The improvements in iol power calculation are the result of improvements in the predictability of the elp. According to clinical studies, the srkt formula is recommended for rather long eyes whereas the hoffer q formula is recommended for rather short eyes. Pdf accuracy of intraocular lens power calculation in. Preoperative refraction and corneal power are unknown. Srkt, hoffer q, haigis, holladay 2, and barrett universal ii. In this prospective case series study, we have shown the performance of okulix software raytracing iol power calculation was not significantly different compared with the other two routine and reliable iol power calculation formulas, srkt and hoffer q. To compare the accuracy of intraocular lens iol calculation formulas barrett universal ii, haigis, hoffer q, holladay 1, holladay 2, olsen, and srkt in the prediction of postoperative refraction using a single optical biometry device. The iol power was calculated using srkt formula and okulix ray tracing software. The implanted iol power was chosen based on okulix ray tracing software calculation aiming for. Features for calculating surgicallyinduced astigmatism and backcalculating values to determine the source of refractive surprises only require clicking one button. Srk ii formula in the calculation of intraocular lens power.
The development of better instrumentation for measuring the eyes axial length al and the use of more precise mathematical formulas to perform the appropriate calculations have significantly improved the accuracy with which the. Iol power calculator for cataract surgery hillrbf calculator. The power of the intraocular lens implant can be calculated accurately when the corneal refractive power, media type, and axial length are properly measured. The haigis formula does not need doublek calculations because elp calculation does not depend on the corneal curvature to determine its value. Srk ii formula in the calculation of intraocular lens.
Predicting the refractive outcome and accuracy of iol. Apr 29, 2005 i believe in this so strongly that i had my hoffer programs iol power calculation system software completely reprogrammed so you can use the doublek, he says. Harold ridley 19062001, who implanted the first intraocular lens in 1949, lived to see cataract surgery evolve into a true refractive procedure, undergoing iol implantations himself in 1989 and 1990. Using the srkt formula, you calculate for an iol power that seems appropriate.
The srkt formula is a theoretical t approach to iol power calculation under the srk umbrella of empirical formulas using existing aconstants and optimization methods. This iol power calculation method does not need special software, and has the potential to reduce refractive errors after cataract surgery compared to existing iol calculation formulas. Since then, cataract and refractive surgery have developed into the most frequent and most successful surgical interventions in the history of medicine. Srkt formula iol power calculations prior rk lasik. It is intended to be used in conjunction with a comprehensive ophthalmic examination and the appropriate diagnostic tests and measurements necessary for cataract surgery candidates with a history of prior refractive surgery.
Development of the srkt intraocular lens implant power calculation formula. The earliest iol power calculation formulas, in the late 1970s and early 1980s, were either theoretical or regression formulas. Dick said the software is as accurate as the classic srk formula for averagesized eyes because the mean acd is still calculated from an aconstant. Sayegh believes that hoffer q is a good choice for iol calculation in short eyes, based on consistent evidence in the literature. This works fine in the average eye but leads to limited prediction accuracy in unusual as well as long or short eyes. Terzi, wang, and kohnen studied the accuracy of holladay 2, hoffer q, srkt, and haigis iol power calculation formulas in refractive lens exchange.
Sustained accuracy improvement in intraocular lens power. This dependence on the central corneal power for the effective lens position calculation is one of the drawbacks of older, 2variable, 3rd generation iol power calculation formulas, such as srk t, holladay 1 and hoffer q, which require an aramberri doublek method correction to remove the artifact generated by a falsely flat central cornea. Previous studies have shown that it provides repeatable and reproducible measurements that are similar to those of the main benchmark for comparison, the iolmaster 500 carl zeiss meditec. Intraocular lens power calculation after corneal refractive. Pdf comparison of okulix raytracing software with srkt and. The hillrbf calculator is an advanced, selfvalidating method for iol power selection employing pattern recognition and sophisticated data interpolation. The srk t, holladay 1, and hoffer q formulas require a corneal power correction and the doublek method to accurately measure the iol power in eyes that had prior lasikprk.
Update on optical biometry and intraocular lens power. The present study was a retrospective analysis, which included 38 eyes with an al iol implantation to compare the predictive accuracy of various iol power calculation formulae. Intraocular lens iol power calculation in eyes with previous excimer laser. Oct 27, 2017 three iol brands were used and for all eyes, iol power calculation was performed using srk t, hoffer q formula and also okulix raytracing software. Software simplifies iol calculations for odd eyes healio. Even if you dont know what the preop k was, youll be better off putting in a standard k like 43 or 44 than using the postop estimated value.
