Calculation of Intraocular Lens Power

The selection of intraocular lens (IOL) power in pediatric patients is decidedly different and more complex than when making a similar choice in adult patients. The choice of IOL power is driven by many factors such as the patient’s age at cataract surgery, the presence of unilateral or bilateral cataracts, the refractive error of the fellow eye, the physical properties of the eye including corneal size and axial length and the presence and density of preexisting amblyopia. Biometry measurements must be obtained as accurately as possible, and special consideration to the equipment needed may be required. A variety of IOL formulas exist, although none are perfectly suited to use in pediatric eyes. The patient’s age, biometry and other factors will contribute to the choice of formula used in a specific case. It is also important to consider the growing/changing eye in childhood and how these changes will translate into challenges managing resultant refractive error(s) and amblyopia.