Accuracy of the Haigis Formula Based on Axial Length and Anterior Chamber Depth

Chan-Hui Yi; Sung-Ho Choi; Eui-Sang Chung; Tae-Young Chung

doi:10.3341/jkos.2011.52.2.175

Journal List > J Korean Ophthalmol Soc > v.52(2) > 1008969

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Yi, Choi, Chung, and Chung: Accuracy of the Haigis Formula Based on Axial Length and Anterior Chamber Depth

Original Article

J Korean Ophthalmol Soc 2011;52(2):175-181.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.2.175

Accuracy of the Haigis Formula Based on Axial Length and Anterior Chamber Depth

Chan-Hui Yi, MD, Sung-Ho Choi, MD, Eui-Sang Chung, MD, PhD, Tae-Young Chung, MD, PhD

Despartment of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Address reprint requests to Tae-Young Chung, MD, PhD Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine #50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea Tel: 82-2-3410-3563, Fax: 82-2-3410-0074, E-mail: tychung@skku.edu

Received 4 May 201020 September 2010 Accepted 25 November 2010

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 evaluate the effect of axial length (AXL) and anterior chamber depth (ACD) on the accuracy of the Haigis formula in comparison to its effect on other 3rd generation IOL power calculations. The possibility of measurement error in ACD using either method was also investigated.

Methods

A study was performed on 137 eyes of 98 patients who underwent cataract surgery in our hospital. AXL and ACD were measured using IOL Master, and IOL power was calculated using the Haigis, SRK/T, Hoffer Q, and Holladay 1 formulas. ACD was also measured using Pentacam. Patients were divided into 3 groups based on ACD and AXL. Mean numeric error and mean absolute error were analyzed 1 month after surgery.

Results

Five formulae showed no significant difference in refractive error in the 3 groups based on AXL. In contrast, the Haigis formula showed statistically significant differences in the group with shallow ACD, in which hyperopic shift was also demonstrated. The difference in ACD between using IOL Master and using Pentacam was significant in the shallow ACD group, with IOL Master showing more shallow measurement. However, the other groups based on ACD showed no significant difference in the refractive error from the Haigis formula, and in the difference in ACD between measurements.

Conclusions

Errors in ACD measurement should be taken into consideration for discrepancy between the Haigis formula measurement and other formula measurements. The authors of the present study suggest that ACD-driven refractive error should be considered in determination of IOL.

Keywords: Anterior chamber depth, Axial length, Haigis formula, Intraocular lens power calculation

References

1. Holladay JT, Prager TC, Ruiz RS, et al. Improving the predictability of intraocular lens power calculations. Arch Ophthalmol. 1986; 104:539–41.

2. Vogel A, Dick HB, Krummenauer F. Reproducibility of optical biometry using partial coherence interferometry: intraobserver and interobserver reliability. J Cataract Refract Surg. 2001; 27:1961–8.

3. Kiss B, Findl O, Menapace R, et al. Biometry of cataractous eyes using partial coherence interferometry: clinical feasibility study of a commercial prototype I. J Cataract Refract Surg. 2002; 28:224–9.

4. Lam AK, Chan R, Pang PC. The repeatability and accuracy of axial length and anterior chamber depth measurements from the IOLMaster. Ophthalmic Physiol Opt. 2001; 21:477–83.

5. Kielhorn I, Rajan MS, Tesha PM, et al. Clinical assessment of the Zeiss IOLMaster. J Cataract Refract Surg. 2003; 29:518–22.

6. Chang SW, Yu CY, Chen DP. Comparison of intraocular lens power calculation by the IOLMaster in phakic and eyes with hydrophobic acrylic lenses. Ophthalmology. 2009; 116:1336–42.

7. Lim LH, Lee SY, Ang CL. Factors affecting the predictability of SRK II in patients with normal axial length undergoing phacoemulsification surgery. Singapore Med J. 2009; 50:120–5.

8. Maeng HS, Ryu EH, Chung TY, Chung ES. Effects of anterior chamber depth and axial length on refractive error after intraocular lens implantation. J Korean Ophthalmol Soc. 2010; 51:195–202.

9. Haigis W. Intraocular lens power calculations. Thorofare NJ, USA: Slack Inc;2003. p. 41–57.

10. Holladay JT, Prager TC. Accurate ultrasonic biometry in pseudophakia. Am J Ophthalmol. 1989; 107:189–90.

11. Holladay JT, Prager TC, Chandler TY, et al. A three-part system for refining intraocular lens power calculations. J Cataract Refract Surg. 1988; 14:17–24.