New approach for the calculation of the intraocular lens. The best known modern formulas are srkt, holladay 1, holladay 2, hofferq and haigis. The effective lens positions for vergence thin lens formula elp o and for thick lens formula elp k are shown. With 100 million power calculations performed worldwide, the iolmaster 500 is the current gold standard biometer. After hyperopic keratorefractive surgery iol power adjustment table for srkt formula. For the calculation of iol power, a doublek modified formula is necessary to remove the calculation artifact of iatrogenically flat keratometry k readings.
Accuracy of intraocular lens power calculation formulas. The hoffer q, holladay i, and srk t formulae are all commonly used. To compare the performance of okulix raytracing software with srkt and hoffer q formula in intraocular lens iol power calculation in patients. The difference in rr for the same iol calculated by oculix and by the 3rd generation formulas srkt, hofferq, holladay1, and haigis was statistically significant all formulas. According to clinical studies, the srk t formula is recommended for rather long eyes whereas the hoffer q formula is recommended for rather short eyes. These fudge factors are necessary because the postrefractive surgery cornea does not have the same relationship between anterior and posterior corneal surface that a normal cornea does. Preoperative axial length al was divided into four subgroups. Iol powers for a target refraction default is emmetropia are calculated using the corrected srk t and haigis formulae, with the exception of the aramberri doublek method, which only uses the srk t formula and the walter method, which is currently only implemented for emmetropia. The new sandersretzlaffkraff srk ii formula was more accurate than the original srk and binkhorst ii formulae.
Eyeworld iol power calculation iol power calculations and biometry all years 2020 2019 2018 2017 2016 2015 2014 20 2012 2011 2010 2009 2008 2007 all months january february march april may june july august september october november december. Intraocular lens calculation after refractive surgery. Empirical optimization methods of the srkt model primarily consist of 1 postoperative acd prediction, 2, a retina thickness correction factor and 3 corneal refractive. Theoretical calculation of correct iol power after corneal. Iol power calculation was performed in all eyes using the srkt formula. A major shortcoming of most 3rd generation, 2variable formulas, such as srk t, is that they often assume that the anterior and posterior segments of the eye are mostly proportional and use only the axial length and keratometric corneal power to estimate the postoperative location of the iol, known as the effective lens position elpo. The srkt variant of the stop formula is one of the best formulas for this purpose. Paulrolf preussner, md, phd, creator of the okulix iol power calculation program, told ocular surgery news the software is particularly useful for odd eyes, such as eyes that have had. Development of a new intraocular lens power calculation. Consensus recommendation of corneal power and iol calculation formulae. Three iol brands were used and for all eyes, iol power calculation was performed using srk t, hoffer q formula and also okulix raytracing software.
Regression formulas topped surgeons preferences, and one of the most successful was the srk formula devised by donald r. Although no formula has been proven to have an advantage, it is preferable to use the theoretical formulas e. Many of the old thinlens iol power calculation formulas, such as the binkhorst, hoffer q, holladay 1, and srkt use only the k reading and the al as input. The srkt formula is one of the third generation iol calculation formulas. Iol power calculations comparing the current third generation formulas holladay2, holladay 1, hoffer q and the srkt are easily performed.
To compare the performance of okulix raytracing software with srk t and hoffer q formula in intraocular lens iol power calculation in patients. Comparison of okulix raytracing software with srkt and. The employment of optical al instead of anatomic al has significantly improved the refractive results of cataract surgery. East valley ophthalmology is a dynamic and rewarding place in which to work. Standard iol calculation formulae such as srkt, holladay 1 or hoffer q all estimate the effective lens position elp based on axial length and k measurements. Every year more than 11 mio lenses are implanted worldwide, providing excellent chances for the majority of patients to regain good. Because rk patients were once myopic but now have flat corneas, they typically have a deeper anterior depth than patients with similarly flat k readings who do not have a history of myopic refractive surgery. Comparison of intraoperative aberrometry, octbased iol formula, haigisl, and masket formulae for iol power calculation after laser vision correction. The aim of an accurate intraocular lens power calculation is to provide an intraocular lens iol that fits the specific needs and desires of the individual patient. The olsen formula uses 5 measurements and 1 iol constant. Jan 01, 2015 iol power calculations comparing the current third generation formulas holladay2, holladay 1, hoffer q and the srk t are easily performed. This calculator uses both the haigis and srk t formula with a variety of fudge factors that have been described in the literature over the past few years. The a constant formulae in use currently utilize constants, which are based on various factors that affect the refractive state of the eye postoperatively. The haigis formula uses 3 measurements and 3 iol constants, and the holladay 2 formula uses 7 measurements and 1 iol constant.
