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Cao D, Hu M, Zhi D, Liang J, Tan Q, Lei Q, Li M, Cheng H, Wang L, Dai W. Systematic evaluation of machine learning-enhanced trifocal IOL power selection for axial myopia cataract patients. Comput Biol Med 2024; 173:108245. [PMID: 38531253 DOI: 10.1016/j.compbiomed.2024.108245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE This study aimed to evaluate and optimize intraocular lens (IOL) power selection for cataract patients with high axial myopia receiving trifocal IOLs. DESIGN A multi-center, retrospective observational case series was conducted. Patients having an axial length ≥26 mm and undergoing cataract surgery with trifocal IOL implanted were studied. METHODS Preoperative biometric and postoperative outcome data from 139 eyes were collected to train and test various machine learning (ML) models (support vector machine, linear regression, and stacking regressor) using five-fold cross-validation. The models' performance was further validated externally using data from 48 eyes enrolled from other hospitals. Performance of seven IOL calculation formulas (BUII, Kane, EVO, K6, DGS, Holladay I, and SRK/T) were examined with and without ML models. RESULTS The results of cross-validation revealed improvements across all IOL calculation formulas, especially for K6 and Holladay I. The model increased the percentage of eyes with a prediction error (PE) within ±0.50 D from 71.94% to 79.14% for K6, and from 35.25% to 51.80% for Holladay I. In external validation involving 48 patients from other centers, six out of seven formulas demonstrated a reduction in the mean absolute error (MAE). K6's PE within ±0.50 D improved from 62.50% to 77.08%, and Holladay I from 16.67% to 58.33%. CONCLUSIONS In this study, we conducted a comprehensive evaluation of seven IOL power calculation formulas in high axial myopia cases and explored the effectiveness of the Stacking Regressor model in augmenting their accuracy. Of these formulas, K6 and Holladay I exhibited the most significant improvements, suggesting that integrating ML may have varying levels of effectiveness across different formulas but holds substantial promise in improving the predictability of IOL power calculations in patients with long eyes.
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Affiliation(s)
- Danmin Cao
- Aier Institute of Digital Ophthalmology & Visual Science, Changsha Aier Eye Hospital, Changsha, China; Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Min Hu
- Aier Institute of Digital Ophthalmology & Visual Science, Changsha Aier Eye Hospital, Changsha, China; Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - Danlin Zhi
- The First Affiliated Hospital of University of South China, Hengyang, China
| | - Jianheng Liang
- Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | - Qian Tan
- Aier Institute of Digital Ophthalmology & Visual Science, Changsha Aier Eye Hospital, Changsha, China
| | - Qiong Lei
- Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Maoyan Li
- Aier Institute of Digital Ophthalmology & Visual Science, Changsha Aier Eye Hospital, Changsha, China
| | - Hao Cheng
- Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Li Wang
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - Weiwei Dai
- Aier Institute of Digital Ophthalmology & Visual Science, Changsha Aier Eye Hospital, Changsha, China.
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Plasencia-Salini R, Havens AP, Miller KM. Biometry challenges in the longest eyes we have encountered to date. Am J Ophthalmol Case Rep 2024; 33:101997. [PMID: 38318443 PMCID: PMC10839859 DOI: 10.1016/j.ajoc.2024.101997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/25/2023] [Accepted: 01/12/2024] [Indexed: 02/07/2024] Open
Abstract
Purpose This report aims to present biometry challenges and solutions for a patient with the longest eyes we have encountered to date. Observations A 41-year-old woman with a history of Crouzon syndrome, extreme axial myopia, and posterior segment staphylomas was referred for cataract evaluation. Optical biometry was attempted using two partial coherence interferometry and optical low-coherence reflectometry devices that were available in 2011. Neither device could measure the axial length (AL) of either eye, unfortunately. We were able to measure them by A scan ultrasound, however, with results of 40.59 mm for the right eye and 38.29 mm for the left eye. Shortly thereafter, she underwent uncomplicated phacoemulsification with posterior chamber intraocular lens implantation under topical anesthesia. Twelve years later, she returned for repeat optical biometry with 3 newer generation devices, 2 of which utilized swept-source optical coherence tomography (SS-OCT). Only 1 SS-OCT device, the Argos biometer, was able to obtain AL measurements, and they were 40.54 mm and 40.84 mm for the right and left eyes, respectively. Conclusions and importance Biometry measurement using optical biometers on a patient with ALs greater than 40 mm was impossible in 2011 because of the relatively short gate for acceptable readings. Ultrasound biometry can also be challenging due to the presence of posterior staphylomas. However, a newer SS-OCT with a longer AL measurement capability enabled readings to be obtained more recently.
