Accuracy of IOL Power Calculation Formulas for AcrySof SN60WF versus Tecnis ZCB00 Intraocular Lenses


Purpose: To compare the accuracy of various intraocular lens power formulas for two monofocal hydrophobic foldable lenses, the AcrySof SN60WF and the Tecnis ZCB00.

Methods: This retrospective study included 409 eyes from 409 patients who underwent uncomplicated cataract surgery (299 eyes with SN60WF and 110 eyes with ZCB00). Biometry was performed for all eyes with an IOLMaster 700. Predicted refraction from five different IOL power formulas (Barrett Universal II, Haigis, Hoffer-Q, Holladay 2, and SRK/T) was compared to postoperative refraction at one to three months for the following axial length strata: short eyes (<22.5 mm), medium eyes (22.5–25.5 mm), and long eyes (>25.5 mm).

Results: In patients with medium eyes, there were no significant differences in the mean absolute error (MAE) and the percentage of eyes within ±0.5 D (%±0.5 D) between both IOLs. In short eyes, although MAE was similar between both lenses, %±0.5 D was significantly higher for Barrett Universal II in ZCB00 than in SN60WF (P = 0.01) while Hoffer-Q and Holladay 2 performed equally for both lenses. In long eyes, ZCB00 had a higher MAE than SN60WF for Barrett Universal II, Haigis, and Hoffer-Q. Additionally, in long eyes, the percentage of eyes within %±0.5 D was significantly higher for SN60WF than ZCB00 for all formulas (P < 0.001).

Conclusion: Although there were no significant differences in the formula accuracy between these two lenses in medium eyes for all formulas and in short eyes for most formulas, the accuracy decreased significantly in long eyes for ZCB00 compared to SN60WF. The effect of IOL model on the postoperative outcomes should be further investigated.


Formula Accuracy, Intraocular Lens, SN60WF, ZCB00

1. Davis G. The evolution of cataract surgery. Mo Med 2016;113:58–62.

2. Hahn U, Krummenauer F, Kölbl B, Neuhann T, Schayan- Araghi K, Schmickler S, et al. Determination of valid benchmarks for outcome indicators in cataract surgery: a multicenter, prospective cohort trial. Ophthalmology 2011;118:2105–2112.

3. Lee ES, Lee SY, Jeong SY, Moon YS, Chin HS, Cho SJ, et al. Effect of postoperative refractive error on visual acuity and patient satisfaction after implantation of the Array multifocal intraocular lens. J Cataract Refract Surg 2005;31:1960–1965.

4. Hoffer KJ. The Hoffer Q formula: A comparison of theoretic and regression formulas. J Cataract Refract Surg 1993;19:700–712.

5. Retzlaff JA, Sanders DR, Kraff MC. Development of the SRK/T intraocular lens implant power calculation formula. J Cataract Refract Surg 1990;16:333–340.

6. Haigis W, Lege B, Miller N, Schneider B. Comparison of immersion ultrasound biometry and partial coherence interferometry for intraocular lens calculation according to Haigis. Graefes Arch Clin Exp Ophthalmol 2000;238:765– 773.

7. Barrett GD. An improved universal theoretical formula for intraocular lens power prediction. J Cataract Refract Surg 1993;19:713–720.

8. Hoffer KJ. Clinical results using the Holladay 2 intraocular lens power formula. J Cataract Refract Surg 2000;26:1233–1237.

9. Miraftab M, Hashemi H, Fotouhi A, Khabazkhoob M, Rezvan F, Asgari S. Effect of anterior chamber depth on the choice of intraocular lens calculation formula in patients with normal axial length. Middle Eastern Afr J Ophthalmol 2014;21:307–311.

10. Lee AC, Qazi MA, Pepose JS. Biometry and intraocular lens power calculation. Curr Opin Ophthalmol 2008;19:13–17.

11. Olsen T. Prediction of the effective postoperative (intraocular lens) anterior chamber depth. J Cataract Refract Surg 2006;32:419–424.

12. MacLaren RE, Natkunarajah M, Riaz Y, Bourne RRA, Restori M, Allan BDS. Biometry and formula accuracy with intraocular lenses used for cataract surgery in extreme hyperopia. Am J Ophthalmol 2007;143:920–931.

13. Zhou D, Sun Z, Deng G. Accuracy of the refractive prediction determined by intraocular lens power calculation formulas in high myopia. Indian J Ophthalmol 2019;67:484–489.

14. Zhang Y, Liang XY, Liu S, Lee JW, Bhaskar S, Lam DS. Accuracy of intraocular lens power calculation formulas for highly myopic eyes. J Ophthalmol 2016;2016:1917268.

15. Liao X, Peng Y, Liu B, Tan QQ, Lan CJ. Agreement of ocular biometric measurements in young healthy eyes between IOLMaster 700 and OA-2000. Sci Rep 2020;10:3134.

16. Hoffer KJ, Savini G. IOL Power calculation in short and long eyes. Asia Pac J Ophthalmol 2017;6:330–331.

17. Moschos MM, Chatziralli IP, Koutsandrea C. Intraocular lens power calculation in eyes with short axial length. Indian J Ophthalmol 2014;62:692–694.

