AIM: To compare the refractive prediction accuracy of 7 intraocular lens(IOL)calculation formulas in the cataract eyes with short axial length(AL)at different corneal curvatures and anterior chamber depth(ACD), and analyze relevant influencing factors contributing to prediction errors.

METHODS: A retrospective analysis was performed for 125 patients(125 eyes)with a short AL, who received cataract phacoemulsification at Shenyang He Eye Specialist Hospital from November 2020 to December 2021. According to the keratometry(Km), they were divided into low flat Km group(≤45.5 D), medium and high Km group(45.5 DRESULTS: There was a significant difference in the absolute prediction error of each formula(χ²=49.934, P<0.001)in the overall comparative analysis, and the MedAE of the Barrett Universal Ⅱ formula was the smallest(0.17 D). There were significant statistical differences in the middle-high and steep Km groups(χ²=34.372, 34.804, all P<0.001), and the MedAE(0.14 D; 0.20 D)of the Barrett Universal Ⅱ formula was the smallest. The absolute prediction error of the 3 ACD subgroups was statistically significant(χ²=22.863, 25.568, 13.647, all P<0.05), and the MedAE(0.27 D; 0.15 D; 0.16 D)of the Barrett Universal Ⅱ formula was the smallest. Multiple linear regression analysis showed that Km, AL, and the IOL degree were important correlated factor leading to postoperative prediction error.

CONCLUSION: The accuracy of the Barrett Universal Ⅱ formula was higher in the short AL population under different biometric parameters, and AL, Km and IOL degree are closely related to the prediction accuracy.