Comparative Accuracy Of Intraocular Lens Power Calculation Formulas In Patients With Age-Related Macular Degeneration

To compare the predictive performance of three widely used intraocular lens (IOL) power calculation formulas in eyes with age-related macular degeneration undergoing cataract surgery.

Department of Ophthalmology, The Catholic University of Korea Uijeongbu St. Mary's Hospital, Uijeongbu, South Korea.

This retrospective study included 144 eyes of 87 patients with AMD who underwent cataract surgery between January 2019 and October 2025. Postoperative refraction (2–4 months) was compared with predicted refraction calculated using the Barrett Universal II, Kane, and SRK/T formulas. Mean prediction error (ME), mean absolute error (MAE), and median absolute error (MedAE) were compared. Subgroup analyses were performed according to AMD subtype, central macular thickness (CMT), and presence of foveal fluid on OCT.

ME was -0.01 D for Barrett Universal II, -0.14 D for Kane, and -0.18 D for SRK/T, with Barrett showing significantly less myopic tendency compared with SRK/T (P = 0.05). MAE was 0.57 D, 0.58 D, and 0.60 D, respectively, with no significant differences. When comparing neovascular AMD with dry/normal eyes, ME showed a significant myopic shift in neovascular AMD across all three formulas (Barrett: +0.28 D vs -0.14 D; Kane: +0.15 D vs -0.27 D; SRK/T: +0.11 D vs -0.32 D; all P < 0.001). Prediction error was not associated with CMT or the presence of subretinal/intraretinal fluid on OCT.

In neovascular AMD, commonly used IOL power calculation formulas demonstrated a consistent postoperative myopic shift despite similar absolute errors. Surgeons should consider this tendency when selecting IOL power in these patients. Preoperative OCT findings did not significantly influence refractive prediction accuracy.