18. Abulafia A, Barrett GD, Rotenberg M, Kleinmann G, Levy A, Reitblat O, et al. Intraocular lens power calculation for eyes with an axial length greater than 26.0 mm: Comparison of formulas and methods. J Cataract Refract Surg 2015;41:548–556.

19. Kane JX, Van Heerden A, Atik A, Petsoglou C. Accuracy of 3 new methods for intraocular lens power selection. J Cataract Refract Surg 2017;43:333–339.

20. Olsen T, Thim K, Corydon L. Accuracy of the newer generation intraocular lens power calculation formulas in long and short eyes. J Cataract Refract Surg 1991;17:187–193.

21. Lee BS, Chang DF. Comparison of the rotational stability of two toric intraocular lenses in 1273 consecutive eyes. Ophthalmology 2018;125:1325–1331.

22. Sakai H, Shimizu K. Physical characteristics of various intraocular lenses. J Cataract Refract Surg 1987;13:151–156.

23. Roberts TV, Hodge C, Sutton G, Lawless M, Contributors to the Vision Eye Institute IOL outcomes registry. Comparison of Hill-radial basis function, Barrett Universal and current lens power during cataract surgery. Clin Exp Ophthalmol 2018;46:240–246.

24. Kane JX, Van Heerden A, Atik A, Petsoglou C. Intraocular lens power formula accuracy: Comparison of 7 formulas. J Cataract Refract Surg 2016;42:1490–1500.

25. Cooke DL, Cooke TL. Comparison of 9 intraocular lens power calculation formulas. J Cataract Refract Surg 2016;42:1157–1164.

26. Reitblat O, Levy A, Kleinmann G, Kleinmann G, Lerman TT, Assia EI. Intraocular lens power calculation for eyes with high and low average keratometry readings: Comparison between various formulas. J Cataract Refract Surg 2017;43:1149–1156.

27. Gökce SE, Zeiter JH, Weikert MP, Koch DD, Hill W, Wang L. Intraocular lens power calculations in short eyes using 7 formulas. J Cataract Refract Surg 2017;43:892–897.

28. Melles RB, Holladay JT, Chang WJ. Accuracy of intraocular lens calculation formulas. Ophthalmology 2018;125:169–178.

29. Salvatore S, Lupo S, Nebbioso M, Huang YH, Vingolo EM. New insight into visual function with aspherical intraocular lenses (IOLs): Tecnis ZCB00 and Acrysof SN60WF. Int Ophthalmol 2011;31:417–419.

30. Gale RP, Saldana M, Johnston RL, Zuberbuhler B, McKibbin M. Benchmark standards for refractive outcomes after NHS cataract surgery. Eye 2009;23:149–152.

31. Aristodemou P, Knox Cartwright NE, Sparrow JM, Johnston RL. Formula choice: Hoffer Q, Holladay 1, or SRK/T and refractive outcomes in 8108 eyes after cataract surgery with biometry by partial coherence interferometry. J Cataract Refract Surg 2011;37:63–71.

32. Kim SY, Lee SH, Kim NR, Chin HS, Jung JW. Accuracy of intraocular lens power calculation formulas using a sweptsource optical biometer. PLoS One 2020;15(1):e0227638.

33. Narváez J, Zimmerman G, Stulting RD, Chang DH. Accuracy of intraocular lens power prediction using the Hoffer Q, Holladay 1, Holladay 2, and SRK/T formulas. J Cataract Refract Surg 2006;32:2050–2053.

34. Beiko GH. A pilot study to determine if intraocular lens choice at the time of cataract surgery has an impact on patient-reported driving habits. Clin Ophthalmol. 2015;9:1573–1579.

35. Johnson & Johnson Vision. Technis monofocal 1-piece IOL. Johnson & Johnson Vision; 2021. Available from:®-1-piece-iol

36. Acrysof IQ. Product information. Alcon Laboratories, Inc.; 2015. Available from: cdrh_docs/pdf4/P040020S050d.pdf

37. Wang L, Koch DD, Hill W, Abulafia A. Pursuing perfection in intraocular lens calculations: III. Criteria for analyzing outcomes. J Cataract Refract Surg 2017;43:999–1002.

38. Wang Q, Jiang W, Lin T, Wu X, Lin H, Chen W. Meta-analysis of accuracy of intraocular lens power calculation formulas in short eyes. Clin Exp Ophthalmol 2018;46:356–363.

39. Wang Q, Jiang W, Lin T, Zhu Y, Chen C, Lin H, et al. Accuracy of intraocular lens power calculation formulas in long eyes: a systematic review and meta-analysis. Clin Exp Ophthalmol 2018;46:738–749.

40. Tang KS, Tran EM, Chen AJ, Rivera DR, Rivera JJ, Greenberg PB. Accuracy of biometric formulae for intraocular lens power calculation in a teaching hospital. Int J Ophthalmol 2020;13:61–65.

41. Wang L, Shirayama M, Ma XJ, Kohnen T, Koch DD. Optimizing intraocular lens power calculations in eyes with axial lengths above 25.0 mm. J Cataract Refract Surg 2011;37:2018–2027.