Can the accuracy of multifocal intraocular lens power calculation be improved to make patients spectacle free?

Hasnain Ramji, Johnny Moore, C B Tara Moore, Sunil Shah

Research output: Contribution to journalArticle


PURPOSE: To optimise intraocular lens (IOL) power calculation techniques for a segmental multifocal IOL, LENTIS™ MPlus(®) (Oculentis GmbH, Berlin, Germany) and assess outcomes.

METHODS: A retrospective consecutive non-randomised case series of patients receiving the MPlus(®) IOL following cataract surgery or clear lens extraction was performed at a privately owned ophthalmic hospital, Midland Eye, Solihull, UK. Analysis was undertaken of 116 eyes, with uncomplicated lens replacement surgery using the LENTIS™ MPlus(®) lenses. Pre-operative biometry data were stratified into short (<22.00 mm) and long axial lengths (ALs) (≥22.00 mm). IOL power predictions were calculated with SRK/T, Holladay I, Hoffer Q, Holladay II and Haigis formulae and compared to the final manifest refraction. These were compared with the OKULIX ray tracing method and the stratification technique suggested by the Royal College of Ophthalmologists (RCOphth).

RESULTS: Using SRK/T for long eyes and Hoffer Q for short eyes, 64% achieved postoperative subjective refractions of ≤±0.25 D, 83%≤±0.50 D and 93%≤±0.75 D, with a maximum predictive error of 1.25D. No specific calculation method performed best across all ALs; however for ALs under 22 mm Hoffer Q and Holliday I methods performed best.

CONCLUSIONS: Excellent but equivalent overall refractive results were found between all biometry methods used in this multifocal IOL study. For eyes with ALs under 22 mm Hoffer Q and Holliday I performed best. Current techniques mean that patients are still likely to need top up glasses for certain situations.

Original languageEnglish
Pages (from-to)160-166
Number of pages7
JournalContact Lens and Anterior Eye
Issue number2
Early online date28 Dec 2015
Publication statusPublished - Apr 2016



  • Biometry/instrumentation
  • Cataract Extraction
  • Eyeglasses
  • Humans
  • Lens Implantation, Intraocular
  • Lenses, Intraocular/standards
  • Nomograms
  • Optics and Photonics/standards
  • Reproducibility of Results
  • Retrospective Studies
  • Visual Acuity/physiology

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