Comparing the accuracy of the new-generation intraocular lens power calculation formulae in axial myopic eyes: a meta-analysis

Abstract

Abstract Purpose To compare the accuracy of the new-generation intraocular lens power calculation formulae in axial myopic eyes. Methods Four databases, PubMed, Web of Science, EMBASE and Cochrane library, were searched to select relevant studies published between Apr 11, 2011, and Apr 11, 2021. Axial myopic eyes were defined as an axial length more than 24.5 mm. There are 13 formulae to participate in the final comparison (SRK/T, Hoffer Q, Holladay I, Holladay II, Haigis for traditional formulae, Barrett Universal II, Olsen, T2, VRF, EVO, Kane, Hill-RBF, LSF for the new-generation formulae). The primary outcomes were the percentage of eyes with a refractive prediction error in ± 0.5D and ± 1.0D. Results A total of 2273 eyes in 15 studies were enrolled in the final meta-analysis. Overall, the new-generation formulae showed a relatively more accurate outcome in comparison with traditional formulae. The percentage of eyes with a predictive refraction error in ± 0.5D (± 1.0D) of Kane, EVO and LSF was higher than 80% (95%), which was only significantly different from Hoffer Q (all P < 0.05). Moreover, another two new-generation formulae, Barrett Universal II and Olsen, had higher percentages than SRK/T, Hoffer Q, Holladay I and Haigis for eyes with predictive refraction error in ± 0.5D and ± 1.0D (all P < 0.05). In ± 0.5D group, Hill-RBF was better than SRK/T (P = 0.02), and Holladay I was better than EVO (P = 0.03) and LSF (P = 0.009), and Hoffer Q had a lower percentage than EVO, Kane, Hill-RBF and LSF (P = 0.007, 0.004, 0.002, 0.03, respectively). Barrett Universal II was better than T2 (P = 0.02), and Hill-RBF was better than SRK/T (P = 0.009). No significant difference was found in other pairwise comparison. Conclusion The new-generation formula is more accurate in intraocular lens power calculation for axial myopic eyes in comparison with the third- or fourth-generation formula.