The Clinical Efficacy of the Haigis Formula Using A-Scan Contact Ultrasound Biometry

Keun Heung Park; Young Mo Cho; Jong Soo Lee

doi:10.3341/jkos.2014.55.12.1793

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Park, Cho, and Lee: The Clinical Efficacy of the Haigis Formula Using A-Scan Contact Ultrasound Biometry

Original Article

J Korean Ophthalmol Soc 2014;55(12):1793-1799.

Published online: 2 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.12.1793

The Clinical Efficacy of the Haigis Formula Using A-Scan Contact Ultrasound Biometry

Keun Heung Park, MD¹, Young Mo Cho, MD², Jong Soo Lee, MD, PhD^1,

¹Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea

²Department of Emergency Medicine, The Armed Forces Medical Command, Seongnam, Korea

Address reprint requests to Jong Soo Lee, MD, PhD, Department of Ophthalmology, Pusan National University Hospital, #179 Gudeok-ro, Seo-gu, Busan 602-739, Korea, Tel: 82-51-240-7323, Fax: 82-51-242-7341, E-mail: jongsool@pusan.ac.kr

Received 24 May 2014 Revised 7 July 2014 Accepted 17 November 2014

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 investigate the accuracy of the Haigis formula compared to other formulas using contact ultrasound biometry.

Methods

This study was performed on 94 patients (114 eyes) who underwent cataract surgery in our hospital. Axial length (AXL) and anterior chamber depth (ACD) were measured using both A-scan and intraocular lens (IOL) Master® Patients were divided into three groups based on AXL; Group I (AXL < 22.5 mm), Group II (22.5 mm ≤ AXL < 25.5 mm), and Group III (AXL≥ 25.5 mm). Before cataract surgery, predicted refraction was calculated using the Haigis, SRK/T, Hoffer Q, and Holladay 1 formulas using both A-scan and IOL Master® measurements. Mean absolute error (MAE) were analyzed at one month after surgery using the various IOL formulas.

Results

Using contact ultrasound biometry, in Group I, MAE of Haigis was 0.80 ± 0.67 D and was significantly lower than that using SRK/T. In Group II, the Haigis MAE was 0.72 ± 0.55 D and was significantly lower than the results of all other formulas. In Group III, the Haigis MAE was 0.76 ± 1.13 D and not significantly different from the results of other formulas. Comparing MAE of A-scan to IOL Master® the Haigis formula showed 0.16 D higher error that decreased when the AXL was close to the normal range.

Conclusions

Using contact ultrasound biometry, the Haigis formula provided the best predictability of postoperative refractive outcome compared to other formulas in eyes with normal axial length.

Keywords: A-scan, Axial length, Cataract, Haigis formula, IOL formulas

References

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Figure 1.

The perform ance of various intraocular lens (IOL) calculation formulas with ultrasound biometry. MAE = mean absolute error.

Figure 2.

Intraocular lens (IOL) power calculation error using A-scan in the various IOL calculation formulas. MAE = mean absolute error using A-scan (diopter).

Figure 3.

The linear regression analysis of absolute mean absolute error difference between ultrasound and intraocular lens (IOL) Master^® using Haigis formula (Linear regression model: R² = 0.170, p < 0.001). MAE_diff = | MAE_A-scan – MAE_IOLM |; MAE_A-scan = mean absolute error of Haigis formula using A-scan; MAE_IOLM = mean absolute error of Haigis formula using IOL Master^®; AXL = axial length.

Table 1.

