ESCRS - POCAT586 - Impact Of Vitreous Cavity Status On Intraocular Lens Calculation

Impact Of Vitreous Cavity Status On Intraocular Lens Calculation

Published 2026 - 44th Congress of the ESCRS

Reference: POCAT586 | Type: Free paper | DOI: 10.82333/6dvs-qr72

Authors: Dr Max Brinkmann* 1 , Jakob von Below 1 , Constantin Geis 2 , Sabrina Rhode 1 , Dr Klemens Kaiser 3 , A/Prof. Thomas Kohnen 3 , Dr Christoph Lwowski 3

1Ophthalmology,UKSH Lübeck ,Luebeck,Germany, 2Ophthalmology,Uni Heidelberg,Heidelberg,Germany, 3Ophthalmology,Goethe University,Frankfurt,Germany

Purpose

To evaluate formulas for intraocular lens (IOL) calculation in post vitrectomy eyes with intraocular fluid fill of the vitreous cavity.

Setting

Two center, retrospective, consecutive case series. Department of Ophthalmology, Goethe University Frankfurt and Department of Ophthalmology, University Clinic Lübeck.

Methods

We included post vitrectomy eyes that are filled with intraocular fluid and received phacoemulsification and IOL implantation into the capsular bag. Preoperative assessments included biometry (IOLMaster 700, Carl Zeiss Meditec, Germany). To evaluate the measurements, we report the mean prediction error (MPE), and compared mean and median absolute prediction error (MAE, MedAE), and number of eyes within a certain range (±0.5D, ±1.0D, ±2.0D) from target refraction calculated by ten different formulas.

Results

Our preliminary data includes 39 eyes from Frankfurt that matched our inclusion criteria. MedAE was lowest in the Barrett-Universal II formula (0.55D ± 0.66) followed by LADAS (0.57D ± 0.64), Hoffer QST (0.59D ± 0.64), Pearl DGS, RBF and Kane (each 0.61D ± 0.61 to 0.64), EVO  (0.62D ± 0.62), Cooke K6 (0.65D ± 0.61), LISA PPV (0.76D ± 0.71), and Haigis (0.9D ± 0.65). Regarding eyes within ±0.5D Barrett Universal II (46%, 18 eyes) performed best, followed by Pearl DGS (43%, 17 eyes) and LADAS (41%, 16 eyes).  Interestingly, eyes using the “vitreous mode” of the IOL Master tended to a lower MedAE compared to those being measured with “post-vitrectomy” mode for most formulas. Data from Lübeck is currently being collected.

Conclusions

Using modern formulas for IOL calculation in post vitrectomy eyes improves predictability but still not as good as in unoperated eyes. This issue is due to the change in refractive index by the fluid fill of the vitreous cavity and therefore a lower precision of axial length measurement and effect lens position prediction.