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Peer-reviewedCC BY 4.0PLOS One

Comparison of IOL power calculation formulas in short eyes using ESCRS calculator and eyetemis: Influence of anterior segment biometry

  • Chung Young Kim1,2
  • Joo Youn Oh1,2
  • Hyuk Jin Choi2,3
  • Mee Kum Kim1,2
  • Chang Ho Yoon1,2
  1. 1Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
  2. 2Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
  3. 3Department of Ophthalmology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
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Abstract

This study compared the refractive prediction accuracy of seven contemporary intraocular lens (IOL) power calculation formulas in eyes with short axial length and assessed the influence of anterior chamber depth (ACD) and lens thickness (LT) on prediction error (PE). A total of 124 eyes with an axial length ≤22.0 mm that underwent uncomplicated phacoemulsification with implantation of a Tecnis ZCB00 IOL were included. Predicted postoperative refractions were obtained using the ESCRS calculator for Barrett Universal II, Cooke K6, EVO 2.0, Hill-RBF 3.0, Hoffer QST, Kane, and Pearl-DGS. Formula performance was evaluated using robust trimmed-mean analyses of trueness, precision, and accuracy implemented in the Eyetemis platform, along with conventional PE metrics and the proportions of eyes within predefined error thresholds. The mean axial length was 21.67 ± 0.31 mm, and the mean implanted IOL power was 25.2 ± 1.6 D. Kane showed a lower trimmed-mean absolute PE than Hoffer QST (0.376 vs. 0.445 D; p = 0.014). No significant inter-formula differences were observed at clinically relevant error thresholds. ACD and LT showed weak, formula-specific associations with PE; however, these findings were exploratory and not clinically actionable. Overall, contemporary formulas provided broadly comparable refractive accuracy in short eyes, although small formula-specific differences were observed.

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Cite

BibTeXRIS
BibTeX
@article{kim2026comparison,
  title = {{Comparison of IOL power calculation formulas in short eyes using ESCRS calculator and eyetemis: Influence of anterior segment biometry}},
  author = {Chung Young Kim and Joo Youn Oh and Hyuk Jin Choi and Mee Kum Kim and Chang Ho Yoon},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0361501},
  url = {https://doi.org/10.1371/journal.pone.0361501},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Comparison of IOL power calculation formulas in short eyes using ESCRS calculator and eyetemis: Influence of anterior segment biometry
AU  - Chung Young Kim
AU  - Joo Youn Oh
AU  - Hyuk Jin Choi
AU  - Mee Kum Kim
AU  - Chang Ho Yoon
PY  - 2026
DA  - 2026/10/27
JO  - PLOS One
DO  - 10.1371/journal.pone.0361501
UR  - https://doi.org/10.1371/journal.pone.0361501
AB  - This study compared the refractive prediction accuracy of seven contemporary intraocular lens (IOL) power calculation formulas in eyes with short axial length and assessed the influence of anterior chamber depth (ACD) and lens thickness (LT) on prediction error (PE). A total of 124 eyes with an axial length ≤22.0 mm that underwent uncomplicated phacoemulsification with implantation of a Tecnis ZCB00 IOL were included. Predicted postoperative refractions were obtained using the ESCRS calculator for Barrett Universal II, Cooke K6, EVO 2.0, Hill-RBF 3.0, Hoffer QST, Kane, and Pearl-DGS. Formula performance was evaluated using robust trimmed-mean analyses of trueness, precision, and accuracy implemented in the Eyetemis platform, along with conventional PE metrics and the proportions of eyes within predefined error thresholds. The mean axial length was 21.67 ± 0.31 mm, and the mean implanted IOL power was 25.2 ± 1.6 D. Kane showed a lower trimmed-mean absolute PE than Hoffer QST (0.376 vs. 0.445 D; p = 0.014). No significant inter-formula differences were observed at clinically relevant error thresholds. ACD and LT showed weak, formula-specific associations with PE; however, these findings were exploratory and not clinically actionable. Overall, contemporary formulas provided broadly comparable refractive accuracy in short eyes, although small formula-specific differences were observed.
SN  - 1932-6203
ER  -