Comparison of Prediction Accuracy of Four Intraocular Lens Power Calculation Formulas for Presbyopia-Correcting Intraocular Lens

Purpose: This study aimed to evaluate the prediction accuracy of four intraocular lens (IOL) power calculation formulas; Barrett Universal II, SRK/T, Hoffer-QST, and Kane, using conventional keratometry (K) and total keratometry (TK) in patients who underwent implantation of a four-haptic hydrophobic multifocal IOL (Artis Symbiose Plus<sup>®</sup>).Methods: We analyzed 26 patients (32 eyes) who underwent cataract surgery with implantation of the Artis Symbiose Plus<sup>®</sup>. Preoperative biometric data, including axial length, keratometry, anterior chamber depth, and lens thickness, were measured using IOL Master 700<sup>®</sup>. Postoperative refractive outcomes were compared with the target refractive errors derived from four formulas with K and TK. The mean error, mean absolute error, and median absolute error were calculated at 1 and 3 months postoperatively. The results were compared between the formulae and K and TK.Results: At 3 months postoperatively, Barrett Universal II and Kane showed significantly lower refractive errors from the target diopter than SRK/T and Hoffer-QST, with Barrett Universal II showing the most hyperopic shift and SRK/T the most myopic than the target refractive error. No significant difference in refractive prediction was found between K and TK across all the formulas. The proportion of eyes with refractive errors within ± 0.50 diopter (D) and ± 1.00 D was highest for Barrett Universal II and Kane, with no statistical significance.Conclusions: Barrett Universal II and Kane provided superior refractive accuracy compared to SRK/T and Hoffer-QST for Artis Symbiose Plus<sup>®</sup>. There was no significant difference between K and TK in predicting refractive outcomes.