Gender-specific vision correction with advanced lens technology.

Refractive Lens Exchange: Are Men and Women Seeing Eye-to-Eye?

Samir D’Costa in Health & Wellness June 2025 • 4 min read.

"Uncover how gender impacts the precision of vision correction surgery and which formulas deliver the best results for everyone."

As vision correction technologies advance, refractive lens exchange (RLE) is gaining traction as a solution for presbyopia and various refractive errors. Unlike traditional cataract surgery, RLE often caters to a younger, more demanding demographic seeking optimal uncorrected visual acuity. This heightened expectation necessitates precise intraocular lens (IOL) power calculations to ensure the best possible outcomes.

A recent study published in the European Journal of Ophthalmology sheds light on an intriguing aspect of RLE: gender differences in refractive prediction. The study explores how different IOL power calculation formulas perform in men versus women, aiming to refine surgical techniques and improve patient satisfaction.

This article delves into the findings of this research, breaking down the complexities of biometry, refractive prediction error, and the subtle yet significant ways in which gender can influence the success of RLE surgery. Whether you're considering RLE or simply curious about the nuances of vision correction, this analysis offers valuable insights into achieving optimal results.

Decoding Refractive Prediction Error: Does Gender Play a Role?

Gender-specific vision correction with advanced lens technology.

The core of the study revolves around refractive prediction error (RPE), a measure of the difference between the intended and actual postoperative refractive outcome. The researchers analyzed data from 512 patients (1024 eyes) who underwent bilateral same-day RLE surgery. All surgeries were performed by the same surgeon, and postoperative controls were managed by one doctor. The goal was emmetropia (zero refractive error) in all cases, with the Haigis formula used for initial IOL power calculations.

The study meticulously calculated both the absolute RPE (RPEAbs) and the RPE with correct signs (RPEsign) for each patient. They then compared these values between men and women, and across two different IOL calculation formulas: the Haigis formula and the SRK/T formula. By scrutinizing these results, the researchers aimed to identify any systematic differences in refractive outcomes based on gender.

Here's a breakdown of the key findings:

Haigis vs. SRK/T: The Haigis formula generally yielded smaller RPEAbs values compared to the SRK/T formula, indicating greater accuracy in predicting refractive outcomes.
Gender and RPEAbs: No significant gender difference was observed in RPEAbs when using the Haigis formula. This suggests that the Haigis formula performs consistently well regardless of gender.
Gender and RPEsign (SRK/T): The SRK/T formula showed a slight myopic error (nearsightedness) in women and a slight hyperopic error (farsightedness) in men.
Haigis Consistency: The Haigis formula did not exhibit this gender-related bias, maintaining consistent refractive outcomes in both men and women.
Anatomical Factors: Men in the study exhibited longer axial lengths, deeper anterior chambers, and flatter corneal curvatures compared to women.

These findings point to a crucial insight: while the Haigis formula appears to be a robust choice for IOL power calculation in RLE, the SRK/T formula may introduce gender-specific biases. The anatomical differences between men and women, particularly axial length, corneal curvature, and anterior chamber depth, seem to influence the SRK/T formula's predictive accuracy.

The Future of RLE: Personalized Vision Correction

The study underscores the importance of considering individual patient characteristics, including gender and anatomical factors, when planning RLE surgery. While the Haigis formula demonstrates superior overall performance in this cohort, further research is needed to refine IOL power calculation formulas and address the subtle nuances that can influence refractive outcomes. Ultimately, the goal is to move towards personalized vision correction strategies that optimize results for every patient, regardless of gender.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.5301/ejo.5000522, Alternate LINK

Title: Gender Differences In Refractive Prediction In Refractive Lens Exchange Surgery

Subject: Ophthalmology

Journal: European Journal of Ophthalmology

Publisher: SAGE Publications

Authors: Oskar Lundqvist, Oscar Westin, Timo Koskela, Anders Behndig

Published: 2014-09-27

Everything You Need To Know

What is refractive prediction error (RPE), and why is it important in refractive lens exchange (RLE) surgery?

Refractive prediction error (RPE) is the difference between the intended and actual refractive outcome after refractive lens exchange (RLE) surgery. It's calculated to measure the accuracy of IOL power calculation formulas like the Haigis formula and the SRK/T formula. Minimizing RPE is crucial for achieving the desired vision correction results, such as emmetropia, where no refractive error exists after surgery.

How did the Haigis formula perform compared to the SRK/T formula in predicting refractive outcomes in RLE?

In the study, the Haigis formula generally provided more accurate refractive prediction in RLE compared to the SRK/T formula. Specifically, the Haigis formula yielded smaller absolute refractive prediction error (RPEAbs) values, indicating greater accuracy in predicting refractive outcomes, and did not exhibit gender-related biases like the SRK/T formula did.

Do anatomical differences between men and women play a role in the accuracy of IOL power calculation formulas during RLE?

Yes, anatomical differences between men and women can influence the accuracy of IOL power calculation formulas in RLE. The study found that men tend to have longer axial lengths, deeper anterior chambers, and flatter corneal curvatures compared to women. These differences can affect how formulas like the SRK/T formula predict refractive outcomes, potentially leading to myopic errors in women and hyperopic errors in men. However, the Haigis formula appeared to be more robust, minimizing the impact of these gender-specific anatomical variations.

Did the study identify any gender-specific biases associated with the SRK/T formula in RLE?

The study found that the SRK/T formula exhibited gender-specific biases in refractive prediction. Specifically, it showed a slight myopic error (nearsightedness) in women and a slight hyperopic error (farsightedness) in men. This suggests that anatomical differences between genders, like axial length and corneal curvature, may affect the SRK/T formula's accuracy. The Haigis formula did not show these gender-related biases, indicating it may be a more consistent choice for IOL power calculation in RLE.

What does personalized vision correction mean in the context of RLE, and how can it improve outcomes for patients?

Personalized vision correction in RLE involves tailoring surgical strategies based on individual patient characteristics, including gender and anatomical factors. This approach recognizes that factors like axial length, anterior chamber depth, and corneal curvature can influence refractive outcomes. By accounting for these individual differences and using more accurate IOL power calculation formulas like the Haigis formula, surgeons can optimize refractive outcomes and improve patient satisfaction after RLE. Future research is geared towards refining these personalized strategies for even better results.