Considerations of a thick lens formula for intraocular lens power calculation

Background: In recent years, some lens manufacturers have committed to providing lens shape data for some of their lens models. The purpose of this study is to present a strategy for prediction of intraocular lens power and residual refraction based on a pseudophakic model eye containing 5 refractive surfaces and to show its applicability using worked examples. Methods: A pseudophakic model eye with a thin spectacle correction, a thick cornea (radius of curvatures for both surfaces and central thickness) and a thick IOL (either radius of curvatures RLa and RLp for front and back surface or equivalent power PL and Coddington factor CL; and either central thickness LT or edge thickness and optic diameter) was set up. Calculations were performed based on linear Gaussian optics (vergence formulae). Formulae were provided to derive the lens power/shape and the residual equivalent spectacle refraction SEQ. From the lens shape the location of the haptic plane HP, the image sided principal plane of the lens HL, and the ocular magnification OM were extracted. Results: The calculation of a thick intraocular lens and the prediction of residual refraction is presented with reference to 3 working examples: A) lens varied in PL and shifted with its haptic plane keeping the CL constant, B) lens varied in CL and shifted with its haptic plane keeping PL constant, and C) CL and PL of the lens varied keeping its haptic plane position in the eye constant. For each combination of parameters (PL, CL, or haptic plane shift) the parameters influencing SEQ, OM and HL-HP were analysed. Conclusion: Some modern optical biometers currently on the market provide the radii of curvature of both corneal surface and all relevant distances in the eye. With additional data on the lens shape, it would be possible to improve lens power calculations by switching from thin to thick lens models for the cornea and for the lens. This would overcome one of the major drawbacks of current lens power calculation methods. © 2022