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Reliability of Different IOL Calculation Formulas in Patients with Relative Anterior Microphthalmos (RAM)

1Bartke T. U., 2Auffarth G. U.,
1Friedrich-Schiller-Universität Jena, Klinik für Augenheilkunde (Jena)
2Ruprecht-Karls-Universität Heidelberg, Universitäts-Augenklinik (Heidelberg)

Background: Patients with relative anterior microphthamos (RAM) are characterized by special anatomical features (corneal diameters <11mm, shallow anterior chamber depth <2mm and normal axial length). Because of these anatomical parameters IOL calculation in this patient group sometimes is difficult.
Patients and Methods: Seventy five patients with RAM aged 75.6±10.3 years were retrospectively evaluated for preoperative target refraction and postoperative refraction after cataract surgery. We used the Haigis-Formula in combination with the GBS for preoperative IOL power calculation. IOL calculation was also performed using several second and third generation IOL calculation formulae.
Results: The average IOL power implanted was 25.2±2.8 dptr. (one-piece all-PMMA-IOL, range: 19 to 31 dptr.). The preoperatively calculated target refraction was -0.71± 1.43 dptr. (range: -4.3 to +2,2 dptr.) for the Haigis formula. The postoperative spherical equivalent was on average -0.41±1.50 dptr. (range -5.5 to +6.0 dptr.). The mean differences between end and target refraction were +0.30±1.54 dptr. (Haigis), +0.16±1.57 dptr. (Hoffer Q), +0.31±1.50 dptr. (Holladay 2), +0.46±1.49 dptr. (SRK/T), -0.12±1.53 dptr. (Binkhorst II) and +0.81±1.46 dptr. (SRK II), respectively.
Conclusions: In spite of the special anatomical conditions in patients with RAM and in spite of different assumptions all IOL calculation formulas except the SRK II formula produced reliable IOL power calculation values. All formulae except the Binkhorst II formula led on average to a hyperopic shift of the calculated target refraction.

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