Intraocular Lens Outcomes: Comparison of Technologies and Formulas Carolina Eyecare Physicians, LLC Research Assistant Professor of Ophthalmology Storm.

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Intraocular Lens Outcomes: Comparison of Technologies and Formulas Carolina Eyecare Physicians, LLC Research Assistant Professor of Ophthalmology Storm Eye Institute - Medical University of South Carolina Charleston, South Carolina Helga P. Sandoval, MD, MSCR, Kerry D. Solomon, MD Financial Disclosure: HP Sandoval, none; KD Solomon, Alcon, Allergan, AMO, Advanced Vision Research,, Aquesys, Bausch and Lomb, Glaukos, Inspire, LensAR, QLT, Wavetec None of the Authors has any financial interest in any product mentioned herein.

Purpose To compare: – biometry measurements between Lenstar LS 900 and IOL Master – IOL power calculations using Haigis and Holladay 2 formulas.

Methods Retrospective chart review of routine cataract patients who had preoperative measurements taken with both Lenstar LS 900 and IOL Master. Steep, flat and average keratometry, axial length, anterior chamber depth and white to white were compared. IOL power obtained using the Haigis and Holladay 2 formulas were compared in patients who underwent uneventful cataract surgery.

Methods The first eye undergoing surgery was selected in patient with bilateral cataracts. SN60WF IOL power was selected using the Haigis formula from IOL Master in all cases by the same physician (HPS). All surgeries were performed by the same surgeon (KDS) using the same technique.

Results: IOL Master vs. Lenstar A total of 64 eyes of 64 patients were included for analysis. Mean age 67.7 ±8.0 years-old. No differences in mean ±SD flat, steep and average K, ACD, and AL were found between the two machines. Lenstar’s mean white to white was 12.2 ±0.4 compared to 12.0 ±0.4 of the IOL master. Mean differences were as follows: – Flat K, 0.06 (range to 1.02); – Steep K, 0.03 (-1.22 to 1.51); – Average K, 0.04 (-0.63 to 1.27); – ACD, 0.01 (-1.87 to 0.17); – AL, (-1.87 to 0.17); – White to white, 1.06 (-1.65 to 1.18).

Results: Haigis vs. Holladay 2 Mean follow-up 30 ±13 days The calculated IOL power was: – The same with both formulas in 56% of cases – 0.5 D lower with the Holladay 2 in 36% of cases – 0.5 D greater with the Holladay 2 in 8% of cases Eyes with different IOL power were excluded from analysis (28 eyes)

Results: Haigis vs. Holladay 2 Mean target refraction was: – Haigis: ±0.13 D – Holladay 2: ±0.10 D Mean arithmetic difference postop MRSE – target refraction was: – Haigis: ±0.43 D – Holladay 2: ±0.45D Mean absolute difference postop MRSE – target refraction was: – Haigis: 0.35 ±0.23 D – Holladay 2: 0.37 ±0.26 D

Accuracy

Conclusions Slight differences in biometry measurements were found between IOL Master and Lenstar. These differences may not be clinically significant but further studies are deem necessary to confirm.

Conclusions Slight differences in target refraction were found between the Haigis and Holladay 2 formulas. These differences were similar when comparing the target refraction to the postoperative MRSE. Haigis formula constants (a0, a1 and a2) were personalized before this review was made while the Holladay 2 was not. Further studies comparing the 2 formulas after customization are underway.