Choice of intraocular lens calculation formula for cataract patients with prior pars plana vitrectomy.

PURPOSE: To determine the optimal intraocular lens (IOL) calculation formula for vitrectomized eyes with diverse surgical and biometric characteristics.

SETTING: Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

DESIGN: Retrospective consecutive case series study.

METHODS: This study included 974 vitrectomized eyes (974 patients) scheduled for phacoemulsification with IOL implantation. 11 formulas were evaluated: Barrett Universal II (BUII), Emmetropia Verifying Optical, Hoffer-QST, Kane, Ladas Super Formula, Pearl-DGS, Radial Basis Function (RBF), Haigis, HofferQ, Holladay1, and SRK/T. Risk factors for prediction error (PE) exceeding 1 diopter (D) were determined using multiple logistic regression. Subgroup analyses were performed based on surgical history and biometric parameters.

RESULTS: The risk of hyperopic PE (>1 D) was higher in patients with silicone oil tamponade (odds ratio [OR], 1.82) and longer axial length (AL) (OR, 1.55), while patients with previous scleral buckling (OR, 2.43) or ciliary sulcus IOL implantation (OR, 6.65) were more susceptible to myopic PE (<-1 D). The Kane formula had the highest overall prediction accuracy, and also the best in silicone oil-filled eyes and the flat cornea subgroup. The BUII and RBF displayed the optimal performance in eyes with previous scleral buckle and steep cornea, respectively. In eyes with an AL ≥ 26 mm, the Holladay1 with the nonlinear version of the Wang-Koch AL adjustment (Holladay1-WKn) showed the lowest absolute PE and highest percentage within ± 1.0 D of PE.

CONCLUSIONS: The Kane achieved the highest overall prediction accuracy in vitrectomized eyes. The optimal formula for eyes with previous scleral buckle, steep cornea, or long AL was BUII, RBF, and Holladay1-WKn, respectively.