12. Retzlaff JA, Sanders DR, Kraff MC. Development of the SRK/T intraocular lens implant power calculation formula. J Cataract Refract Surg. 1990; 16:333–40.

13. Hoffer KJ. The Hoffer Q formula: a comparison of theoretic and regression formulas. J Cataract Refract Surg. 1993; 19:700–12.

14. Kim DY, Kim MJ, Kim JY, Tchah H. Comparison of formulas for intraocular lens power calculation installed in a partial coherence interferometer. J Korean Ophthalmol Soc. 2009; 50:523–8.

15. Petermeier K, Gekeler F, Messias A, et al. Intraocular lens power calculation and optimized constants for highly myopic eyes. J Cataract Refract Surg. 2009; 35:1575–81.

16. Wang JK, Hu CY, Chang SW. Intraocular lens power calculation using the IOLMaster and various formulas in eyes with long axial length. J Cataract Refract Surg. 2008; 34:262–7.

17. Bai L, Zhang ZP, Yi GL, et al. [Selection of accurate IOL formula in patients with cataract and high hyperopia]. Zhonghua Yan Ke Za Zhi. 2008; 44:1063–5.

18. MacLaren RE, Natkunarajah M, Riaz Y, et al. Biometry and formula accuracy with intraocular lenses used for cataract surgery in extreme hyperopia. Am J Ophthalmol. 2007; 143:920–31.

19. Savant V, Chavan R, Pushpoth S, Ilango B. Comparability and in-tra-/interobserver reliability of anterior chamber depth measurements with the Pentacam and IOLMaster. J Refract Surg. 2008; 24:615–8.

20. Reddy AR, Pande MV, Finn P, El-Gogary H. Comparative estimation of anterior chamber depth by ultrasonography, Orbscan II, and IOLMaster. J Cataract Refract Surg. 2004; 30:1268–71.

21. Rabsilber TM, Becker KA, Frisch IB, Auffarth GU. Anterior chamber depth in relation to refractive status measured with the Orbscan II Topography System. J Cataract Refract Surg. 2003; 29:2115–21.

22. Lackner B, Schmidinger G, Skorpik C. Validity and repeatability of anterior chamber depth measurements with Pentacam and Orbscan. Optom Vis Sci. 2005; 82:858–61.

23. Su PF, Lo AY, Hu CY, Chang SW. Anterior chamber depth measurement in phakic and pseudophakic eyes. Optom Vis Sci. 2008; 85:1193–200.

24. Sheng H, Bottjer CA, Bullimore MA. Ocular component measurement using the Zeiss IOLMaster. Optom Vis Sci. 2004; 81:27–34.

Table 1.

Characteristics of each group according to the axial length (AXL)

Group (AXL, mm)	AXL I (< 22.5)	AXL II (≥ 22.5, < 24.5)	AXL III (24.5 ≤)	Total	p-value
Eyes	19	90	28	137
Age (yr, mean ± SD)	65.4 ± 10.8	65.3 ± 10.8	56.0 ± 12.7	63.0 ± 11.8
AXL (mm, mean ± SD)	22.04 ± 0.46	23.42 ± 0.53	27.80 ± 2.51	24.22 ± 2.36
MNE (D, mean ± SD)
Haigis	+0.01 ± 0.57	-0.18 ± 0.58	-0.61 ± 0.59	-0.24 ± 0.60	0.001^∗
SRK/T	-0.09 ± 0.48	-0.09 ± 0.46	-0.61 ± 0.56	-0.18 ± 0.54	0.001
Hoffer Q	-0.09 ± 0.50	-0.20 ± 0.50	-0.97 ± 0.76	-0.32 ± 0.65	0.000
Holladay 1	-0.04 ± 0.46	-0.15 ± 0.47	-0.87 ± 0.73	-0.27 ± 0.61	0.000
p-value^†	0.460	0.364	0.075	0.312
MAE (D, mean ± SD)
Haigis	0.44 ± 0.36	0.45 ± 0.39	0.66 ± 0.54	0.49 ± 0.42	0.037^‡
SRK/T	0.41 ± 0.28	0.38 ± 0.27	0.63 ± 0.53	0.44 ± 0.36	0.005
Hoffer Q	0.39 ± 0.31	0.41 ± 0.35	0.99 ± 0.74	0.52 ± 0.50	0.000
Holladay 1	0.36 ± 0.28	0.38 ± 0.30	0.90 ± 0.67	0.48 ± 0.45	0.000
p-value^†	0.474	0.386	0.073	0.463

MNE = mean numeric error = the predicted postoperative diopter - actual postoperative diopter. MAE = mean absolute error = the mean absolute value of the numeric error.

