Accuracy of the Holladay 2 intraocular lens formula for pediatric eyes in the absence of preoperative refraction.

PURPOSE: To evaluate the prediction error in pediatric eyes using the Holladay 2 formula in the absence of preoperative refraction and to compare it with the prediction error using the Holladay 1, Hoffer Q, and SRK/T formulas.

SETTING: Storm Eye Institute, Charleston, South Carolina, USA.

DESIGN: Evaluation of diagnostic test or technology.

METHODS: Eyes having pediatric cataract surgery with intraocular lens (IOL) implantation were analyzed. One eye of bilateral cases was randomly selected for inclusion. Prediction error was calculated using the predicted postoperative refraction minus the actual postoperative refraction.

RESULTS: Forty-five eyes were included. The median age at surgery was 3.56 years and the median follow-up, 28 days. Using the Holladay 2, Holladay 1, Hoffer Q, and SRK/T formulas, the mean prediction error was 0.02 diopter (D) ± 0.91 (SD), -0.21 ± 0.90 D, 0.07 ± 1.01 D, and -0.47 ± 0.98 D, respectively. The mean absolute prediction error was 0.68 ± 0.61 D, 0.71 ± 0.58 D, 0.72 ± 0.71 D, and 0.84 ± 0.69 D, respectively. The Holladay 2 formula had the least prediction error for shorter eyes (<22.0 mm). The mean difference between the actual versus the predicted refraction was -0.05 D using Holladay 2 (P=.71), -0.02 D using Holladay 1 (P= .89), -0.12 D using Hoffer Q (P=.44), and 0.04 D using SRK/T (P=.78).

CONCLUSION: The Holladay 2 formula had the least prediction error and absolute prediction error even in the absence of preoperative refraction.