Formula Comparison for Intraocular Lens Power Calculation Using IOL Master and Ultrasound for the ZCB00 IOL

Dong Hoon Shin; Dong Hui Lim; Ja Young You; Eui Sang Chung; Tae Young Chung

doi:10.3341/jkos.2014.55.4.527

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Shin, Lim, You, Chung, and Chung: Formula Comparison for Intraocular Lens Power Calculation Using IOL Master and Ultrasound for the ZCB00 IOL

Original Article

J Korean Ophthalmol Soc 2014;55(4):527-533.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.4.527

Formula Comparison for Intraocular Lens Power Calculation Using IOL Master and Ultrasound for the ZCB00 IOL

Dong Hoon Shin, MD, Dong Hui Lim, MD, Ja Young You, MD, Eui Sang Chung, MD, PhD, Tae Young Chung, MD, PhD

Department 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, #81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea, Tel: 82-2-3410-3563, Fax: 82-2-3410-0074 E-mail: tychung@skku.edu

Received 8 July 20134 October 2013 Accepted 4 March 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 evaluation the accuracy of the IOL power calculation formulae measured by IOL Master^® and applanation ultrasonography for the Tecnis ZCB00 IOL

Methods

We performed a retrospective study of 170 eyes in 121 patients who underwent cataract surgery in our hospital with AMO Tecnis ZCB00 IOL.s. The SRK/T formula was used to predict the patient’s implanted IOL power. Differences in the predicted refractive errors between IOL Master^® and ultrasonography were analyzed and factors attributed to the differences were also analyzed. Three months after cataract surgery, mean numeric error and mean absolute error were analyzed.

Results

SRK/II and SRK/T formulas calculated using ultrasonography showed differences compared to the same formulas calculated using IOL Master^®, in which hyperopic shift was also demonstrated. No definite factor was attributed to the differences between the 2 methods. Although the 3 formulas of IOL Master^® showed no significant difference in refractive errors, the SRK/T formula calculated using IOL Master^® showed the least mean absolute and numeric errors.

Conclusions

IOL Master^® is considered more suitable when determining proper AMO Tecnis ZCB00 IOL power in cataract surgery. The hyperopic shift should be considered when calculating the IOL power using only ultrasonography.

Keywords: Intraocular lens power calculation, IOL Master^®, Ultrasound (A-scan), ZCB00

References

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Table 1.

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

	AXL I (<22.5)	AXL II (≥22.5, <24.5)	AXL II (24.5≤)	Total
Eyes	14	132	24	170
Age (years)	69.3 ± 12.0	66.8 ± 10.4	62.8 ± 11.6	66.4 ± 10.8
AXL (mm)	22.24 ± 0.23	23.50 ± 0.54	25.21 ± 0.67	23.64 ± 0.90
MNE
IOL Master
SRK-II	-0.52 ± -0.73	0.03 ± 0.54	0.00 ± 0.91	-0.02 ± 0.63
SRK-T	-0.09 ± 0.56	-0.01 ± 0.47	-0.31 ± 0.79	-0.06 ± 0.54
Haigis	-0.46 ± 0.56	-0.11 ± 0.49	-0.25 ± 0.71	-0.16 ± 0.54
A-scan
SRK-II (A)	-1.08 ± 0.65	-0.58 ± 0.54	-0.79 ± 0.90	-0.65 ± 0.62
SRK-T (A)	-0.47 ± 0.65	-0.34 ± 0.48	-0.66 ± 0.78	-0.40 ± 0.56
p-value^*	0.003	<0.001	0.008	<0.001
MAE
IOL Master
SRK-II	0.69 ± 0.56	0.43 ± 0.31	0.51 ± 0.74	0.47 ± 0.43
SRK-T	0.47 ± 0.30	0.37 ± 0.29	0.43 ± 0.73	0.39 ± 0.38
Haigis	0.54 ± 0.48	0.41 ± 0.30	0.44 ± 0.60	0.42 ± 0.37
A-scan
SRK-II (A)	1.08 ± 0.64	0.64 ± 0.47	0.84 ± 0.84	0.70 ± 0.56
SRK-T (A)	0.61 ± 0.50	0.48 ± 0.34	0.69 ± 0.76	0.52 ± 0.44
p-value^*	0.020	<0.001	0.239	<0.001

Values are presented as mean ± SD.

AXL = axial length; MNE = mean numeric error; MAE = mean absolute error.

^* Kruskal-Wallis test.

Table 2.

Characteristics between groups with low and high GAP (Tecnis ZCB00 IOL)

	GAP < 0.34 (n = 86)	GAP ≥ 0.34 (n = 84)	p-value^*
Age (years)	67.22 ± 11.60	65.61 ± 9.93	0.332^*
Sex (male)	41	36	0.542^†
Diabetes	37	31	0.437^†
Hypertension	50	37	0.091^†
SEq (diopter)	-0.48 ± 0.98	-0.55 ± 0.78	0.589^*
AXL (mm)	23.71 ± 0.96	23.57 ± 0.83	0.326^*
ACD (mm)	3.10 ± 0.39	3.09 ± 0.38	0.857^*
Mean K-value (diopter)	44.13 ± 1.52	44.06 ± 1.58	0.771^*
Lens thickness (mm)	4.70 ± 0.61	4.67 ± 0.47	0.687^*

Values are presented as mean ± SD.

GAP = difference in postop refractive error estimates between IOL Master method and ultrasound method (SRK/T by IOL Master^Ⓡ method – SRK/T by Ultrasound method); SEq = spherical equivalent; AXL = axial length; ACD = anterior chamber depth.

^* Independent samples t-test

^† Chi-squared test.

Table 3.

Postop refractive accuracy in groups with high GAP (3 months postop)

	GAP ≥ 0.34 (n = 84)	GAP ≥ 0.68 (n = 15)
AXL (mm)	23.57 ± 0.83	23.64 ± 1.11
MNE (diopter)
IOL Master
SRK/II	0.09 ± 0.53	0.00 ± 0.72
SRK/T	0.05 ± 0.43	0.00 ± 0.56
Haigis	-0.04 ± 0.48	-0.01 ± 0.73
A-scan
SRK/II	-0.73 ± 0.56	-1.08 ± 0.69
SRK/T	-0.47 ± 0.47	-0.80 ± 0.58
p-value^*	<0.001	<0.001
MAE (diopter)
IOL Master
SRK/II	0.43 ± 0.33	0.55 ± 0.44
SRK/T	0.33 ± 0.27	0.44 ± 0.33
Haigis	0.38 ± 0.29	0.61 ± 0.37
A-scan
SRK/II	0.76 ± 0.53	1.11 ± 0.63
SRK/T	0.55 ± 0.37	0.86 ± 0.49
p-value^*	<0.001	0.001

Values are presented as mean ± SD.

GAP = difference in postop refractive error estimates between IOL Master method and ultrasound method (SRK/T by IOL Master^Ⓡ method - SRK/T by Ultrasound method); 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.

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