However, some iol formulas such as the srk t or srk ii formulas assume a relationship between keratometry and anterior chamber depth. Empirical optimization methods of the srk t model primarily consist of 1 postoperative acd prediction, 2, a retina thickness correction factor and 3 corneal refractive. The decision of how much emmetropic iol power was to be undercorrected was based on age of the child at. The purpose of this study was to evaluate the performance of the srkt formula in predicting a target refraction 1. One of the interesting aspects of this case was the patient had a significant angle kappathe distance between the pupil center and the visual axis. The difference between the predicted postoperative residualrefraction rr of the iol determined by ray tracing and the rr of the same iol obtained using 3rd generation iol calculation formulas namely the srkt, hofferq, holladay1, and haigis formulas 18,19,20,21, was calculated and analyzed. Double k correction method iol calculation formulas hoffer q. The term was originally used by whewell initially in the 1800s for calculating life expectancy. Intraocular lens power calculation in eyes with previous. I use the hofferq, holladay 1, srkt, holladay 2, haigis, and barrett formulas in combination to choose the spherical power and then calculate the cylindrical power separately.
However, some iol formulas such as the srkt or srkii formulas assume a relationship between keratometry and. Effect of anterior chamber depth on the choice of intraocular. Regarding to the iol power calculation in patients with long axial length, both the haigis and srk t formulas would take the axial length and anterior chamber depth into consideration, while the. Biometry for intraocular lens iol power calculation eyewiki. Holladay iol consultant hic program uses holladay 2 formula and.
Accuracy of intraocular lens calculation formulas sciencedirect. Pdf intraocular lens power calculation using ray tracing. Srk i and ii regression formulae are now regarded as obsolete. Iol power calculation formulas zeiss medical technology. After iol implantation in eyes with previous lasik, prk or rk, a refractive surprise can occur because i the altered ratio between the anterior and posterior corneal. Calculated iol data in iol calculation window srkt in the columns below each specified lens you will find the calculated refractive powers and target refractions for those lenses.
The major drawback is that you have to pay to use it. Update on optical biometry and intraocular lens power calculation nazneen nazm 1, arup chakrabarti 2 1 department of ophthalmology, esipgimsr, esi medical college and hospital, kolkata, west bengal, india 2 chakrabarti eye care centre, thiruvananthapuram, kerala, india. To compare the accuracy of intraocular lens iol calculation formulas barrett universal ii, haigis, hoffer q, holladay 1, holladay 2, olsen, and srk t in the prediction of postoperative refraction using a single optical biometry device. To compare the performance of okulix raytracing software with srkt and hoffer q formula in intraocular lens iol power calculation in patients presenting. A new device, the iol master, yields accurate axial length measurements using optical coherence techniques. Olsen is the author of the olsen formula and the originator of the phacooptics pc software iol innovations, aarhus, denmark using the newly described cconstant approach for the prediction of the iol position. Crstoday iol power calculation after refractive surgery. The authors suggested that the srkt formula should not been used in iol power calculation in eyes with al shorter than 22 mm. The refractive power of the eye primarily depends upon the cornea, the lens, ocular media, and the axial length of the eye. Iol power calculations have become a focal point of cataract surgery. Biometry is the method of applying mathematics to biology. Six decades have passed since the first implantation of an artificial intraocular lens iol into a human eye. Effective ocular biometry and intraocular lens power. Validation of the stop formula for calculating intraocular.
