Purpose: To investigate the influence of preoperative biometric parameters on the accuracy of Haigis and SRKT formulae in predicting postoperative target refraction.
Methods: Retrospective analysis of 108 eyes (70 patients) underwent uneventful phacoemulsification surgery with implant of Alcon-SN60WF intraocular lens (IOL). Forty-five eyes were intentionally targeted to myopia (-0.75 to -1.25 dpt), while the others targeted between 0 and -0.75 dpt. Preoperative axial length and keratometry (K) were measured with optical biometry (LENSTAR-Haag-Streit). Postoperative spherical equivalent was assessed 3 ± 2 months after surgery.
Results: There is a significant correlation between the mean keratometry (K) and the Haigis-SRKT prediction differences (P < 0.001; r = 0.749). Linear regression indicates that a decrease of 1 diopter (D) on K implies an increase of 0.23 D on the difference between formulae prediction. K alone does not influence the prediction error for both formulas. The difference between the two formulae is dependent on K (r = -0.75; P < 0.01). Moreover, eyes with K <43.75 targeted at myopia (n = 23) showed a significant myopic shift of -0.26 ± 0.09 dpt (P < 0.05) with Haigis, but a hyperopic shift of 0.24 ± 0.09 dpt (P < 0.05) with SRKT.
Conclusion: Divergences between Haigis and SRKT formulae cause uncertainty in choosing the IOL. Our results indicate that, in eyes with lower preoperative K, an IOL targeted at myopia might result in a small, but significant myopic shift with the Haigis formula, while a hyperopic shift with the SRKT formula.
Keywords: Biometry; Cataract surgery; Intraocular lens; Monovision; Myopia; Phacoemulsification.