Refractive predictive errors using Barrett II, Hoffer-Q, and SRKT formulae for pediatric IOL implantation

Graefes Arch Clin Exp Ophthalmol. 2024 Jul;262(7):2309-2320. doi: 10.1007/s00417-024-06401-4. Epub 2024 Feb 15.

Abstract

Purpose: To compare the accuracy of the Barrett II universal (BU II) formula, Hoffer-Q, and SRKT formulae following lensectomy and IOL implantation in a large pediatric cohort.

Methods: Retrospective study of children who underwent lensectomy and IOL implantation between 2015 and 2023 at Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Results: One hundred and fifty-one eyes of 104 children aged 6.0 ± 3.9 years were included. The mean prediction error (PE) was - 0.08 ± 1.54 diopters (D) with BU II, 0.24 ± 1.46 D with Hoffer-Q, and 0.71 ± 1.92 D with SRKT (P = 0.10). In eyes with axial length (AL) < 22 mm, BU II and Hoffer-Q had a smaller PE than SRKT (P = 0.024). In eyes with AL ≥ 22 mm, BU II had a smaller PE than Hoffer-Q (P = 0.048). In children 24 months or older at surgery, BU II had a smaller PE than SRKT and Hoffer-Q (P = 0.012). However, in younger children, no difference was found between the formulae (P = 0.61). For mean k-values ≥ 44.5 D, BU II and Hoffer-Q had a smaller PE than SRKT (P = 0.002). An absolute prediction error < 1.0 D was obtained with BU II in 66% of eyes and SRKT in 35% (P = 0.01).

Conclusions: The BU II formula performed well with a small prediction error. No significant difference in PE was detected overall between the formulae. However, only BU II demonstrated a stable prediction error at varying axial lengths, K-readings, and ages. As the biometric parameters of the developing eye change with growth, the BU II formula offers a reliable and stable option for pediatric IOL calculation.

Keywords: Accuracy; Barrett Universal II formula; Children; Intra-ocular lens power calculation; Pediatric cataract; Predictive error.

MeSH terms

  • Adolescent
  • Axial Length, Eye / pathology
  • Biometry* / methods
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Lens Implantation, Intraocular* / methods
  • Lenses, Intraocular
  • Male
  • Refraction, Ocular* / physiology
  • Refractive Errors / diagnosis
  • Refractive Errors / physiopathology
  • Reproducibility of Results
  • Retrospective Studies
  • Visual Acuity*