Refractive Predictability of Two Intraocular Lens Power Formulas in Long, Medium, and Short Eyes Using a Swept Source Optical Coherence Tomography Biometer

Clayton Blehm,1 Zach Balest,1 Ashton C Blehm,1 Brad Hall2 1North Georgia Eye Associates, Gainesville, GA, USA; 2Sengi, Penniac, NB, CanadaCorrespondence: Clayton Blehm, North Georgia Eye Associates, 2061, Beverly Road, Gainesville, GA, 30501, USA, Tel +1 770-532-4444, Email [email protected]: To compare the refractive predictability of Argos measurements with Barrett Universal II (BUII) and Barrett True Axial Length (BTAL) formulas in a large sample of long, medium, and short axial length (AL) eyes.Methods: A retrospective chart review identified 445 eyes of 247 patients for inclusion. The Argos was used for preoperative biometry, and BUII formula for intraocular lens (IOL) power calculations. Back calculations were performed using data from the Argos for the BTAL formula. Data were collected for postoperative absolute prediction error (APE), refractive outcomes, and monocular uncorrected and distance corrected visual acuities at distance (UDVA, CDVA).Results: Overall, mean APE was 0.36 ± 0.33 D for BUII and for 0.34 ± 0.32 D BTAL (p = 0.04). In short AL eyes, mean APE was 0.45 ± 0.37 D for BUII and for 0.37 ± 0.31 D BTAL (p < 0.001). No significant differences between BUII and BTAL were identified for long AL or medium AL eyes. The percentages of eyes with APE of 0.5 D or less in long, medium, and short eyes were 79%, 79% and 51%, respectively, for BUII and 82%, 78% and 69%, respectively, for BTAL.Conclusion: The prediction accuracies were high with both the BUII and BTAL formulas in long, medium, and short eyes, leading to excellent refractive outcomes. The BTAL formula may have lower absolute prediction error in short eyes compared to BUII.Plain Language Summary: When the natural lens inside the eye becomes opaque, it can be replaced during cataract surgery with a clear artificial intraocular lens (IOL). It is critical for good postoperative outcomes that the optimal power for the IOL is implanted. Biometers are devices used to measure the eye and typically have built-in formulas to calculate the most appropriate IOL power for implantation. However, it is challenging to select the optimal power in eyes that are longer or shorter than average. The purpose of this study was to compare the refractive predictability of a novel biometer using two IOL power calculation formulas in a large sample of long, medium, and short eyes. The results of this study suggest that predictability was high with both formulas in long, medium, and short eyes, leading to excellent refractive outcomes.Keywords: Argos, biometry, SS-OCT, BUII, BTAL