Intraocular lens power calculation--the selection of formula. 1985

J S Hillman

The postoperative refraction of the eye after intraocular lens (IOL) implantation is an important aspect of the quality of aphakia correction. The postoperative refraction cannot be guessed with consistent accuracy as the refractive power of an eye is multifactorial. Calculation of IOL power is based upon measurements of corneal curvature and axial length and an estimation of postoperative anterior chamber depth. There are a number of formulae available for the calculation of IOL power. The optical formulae, of which those of R. D. Binkhorst are the most popular, give results which are very similar and which all differ from the mathematical regression SRK formula by the indication of a stronger IOL power for short eyes. A statistical analysis of postoperative results confirms that the R. D. Binkhorst formula gives the author an over-powered IOL for short eyes when calculated for emmetropia but not when calculated for planned ametropia. Results with the R. D. Binkhorst formula will be improved by the modification of the anterior chamber depth according to the axial length. Both formulae give satisfactory results for the range of axial lengths commonly encountered in clinical practice. Whichever formula is used, it is important for each surgeon to analyse postoperative results and to modify the selection of IOL power according to this feedback to correct for consistent errors of instrumentation or technique.

UI MeSH Term Description Entries
D007910 Lenses, Intraocular Artificial implanted lenses. Implantable Contact Lens,Lens, Intraocular,Contact Lens, Implantable,Intraocular Lens,Intraocular Lenses,Lens, Implantable Contact
D012029 Refraction, Ocular Refraction of LIGHT effected by the media of the EYE. Ocular Refraction,Ocular Refractions,Refractions, Ocular
D003315 Cornea The transparent anterior portion of the fibrous coat of the eye consisting of five layers: stratified squamous CORNEAL EPITHELIUM; BOWMAN MEMBRANE; CORNEAL STROMA; DESCEMET MEMBRANE; and mesenchymal CORNEAL ENDOTHELIUM. It serves as the first refracting medium of the eye. It is structurally continuous with the SCLERA, avascular, receiving its nourishment by permeation through spaces between the lamellae, and is innervated by the ophthalmic division of the TRIGEMINAL NERVE via the ciliary nerves and those of the surrounding conjunctiva which together form plexuses. (Cline et al., Dictionary of Visual Science, 4th ed) Corneas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000867 Anterior Chamber The space in the eye, filled with aqueous humor, bounded anteriorly by the cornea and a small portion of the sclera and posteriorly by a small portion of the ciliary body, the iris, and that part of the crystalline lens which presents through the pupil. (Cline et al., Dictionary of Visual Science, 4th ed, p109) Anterior Chambers,Chamber, Anterior,Chambers, Anterior
D055095 Optics and Photonics A specialized field of physics and engineering involved in studying the behavior and properties of light and the technology of analyzing, generating, transmitting, and manipulating ELECTROMAGNETIC RADIATION in the visible, infrared, and ultraviolet range. Photonics,Photonics and Optics

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