REFRACTIVE SURPRISE IN FOUR CATARACT CASES WITH EXTREME AXIAL LENGTHS
Abstract:
We present four operated cataract cases with extreme axial lengths where the biometric
formulas used for intraocular lens dioptre calculation have made surprising or unusual predictions.
The four operated cases were part of a study on 1192 eyes that compared the accuracy of five
biometric formulas. Case 2 and 3 had an unexpected increase in both keratometric and refractive
cylinder, compared to the preoperative cylinder. Case 1 with short axial length showed unexpectedly
poor results for Hoffer Q formula and Case 4 showed good results for all five formulas, even Hoffer Q
that is not recommended for long axial lengths. Refraction prediction errors altered by test-to-test
variations in keratometry or surgically induced astigmatism, as well as other erroneous measured
variables, could influence the results of studies analysing accuracy of biometric formulas, if the
number of cases is great enough, and should not be ignored
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