• Kieren Darcy, David Gunn, Shokufeh Tavassoli, John Sparrow, and Jack X Kane.
• From the Bristol Eye Hospital, University Hospitals Bristol NHS, Foundation Trust (Darcy, Gunn, Tavassoli, Sparrow), Bristol, United Kingdom; and Department of Ophthalmology, Alfred Health (Kane), Melbourne, Australia.
• J Cataract Refract Surg. 2020 Jan 1; 46 (1): 2-7.

PurposeTo compare the accuracy of new/updated methods of intraocular lens (IOL) power calculation (Kane, Hill-RBF 2.0, and Holladay 2 with new axial length adjustment) with that of established methods (Barrett Universal II, Olsen, Haigis, Holladay 1, Hoffer Q, and SRK/T).SettingBristol Eye Hospital, University Hospitals Bristol National Health Service, Foundation Trust, Bristol, UK.DesignRetrospective consecutive case series.MethodsData from patients having uneventful cataract surgery with the insertion of 1 of 4 IOL types were included. Optimized IOL constants were used to calculate the predicted refraction of each formula for each patient. This was compared with the actual refractive outcome to give the prediction error. A subgroup analysis occurred based on the axial length and IOL type.ResultsThe study included 10 930 eyes of 10 930 patients with the Kane formula having the lowest mean absolute prediction error (MAE), which was statistically significant (P < .001 in all cases) followed by the Hill 2.0, Olsen, Holladay 2, Barrett Universal 2, Holladay 1, SRK/T, Haigis, and Hoffer Q formula. The percentage of eyes predicted within ±0.5 D was Kane, 72%; Hill 2.0, 71.2%; Olsen, 70.6%; Holladay 2, 71%; Barrett 2, 70.7%; SRK/T, 69.1%; Haigis, 69%; and Hoffer Q, 68.1%. The Kane formula had the lowest MAE for short, medium, and long axial length subgroups and for each IOL type assessed. The updated versions of the Holladay 2 and Hill 2.0 formulas have resulted in improved accuracy.ConclusionsOverall and in each axial length subgroup, the Kane formula was more accurate than the other formulas.

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