Purpose: To compare the accuracy of SRK/T, Holladay I, Olsen and Barrets Universal II IOL power calculation formulae in patients of senile cataract with axial myopia..

Methods: A prospective clinical study was carried out on 50 eyes of 35 patients with an axial length from 24.5 to 31.87 mm including 21 (60%) males and 14(40%) females. Calculation of the IOL power to be implanted was done by SRK/T, Holladay I, Olsen and Barrets Universal II formulae. Mean error was calculated from the difference between the formula predicted refractive error and the actual post operative refractive error.

Results: There was no statistically significant difference between the mean errors of the four formulae used (p value 0.996).  In patients with axial length > 26 mm, SRK/T formula showed least mean error (0.26 ± 0.60) but with a statistically insignificant difference (p value 0.854).

Conclusion: Cataract surgery in high myopes is challenging. The calculation of IOL power in patients with high axial myopia using the third or  the fourth generation formulas help in improvement of the accuracy of the calculation and decreasing the post operative refractive error.