures.

To our knowledge, there are no studies to date that predict the significance of using the Holladay Equivalent in corneas not considered pathological but with elevated keratometry.

Methods

Prospective, longitudinal, observational, and descriptive study. Population: Patients of any gender, over the age of 18. n=18

Inclusion: Paients with adequate fixation despite senile cataract, eligible for cataract surgery, keratometry readings greater than 45D, astigmatism equal to or less than 1.5.

Exclusion; Prior ophthalmological surgical treatment, abnormalities on the ocular surface such as corneal scars, pterygium, etc, criteria for corneal ectasia, astigmatism greater than 1.5D.

Variables:

Predicted error (PE) with SRK/T, Holladay I, Hoffer Q formula using Holladay Equivalent.

PE SRK/T, Holladay I, Hoffer Q formula using simulated keratometry from anterior curvature map.

PE SRK/T, Holladay I, Hoffer Q formula using IOL Master700.

Results

62 patients, the median measured astigmatism was found to be 0.61. Significant differences were observed in keratometric variables (K1, K2, and Km) among three different methods, with a p-value < 0.001.

The comparison of three measuring instruments for intraocular lens calculation and predicted refractive error, using the Friedman Test, revealed a statistically significant difference in lens calculation averages across the three methods for the same patient. However, there was no statistical significance in the predicted refractive error.

Additionally, when comparing prediction error and absolute error using the Kruskal-Wallis test for the three instruments and three formulas, the results did not show statistically significant differences.

Conclusions

Despite finding a statistically significant difference in the measurement of keratometry with the equivalent keratometry readings and simulated keratometry from the anterior curvature vs. IOL Master 700, this difference does not translate into statistical significance for lens calculation and predicted error with the three selected formulas for elevated keratometry without ectasia criteria or modifications from surgical procedures. This leads to the conclusion that the three formulas result in adequate prediction in patients with these characteristics. Although there is a difference in intraocular lens calculation when analyzing the results for each patient, this does not result in a predicted error with statistically significant changes.