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The challenge, the solution and the reward: achieving post-operative target refraction following cataract surgery in eyes with axial length (AL) < 22mm

Poster Details

First Author: A.Ng UK

Co Author(s):                  

Abstract Details


To ascertain degree of SRKT and Hoffer Q formulae being used for eyes with AL < 22mm undergoing cataract surgery in the Ophthalmology department of a United Kingdom (UK) district general hospital. To determine visual acuity and refraction outcomes following use of either formula. To form recommendations following results of audit and to reassess refractive and visual outcomes following intervention.


The Royal College of Ophthalmologists in the UK has recommended use of Hoffer Q for cataract surgery on eyes with AL < 22mm in their cataract surgery guidelines. We have identified patients with AL < 22mm still underwent cataract surgery with use of SRKT formula.


Retrospective case notes review of 33 cases of cataract surgery with AL < 22mm as measured by Zeiss IOLmaster September 2008 till September 2013. Post operative refraction obtained from correspondence with community opticians.


33 eyes of 28 patients were audited. 23/28 patients (82%) were female and 5/28 patients (18%) were male. Mean age was 75.72 years with age range 45 – 92 years. AL range between 20.33 to 21.99 mm with a median of 21.58mm. 22/33 eyes (66.67%) had undergone cataract surgery with intraocular lens implant selected using SRKT formula as compared to 11 (33.33%) had HofferQ. SRKT has a higher mean deviation from target refraction as compared to HofferQ (0.65 vs -0.22; P-value 0.009 showing statistical significance). We have implemented colour-coded biometry for SRKT and HofferQ and highlighted need to comply with guidelines.


Initial audit results show that we are not meeting target refraction when we use SRKT. We introduced intervention with colour-coded biometry and prospective audit carried out from September 2015 till January 2016. Results of the prospective audit will be presented. FINANCIAL DISCLOUSRE: NONE

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