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Choi and Choi: Accuracy of Intraocular Lens Power Calculation in Diabetic Patients
Original Article

J Korean Ophthalmol Soc 2010;51(2):188-194.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.2.188

Accuracy of Intraocular Lens Power Calculation in Diabetic Patients

Joohyun Choi, MD, Sang Kyung Choi, MD

Department of Ophthalmology, Seoul Veterans Hospital, Seoul, Korea

Address reprint requests to Sang Kyung Choi, MD Department of Ophthalmology, Seoul Veterans Hospital #6-2 Doonchon2-dong, Gangdong-gu, Seoul 134-791, Korea. Tel. 82-2-2225-1382, Fax. 82-2-2225-1485, E-mail: drskchoi@hanmail.net

Received 1 June 2009       Accepted 4 November 2009

Copyright © 2010 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To assess the refractive outcome of cataract surgery employing IOL master and A-scans in diabetic and non-diabetic patients

Methods

The retrospective comparative study included 205 eyes of consecutive patients who had uneventful cataract surgery implanting I-Flex IOL. Axial length was measured with IOL master and A-scan and IOL power was calculated using various formulas (SRK II, SRK/T, Haigis, Holladay). Subjects was separated into five groups according to axial length, and then the groups were divided into diabetic and non-diabetic subgroups. Differences between the predicted refraction and the actual refraction were compared and analyzed at two months after the operation.

Results

The mean absolute errors (MAE) of ten groups showed no significant differences. Comparing diabetic groups and non-diabetic groups, there were no statistically significant differences. Also the result of the two modalities, IOL master and A-scan, were not different in statistical analysis.

Conclusions

In diabetic and non-diabetic patients, IOL master and A-scan may be the accurate methods for calculating IOL power regardless of the axial length.

Keywords: Diabetes mellitus, Intraocular lens power calculation, IOL master

References

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Table 1.
Characteristics of each group according to the axial length
Group Diabetes A B C Total
N yes 3 54 7 64 205
no 2 128 11 141
Sex(M/F) yes 1/2 49/5 6/1 56/8 167/38
no 2/0 103/25 6/5 111/30
Right/Left yes 2/1 32/22 4/3 38/26 104/101
no 1/1 60/68 5/6 66/75
Age (years) yes 77.67±5.03 70.10±5.24 65.71±6.87 70.27±7.31 73.27±6.80
no 70.50±9.19 74.67±5.37 74.82±8.05 74.63±6.11
Axial length (mm) yes 21.90±0.14 23.87±0.35 25.97±0.70 23.80±1.08 23.66±0.97
(21.74–21.98) (22.00–24.74) (25.18–27.04) (21.74–27.04)
no 21.75±0.35 23.53±0.26 25.52±0.41 23.60±0.92
(21.50–21.99) (22.15–24.86) (25.07–26.10) (21.50–26.10)

A: Group A, axial length <22 mm; B: Group B, axial length ≥22, <25 mm; C: Group C, axial length ≥25 mm.

Table 2.
Comparison of various IOL power calculation formulas installed in IOL Master
Group (Axial length, mm) Diabetes Eyes Mean Absolute Difference, Predicted vs Actual Postop SE(Diopter)
 p-value
MAEhd MAEs2 MAEst MAEhg MAEas Total
Group A1 (<22) yes 3 0.54±0.49 0.9910
 Mean± SD 0.73±0.81 0.97±0.75 0.94±0.71 0.70±0.76 0.71±0.75 0.81±0.75 (0.07–1.25) (0.2125)§
 Range 0.15–1.43 0.20–1.70 0.16–1.55 0.13–1.35 0.00–1.50 0.02–1.51*
Group A2 (<22) no 2
 Mean± SD 0.38±0.22 0.29±0.19 0.34±0.22 0.40±0.26 0.26±0.94 0.33±0.37
 Range 0.23–0.54 0.15–0.43 0.18–0.50 0.22–0.59 0.41–0.93 0.07–0.59
Group B1 (≥22, <25) yes 54 0.83±1.92 0.9772
 Mean± SD 1.52±1.24 1.53±1.249 1.24±1.35 1.12±1.45 1.01±1.37 1.53±1.17 (1.53–8.92) (0.8482)∏
 Range 0.49–8.21 0.45–8.48 0.48–8.48 0.54–8.36 0.38–8.38 0.32–8.54†
Group B2 (≥22, <25) no 128
 Mean± SD 2.37±1.80 2.14±1.75 2.54±1.90 2.52±1.85 2.32±1.00 2.38±1.54
 Range 2.61–9.49 2.60–9.50 2.63–9.47 2.33–9.47 2.50–9.50 2.67–9.68
Group C1 (≥23, <24) yes 25 0.48±1.74 0.9582
 Mean± SD 0.17±1.13 0.16±1.11 0.17±1.12 0.17±1.14 0.03±1.10 0.13±1.11 (7.17–8.92) (0.9037)＃
 Range 1.61–4.28 1.40–4.25 1.61–4.28 1.50–4.33 1.38–4.25 1.48–4.28‡
Group C2 (≥23, <24) no 50
 Mean± SD 0.78±2.53 0.82±2.55 0.82±2.52 0.80±2.53 0.65±2.64 0.77±2.55
 Range 9.01–11.16 9.10–11.15 8.87–11.15 8.98–11.16 9.81–11.25 9.15–11.17
Total yes 64 0.66±2.12 0.6290
 Mean± SD 0.80±1.70 0.80±1.73 0.82±1.71 0.79±1.73 0.63±1.76 0.65±1.37 (7.17–8.92)
 Range 4.28–8.21 4.25–8.48 4.28–8.48 4.33–8.36 4.25–8.38 3.42–6.93
Total no 141
 Mean± SD 0.63±2.28 0.64±2.29 0.65±2.28 0.65±2.28 0.49±2.34 0.52±1.82
 Range 9.01–11.16 9.10–11.15 8.90–11.15 8.98–11.16 9.81–11.25 7.17–8.92
Total 205 0.9170
 Mean± SD 0.68±2.11 0.69±2.13 0.70±2.12 0.69±2.12 0.53±2.17 0.66±2.12
 Range 9.01–11.16 9.10–11.15 8.90–11.15 8.98–11.16 9.81–11.25 (9.15–11.17)
p-value 0.8809 0.9375 0.9103 0.8688 0.8884 0.8988