Patient preoperative demography

	Group I (AXL < 22.5)	Group II (22.5 ≤ AXL < 25.5)	Group III (AXL ≥ 25.5)	Total
No. of eyes	27 (23.7%)	55 (48.2%)	32 (28.1%)	114
Age (years)	71.6 ± 9.0	69.3 ± 7.8	56.2 ± 16.0	66.2 ± 12.5
Implanted IOL power (D)	22.57 ± 1.83	20.26 ± 2.14	10.33 ± 5.08	18.02 ± 5.85
A-scan
AXL (mm)	22.06 ± 0.41	23.47 ± 0.57	27.95 ± 2.39	24.40 ± 2.66
ACD (mm)	2.63 ± 0.47	2.76 ± 0.31	3.14 ± 0.51	2.83 ± 0.45
IOL Master®
AXL (mm)	22.16 ± 0.39	23.61 ± 0.58	28.26 ± 2.48	24.57 ± 2.75
ACD (mm)	2.88 ± 0.41	3.15 ± 0.31	3.69 ± 0.30	3.24 ± 0.45
Keratometry (D)	45.83 ± 1.29	44.08 ± 1.38	43.75 ± 1.59	44.40 ± 1.63
p-value^†
AXL	<0.001^*	<0.001^*	<0.001^*	<0.001^*
ACD	<0.001^*	<0.001^*	<0.001^*	<0.001^*

Values are presented as mean ± SD unless otherwise indicated; Group: Classification of patients was based on the IOL Master® measurements.

AXL = axial length; IOL = intraocular lens; D = diopter; ACD = anterior chamber depth.

^* Statistically significant;

^† Wilcoxon's signed rank test between A-scan & IOL Master® measurement.

Table 2.

Comparison of IOL power calculation error between A-scan and IOL Master®

	A-scan	IOL Master®	p-value^†
Group I-MAE (D)
Haigis	0.80 ± 0.67	0.80 ± 0.88	0.572
SRK/T	1.09 ± 0.77	0.94 ± 0.86	0.007^*
Holladay 1	0.94 ± 0.75	0.85 ± 0.80	0.064
Hoffer Q	0.91 ± 0.76	0.88 ± 0.83	0.373
Group II-MAE (D)
Haigis	0.72 ± 0.55	0.56 ± 0.51	0.001^*
SRK/T	1.04 ± 0.58	0.77 ± 0.55	<0.001^*
Holladay 1	0.89 ± 0.57	0.65 ± 0.55	<0.001^*
Hoffer Q	0.80 ± 0.59	0.57 ± 0.54	<0.001^*
Group III-MAE (D)
Haigis	0.76 ± 1.13	0.85 ± 1.37	0.806
SRK/T	0.86 ± 1.07	0.85 ± 1.28	0.232
Holladay 1	0.74 ± 1.17	0.95 ± 1.41	0.199
Hoffer Q	0.72 ± 1.20	0.95 ± 1.43	0.063

Values are presented as mean ± SD.

IOL = intraocular lens; MAE = mean absolute error; D = diopter.

^* Statistically significant;

^† Wilcoxon's signed rank test between A-scan & IOL Master® measurement.

Table 3.

IOL power calculation error with various formulas by ultrasound biometry

	MAE_A-scan	p-value^†
Group I
MAE _A-scan (D)
Haigis	0.80 ± 0.67	−
SRK/T	1.09 ± 0.77	0.004^*
Holladay 1	0.94 ± 0.75	0.044
Hoffer Q	0.91 ± 0.76	0.034
Overall p-value^‡	<0.001^*
Group II
MAE _A-scan (D)
Haigis	0.72 ± 0.55	−
SRK/T	1.04 ± 0.58	<0.001^*
Holladay 1	0.89 ± 0.57	<0.001^*
Hoffer Q	0.80 ± 0.59	0.006^*
Overall p-value^‡	<0.001^*
Group III
MAE _A-scan (D)
Haigis	0.76 ± 1.13	−
SRK/T	0.86 ± 1.07	0.181
Holladay 1	0.74 ± 1.17	0.570
Hoffer Q	0.72 ± 1.20	0.125
Overall p-value^‡	0.140

Values are presented as mean ± SD.

IOL = intraocular lens; MAE _A-scan = mean absolute error using A-scan; D = diopter.

^* Statistically significant;

^† Post-hoc analysis with Wilcoxon's signed rank test between Haigis and other formulas (significant p-value is p < 0.013);

^‡ Friedman's test among all formulas.

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