Global Perspectives On Intraocular Lens Power Calculation And Preoperative Assessment In Cataract Surgery
Published 2026 - 44th Congress of the ESCRS
Reference: PP18.12 | Type: Free paper | DOI: 10.82333/x9fx-pf79
Authors: Mr Michael Cheng 1 , Dr Karanpreet Singh Multani 1 , Dr Jascha Wendelstein 2 , Dr Fasika Woreta 3 , Dr Kamran Riaz* 1
1Ophthalmology,Dean McGee Eye Institute,Oklahoma City,United States, 2Ophthalmology,Institut für Refraktive und Ophthalmo-Chirurgie (IROC),Zurich,Switzerland, 3Ophthalmology,Wilmer Eye Institute, Johns Hopkins University,Baltimore,United States
Purpose
To characterize global decision-making patterns in intraocular lens (IOL) power calculation among cataract surgeons, including formula selection and diagnostic technologies used in routine and complex eyes.
Setting
Cross-sectional observational study.
Methods
Cross-sectional observational study of a 29-item survey conducted between October 2023 and October 2024. Survey items assessed demographics, biometry and imaging use, IOL calculation strategies for routine and complex eyes (e.g., long or short axial length [AL], post–myopic laser vision correction [M-LVC]), intraoperative aberrometry (IOA), and adoption of online planning tools. Analyses were limited to respondents for each item. Subgroup comparisons were performed by gender, geographic region, practice setting, fellowship training, and years in practice.
Results
228 responses were included (response rate 22.8%), with 67.1% from North America. In routine cases, most surgeons prioritized biometer-integrated multivariable formulas, with Barrett Universal II most often ranked first (72.9%). In long and short AL eyes, multivariable formulas were preferred by 73.9% and 68.6% of respondents. After M-LVC, 93.8% used online post-refractive calculators, and 32.1% used IOA. The ESCRS formula repository was used by 60.4%, while 23.4% used commercial planning software. Practice patterns varied by region and career stage, with early-career surgeons favoring multivariable formulas and online tools and later-career surgeons relying more on third-generation formulas.
Conclusions
IOL power planning remains heterogeneous and is influenced by formula familiarity, technology access, workflow considerations, and training era. These findings highlight a disconnect between new formulas and technologies and real-world adoption, underscoring opportunities for education, standardization, and improved decision support in refractive cataract surgery.