MSE=mean spherical equivalent; SD=standard deviation; Kruskal-Wallis test

* Group A1 vs Group A2: p=0.7429

† Group B1 vs Group B2: p=0.3784

‡ Group C1 vs Group C2: p=0.5512

§ Group A (IOL Master® vs A-scan): p=0.2125

∏ Group B (IOL Master® vs A-scan): p=0.8482

＃ Group C (IOL Master® vs A-scan): p=0.9037 (Mann-Whitney U test).

Table 3.
Comparison of various IOL power calculation formulas installed in IOL Master
Group (Axial length, mm) Formula Percentage of eyes within 0.50D, 1.00 D, and 1.50 D from intended refraction.
≤0.50 D ≤1.00 D ≤1.50 D
Group A (<22) MAEhd 100% 100% 100%
MAEs2 100% 100% 100%
MAEst 100% 100% 100%
MAEhg 100% 100% 100%
MAEas 100% 100% 100%
Group B (≥22, <25) MAEhd 93.76% 100% 100%
MAEs2 93.76% 100% 100%
MAEst 93.76% 100% 100%
MAEhg 90.71% 100% 100%
MAEas 90.24% 98.25% 100%
Group C (≥25) MAEhd 88.89% 94.44% 100%
MAEs2 88.89% 94.44% 100%
MAEst 88.89% 94.44% 100%
MAEhg 88.89% 94.44% 100%
MAEas 83.33% 94.44% 100%
Table 4.
Comparison of various IOL power calculation formulas installed in IOL Master
Group (Axial length, mm) Formula Over 0.50 D Myopia*(≥0.50 D) Over 1.00 D Myopia†(≥1.00 D) Over 0.50 D Hyperopia‡(≥0.50 D) Over 1.00 D Hyperopia§(≥1.00 D)
Group A (<22) MAEhd 0% 0% 0% 0%
MAEs2 0% 0% 0% 0%
MAEst 0% 0% 0% 0%
MAEhg 0% 0% 0% 0%
MAEas 0% 0% 0% 0%
Group B (≥22, <25) MAEhd 2.19% 1.02% 25.24% 18.84%
MAEs2 2.19% 1.02% 25.24% 14.82%
MAEst 2.19% 1.02% 29.87% 16.54%
MAEhg 2.21% 1.02% 29.87% 14.82%
MAEas 4.65% 1.54% 55.37% 28.52%
Group C (≥25) MAEhd 14.28% 7.14% 0% 0%
MAEs2 14.28% 7.14% 0% 0%
MAEst 14.28% 7.14% 0% 0%
MAEhg 14.28% 7.14% 0% 0%
MAEas 14.28% 7.14% 25.00% 0%

* Percentage of eye which was myopic shift over 0.50 D from intended refraction

† Percentage of eye which was myopic shift over 1.00 D from intended refraction

‡ Percentage of eye which was hyperopic shift over 0.50 D from intended refraction

§ Percentage of eye which was hyperopic shift over 1.00 D from intended refraction.

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