Sanders, retzlaff and kraff developed the srk formula which was. The srk t formula is a theoretical t approach to iol power calculation under the srk umbrella of empirical formulas using existing aconstants and optimization methods. Formulas include barrett universal ii, hillrbf, olsen, holladay, hoffer q, haigis, srk t, ladas. The hoffer q, holladay 1, and srkt use 2 biometric measurements and a single iol constant. This calculator uses both the haigis and srkt formula with a variety of fudge factors that have been described in the literature over the past few years. Jun 14, 2016 using the correct iol calculation formula is important for good surgical outcomes. Theres not one, but dozens of papers, and each of those papers has 100, 200 or maybe thousands of eyes, so theres some consistency there, where you know that this has been tested again and again. Firstgeneration formulas, such as the sandersretzlaffkraff srk, used the power of the cornea and the axial length, along with the aconstant of the specific iol, to come up with power. Purpose to investigate the effect of anterior chamber depth acd on the refractive outcomes of the srkt, holladay 1, hoffer q and haigis formulae in short, normal, long and extremely long eyes. In conclusion, calculation of the iol power can be performed using a great variety of formulas. Intraocular lens power calculation using ray tracing following excimer laser surgery article pdf available in eye 216. I utilize intraoperative aberrometry to finetune both the iols spherical power and the axis, but i rarely change the cylindrical power unless i am using aberrometry. Iol power calculations comparing the current third generation formulas holladay2, holladay 1, hoffer q and the srk t are easily performed. This nomogram is easy to use by just look up the axial length of the patient and add or subtract the adjusted iol power to the iol power calculated using the srk t, hoffer q, and holladay 1 formulas.
Currently, the most recommended formulas for iol power calculation for short eyes are the thirdgeneration formula hoffer q64,65,43 and the fourthgeneration formula holladay2. Various theoretical and regression iol calculation formulas have been used since fedorov et al in 1967. The manufacturer iol constant was used for power calculation. Intraocular lens power selection in eyes with axial myopia. The purpose of this study was to evaluate the performance of the srk t formula in predicting a target refraction 1. The srk t formula is one of the third generation iol calculation formulas. Iol power calculation by ray tracing with sirius costruzione strumenti oftalmici. Having this type of information helps determine the best possible calculation and customization for iol implant selection.
The iol calculator is meant to serve as an adjunct tool to assist physicians in selecting the appropriate iol for a particular patient. The commonly used and more recent five iol power calculation formulas builtin software of iolmaster 700 software version 1. The srkt formula calculations used the same preoperative data and the latest constants from the user group for laser interference biometry. Crstoday iol choice and calculations in a postrk patient. Pdf comparison of okulix raytracing software with srkt. For all patients, axial length and keratometry data was obtained with iolmaster 500 device and iol power was determined using hoffer q and srk t formula. Authors concluded that all 5 iol power calculation formulas were unsatisfactory in achieving target refraction. Comparison of okulix raytracing software with srkt and hoffer. This translates into a 510fold precision in al measurement. The srk formula uses the following equation to calculate iol power. Okulix ray tracing has a software interface to all tomey devices, to the. In this prospective case series study, we have shown the performance of okulix software raytracing iol power calculation was not significantly different compared with the other two routine and reliable iol power calculation formulas, srk t and hoffer q. Pdf purpose to compare the performance of okulix raytracing software with srkt and hoffer q formula in intraocular lens iol power.
The srkt, holladay 1, and hoffer q formulas require a corneal power correction and the doublek method to accurately measure the iol power in eyes that had prior lasikprk. Methods this retrospective study involved patients who had uncomplicated cataract surgery. Pdf srk ii formula in the calculation of intraocular lens power. We strive to employ a team of the most talented and responsible professionals in ophthalmology. We studied 400 eyes which underwent cataract extraction with posterior chamber intraocular lens iol implantation to compare the predictive accuracy of various iol power calculation formulae. The holladay 1 and hoffer q formulas are equally good for eyes with an al between 21. After refractive corneal surgery the haigisl formulae may be selected.
Other formulas that should be taken into consideration are the triples, masket, besst, and savini. We have a passion for our profession and a worldclass reputation. The authors tested srk, srk ii, holladay, hoffer q, and srk t formulas. The binkhorst and the hoffer formulae use the postoperative ac depth, the srk ii. These formulas are programmed into the iolmaster, lenstar and most modern ultrasonographic instruments, thus eliminating any need for regression formulas. Comparison of iol power calculation formulae for pediatric. Comparison of formula accuracy for intraocular lens power. Based on the aramberri double k method, the numbers in each row of the hyperopic refractive correction represent the amount in diopters that must be subtracted from the calculated iol power when using the srkt formula. If your office does not have this software package, a trial version can be. It has been optimized for use with the haagstreit lenstar, using optical biometry for all axial measurements and high density autokeratometry. If no number appears, it means that the formula is not applicable for. Purpose to compare the performance of okulix raytracing software with srk t and hoffer q formula in intraocular lens iol power calculation in patients presenting with cataract. The middle line appearing in bold type indicates which refraction of the corresponding iol comes closest to the desired target refraction.