^∗ 1-Way ANOVA test; Group AXL I vs Group AXL II: p = 0.170; Group AXL I vs Group AXL III: p = 0.001; Group AXL II vs Group AXL III: p = 0.001;

^† Kruskal-Wallis test;

^‡ 1-Way ANOVA test; Group AXL I vs Group AXL II: p =0.680; Group AXL I vs Group AXL III: p =0.042; Group AXL II vs Group AXL III: p = 0.028.

Table 2.

Characteristics of each group according to anterior chamber depth (ACD)

Group (ACD, mm)	ACD I (< 2.5)	ACD II (≥ 2.5, < 3.5)	ACD III (3.5 ≤)	Total	p-value^‡
Eyes	12	99	26	137
Age (yr, mean ± SD)	60.3 ± 10.2	65.4 ± 11.4	55.2 ± 11.1	63.0 ± 11.8
ACD (mm, mean ± SD)	2.25 ± 0.27	3.18 ± 0.28	3.82 ± 0.46	3.14 ± 0.46
MNE (D, mean ± SD)
Haigis	-0.41 ± 0.60	-0.19 ± 0.58	-0.35 ± 0.67	-0.24 ± 0.60	0.279
SRK/T	+0.05 ± 0.49	-0.14 ± 0.53	-0.44 ± 0.53	-0.18 ± 0.54	0.010
Hoffer Q	-0.09 ± 0.61	-0.24 ± 0.61	-0.69 ± 0.68	-0.32 ± 0.65	0.003
Holladay 1	-0.02 ± 0.52	-0.21 ± 0.58	-0.60 ± 0.64	-0.27 ± 0.61	0.005
p-value^†	0.030	0.446	0.144^‡	0.312
MAE (D, mean ± SD)
Haigis	0.60 ± 0.36	0.46 ± 0.42	0.57 ± 0.45	0.49 ± 0.42	0.318
SRK/T	0.37 ± 0.27	0.43 ± 0.34	0.49 ± 0.44	0.44 ± 0.36	0.652
Hoffer Q	0.49 ± 0.32	0.47 ± 0.47	0.73 ± 0.64	0.52 ± 0.50	0.061
Holladay 1	0.39 ± 0.29	0.45 ± 0.43	0.65 ± 0.56	0.48 ± 0.45	0.096
p-value^†	0.021	0.493	0.196	0.463

MNE = mean numeric error = the predicted postoperative diopter - actual postoperative diopter. MAE = mean absolute error = the mean absolute value of the numeric error.

^† Kruskal-Wallis test;

^‡ 1-Way ANOVA test.

Table 3.

Comparison of anterior chamber depth (ACD) measurement obtained with IOL Master® and Pentacam

Group^∗	IOL Master®(mm, mean ± SD)	Pentacam (mm, mean ± SD)	ACD difference^†(mm, mean ± SD)	95% LoA^‡(mm, mean ± SD)	P-value^§
AXL I	2.92 ± 0.30	2.84 ± 0.37	0.07 ± 0.15	0.01 to 0.14	0.138
AXL II	3.10 ± 0.48	3.12 ± 0.42	-0.02 ± 0.55	-0.14 to 0.08	0.641
AXL III	3.44 ± 0.28	3.38 ± 0.25	0.06 ± 0.11	0.01 to 0.11	0.108
ACD I	2.26 ± 0.19	2.93 ± 0.60	-0.67 ± 0.69	-1.11 to −0.23	0.006
ACD II	3.10 ± 0.26	3.06 ± 0.32	0.03 ± 0.23	-0.01 to 0.08	0.121
ACD III	3.73 ± 0.35	3.52 ± 0.43	0.21 ± 0.68	-0.06 to 0.49	0.134
Total	3.14 ± 0.46	3.13 ± 0.41	0.01 ± 0.45	-0.07 to 0.08	0.874

^∗ Group AXL I: axial length < 22.5 mm, Group AXL II: 22.5 ≤ axial length < 24.5 mm, Group AXL III: 24.5 mm ≤ axial length, Group ACD I: anterior chamber depth < 2.5 mm, Group ACD II: 2.5 ≤ anterior chamber depth < 3.5 mm, Group ACD III: 3.5 mm ≤ anterior chamber depth;

^† ACD difference = anterior chamber depth measured by IOL Master® - anterior chamber depth measured by Pentacam;

^‡ LoA = limit of agreement;

^§ paired t-test.

TOOLS

Similar articles