Predicting the Postoperative Addition Power of a Multifocal Intraocular Lens at the Spectacle Plane
Abstract
PURPOSE:
To establish a simple clinical method of predicting addition power achieved with a multifocal intraocular lens (IOL).
METHODS:
In this prospective cohort study, 41 patients were bilaterally implanted with the Bi-Flex MY multifocal IOL (Medicontur) with +3.50 diopters (D) near addition power. Monocular defocus curves were plotted for each patient and effective addition power was calculated as the dioptric difference between the distance and near inflection points of the defocus curve. Six biometry formulas (Haigis, Holladay, SRK/T, Hill RBF, Barrett Universal II, and Holladay 2) were used to predict the addition power at the spectacle plane.
RESULTS:
Mean effective addition power was 2.60 ± 0.29 D, with significant (P < .01) differences between the prediction methods. Significant differences were found between predicted and effective addition when the Holladay, SRK/T, Hill RBF, and Holladay 2 formulas were used. A moderate but significant correlation (r = 0.342, P = .033) was found with the Barrett formula, and this was also the method to show the least proportional bias with Bland-Altman analysis.
CONCLUSIONS:
The study demonstrates that the effective addition power can be predicted using the proposed simple clinical method derived using the Barrett Universal II formula. The proposed technique may have significant clinical value in screening for patients where ocular biometry may lead to aberrant addition power.
[J Refract Surg. 2021;37(5):318–323.]
- 1.. How to prescribe spectacles for presbyopia. Community Eye Health. 2006; 19(57):12–13. > MedlineGoogle Scholar
- 2.. Spectacle plane add power of multi-focal intraocular lenses according to effective lens position. Can J Ophthalmol. 2017; 52(1):54–60. doi:
10.1016/j.jcjo.2016.07.026 28237150 > Crossref MedlineGoogle Scholar - 3.. Influence of the effective lens position, as predicted by axial length and keratometry, on the near add power of multifocal intraocular lenses. J Cataract Refract Surg. 2016; 42(1):44–49. doi:
10.1016/j.jcrs.2015.07.044 26948777 > Crossref MedlineGoogle Scholar - 4.. Outcomes of the Acrysof ReSTOR IOL in myopes, emmetropes, and hyperopes. J Refract Surg. 2009; 25(12):1103–1109. doi:
10.3928/1081597X-20091117-10 20000292 > LinkGoogle Scholar - 5.. Intraocular lens power calculations for multifocal intraocular lenses. Am J Ophthalmol. 1992; 114(4):405–408. doi:
10.1016/S0002-9394(14)71849-5 1415448 > Crossref MedlineGoogle Scholar - 6.. Lens Power Calculations for Multifocal IOLs: Current Concepts of Multifocal Intraocular Lenses. SLACK Incorporated; 1991:193–208. > Google Scholar
- 7.. Standardizing constants for ultrasonic biometry, keratometry, and intraocular lens power calculations. J Cataract Refract Surg. 1997; 23(9):1356–1370. doi:
10.1016/S0886-3350(97)80115-0 > Crossref MedlineGoogle Scholar - 8.. Optimizing measurement of subjective amplitude of accommodation with defocus curves. J Cataract Refract Surg. 2008; 34(8):1329–1338. doi:
10.1016/j.jcrs.2008.04.031 18655984 > Crossref MedlineGoogle Scholar - 9.. A three-part system for refining intraocular lens power calculations. J Cataract Refract Surg. 1988; 14(1):17–24. doi:
10.1016/S0886-3350(88)80059-2 3339543 > Crossref MedlineGoogle Scholar - 10.. Sources of error in intraocular lens power calculation. J Cataract Refract Surg. 1992; 18(2):125–129. doi:
10.1016/S0886-3350(13)80917-0 1564648 > Crossref MedlineGoogle Scholar - 11.. Sources of error in intraocular lens power calculation. J Cataract Refract Surg. 2008; 34(3):368–376. doi:
10.1016/j.jcrs.2007.10.031 18299059 > Crossref MedlineGoogle Scholar - 12.. Improved accuracy of intraocular lens power calculation with the Zeiss IOLMaster. Acta Ophthalmol Scand. 2007; 85(1):84–87. doi:
10.1111/j.1600-0420.2006.00774.x 17244216 > Crossref MedlineGoogle Scholar - 13.. Clinical results using the Holladay 2 intraocular lens power formula. J Cataract Refract Surg. 2000; 26(8):1233–1237. doi:
10.1016/S0886-3350(00)00376-X 11008054 > Crossref MedlineGoogle Scholar - 14.. Accuracy of intraocular lens calculation formulas. Ophthalmology. 2018; 125(2):169–178. doi:
10.1016/j.ophtha.2017.08.027 > Crossref MedlineGoogle Scholar - 15.. An improved universal theoretical formula for intraocular lens power prediction. J Cataract Refract Surg. 1993; 19(6):713–720. doi:
10.1016/S0886-3350(13)80339-2 8271166 > Crossref MedlineGoogle Scholar - 16.. Topical nonsteroidal anti-inflammatory drugs and cataract surgery: a report by the American Academy of Ophthalmology. Ophthalmology. 2015; 122(11):2159–2168. doi:
10.1016/j.ophtha.2015.05.014 26123091 > Crossref MedlineGoogle Scholar - 17.. Working-age cataract patients: visual results, reading performance, and quality of life with three diffractive multifocal intraocular lenses. Ophthalmology. 2014; 121(1):34–44. doi:
10.1016/j.ophtha.2013.06.034 > Crossref MedlineGoogle Scholar - 18.. Visual outcome and patient satisfaction after multifocal intraocular lens implantation: aspheric versus spherical design. J Cataract Refract Surg. 2010; 36(11):1897–1904. doi:
10.1016/j.jcrs.2010.05.030 21029898 > Crossref MedlineGoogle Scholar