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Affiliation(s)
- Raul Plasencia-Salini
- From the Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Amanda P. Havens
- From the Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Kevin M. Miller
- From the Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Lim H, Jang JH, Nam S, Lee K, Kim JY, Tchah H, Lee H. Refractive Predictability between Standard and Total Keratometry during the Femtosecond Laser-Assisted Cataract Surgery with Monofocal Intraocular Lens with Enhanced Intermediate Function. KOREAN JOURNAL OF OPHTHALMOLOGY 2024; 38:9-16. [PMID: 38110185 PMCID: PMC10869425 DOI: 10.3341/kjo.2023.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 11/14/2023] [Accepted: 11/19/2023] [Indexed: 12/20/2023] Open
Abstract
PURPOSE We aimed to compare the accuracy of the intraocular lens (IOL) calculation formula using the standard keratometry (K) and total K (TK) during the femtosecond laser-assisted cataract surgery (FLACS) with a monofocal IOL with enhanced intermediate function using currently used formulas. METHODS A retrospective review of 125 eyes from 125 patients who had undergone FLACS with implantation of monofocal IOL with enhanced intermediate function was conducted. The predicted refractive power was calculated using an optical biometer (IOLmaster 700) according to the K and TK in the Barrett Universal II, SRK/T, Haigis, and Holladay 2 formulas. Absolute prediction error (APE) obtained from the actual postoperative refractive outcomes and the refractive error predicted in each formula was compared one month after surgery. RESULTS Mean APE ranged between 0.29 and 0.39 diopters (D) regardless of the calculation formula and the method of measuring corneal curvature. Significant differences were observed in the APE from the four formulas and the two keratometric measurements (p = 0.014). In a total of 125 eyes from 125 patients, the mean APE was lowest with the Barrett Universal II formula. Across all formulas, both the mean APE and the median APE tended to be lower for K than for TK, although there was no significant difference. Approximately 70% to 80% of the patients were included within 0.5 D of the refractive error across all formulas. The percentage of eyes within 0.5 D of APE outcomes was not statistically different between the K and TK data when using each formula. CONCLUSIONS Keratometric measurements considering the poster corneal curvature did not show any additional advantages when implanting the monofocal IOL with enhanced intermediate function during the FLACS.
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Affiliation(s)
- Hyunah Lim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Hyuck Jang
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sanghyu Nam
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Koeun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hungwon Tchah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Alshehri M, Bin Helayel H, Vargas JM, Almutlak M, Fairaq R. Preferred surgical techniques for secondary intraocular lens implantation in adults with aphakia. Int Ophthalmol 2023; 43:3539-3547. [PMID: 37356032 DOI: 10.1007/s10792-023-02761-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/21/2023] [Indexed: 06/27/2023]
Abstract
AIM To identify the current surgical management of aphakia and the outcomes and complications of each technique. METHODS This cross-sectional study included ophthalmic surgeons with at least one-year experience in surgery for aphakia. A study questionnaire was formulated to collect data in Saudi Arabia and other regional countries. The questionnaire included 22 questions on demographics, preferred surgical techniques, complications and the factors related to surgeon decision and the choice for managing aphakia. RESULTS The study included 145 participants (111; 76.6% were males) with mean age of 46.7 ± 11.5 years. The mean duration of cataract surgery experience was 17.6 ± 11.1 years. Most participants (86.2%) were trained in cataract surgery. Scleral fixation of intraocular lens (SFIOL) was the most commonly preferred technique, followed by iris fixation IOL, and anterior chamber IOL (75.2%, 9%, and 15.9%, respectively). The main determinants for selection of a surgical technique were simplicity (56.6%), surgical instrument availability (48.3%), and training on the technique (47.6%). The most frequent postoperative complications were pupil distortion, high intraocular pressure (IOP), pupillary capture of the IOL, and IOL decentration. CONCLUSIONS SFIOL is the preferred surgical technique for managing aphakia. The decision to choose one technique over another is complex and is based on several factors, including technical difficulty, previous training, anatomical variations, ocular comorbidities, and the potential complications. The most frequent complications after surgical correction of aphakia are pupil distortion, high IOP, pupillary capture of the IOL, and decentered IOLs.
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Affiliation(s)
- Mohammed Alshehri
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia
- Anterior Segment Division, King Faisal Medical City, Abha, Saudi Arabia
| | - Halah Bin Helayel
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia
| | - José Manuel Vargas
- Ophthalmology Division, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Mohammed Almutlak
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia
| | - Rafah Fairaq
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia.
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Mo E, Chen Z, Feng K, Yang F, Li J, Zhao YE. Accuracy of Seven Modern Online IOL Formulas in Eyes With Axial Lengths Longer Than 30 mm. J Refract Surg 2023; 39:705-710. [PMID: 37824298 DOI: 10.3928/1081597x-20230831-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
PURPOSE To evaluate the accuracy of newer online intraocular lens (IOL) formulas in extremely elongated eyes (axial length > 30 mm). METHODS This retrospective case series study included 236 patients (236 eyes). Postoperative refractive outcomes of the Barrett Universal II (BU II), Cooke K6 (K6), Emmetropia Verifying Optical (EVO) 2.0, Hoffer QST (HQST), Kane, Pearl-DGS, and Radial Basis Function (RBF) 3.0 formulas were compared. Subgroup analysis was performed in the extreme myopia group 1 (30 < axial length ≤ 32 mm), extreme myopia group 2 (32 < axial length ≤ 35 mm), and meniscus IOL group. The root mean square absolute prediction error (RMSAE) and proportions of eyes of prediction errors within ±0.50 diopters (D) were calculated for statistical analysis. RESULTS For the extreme myopia group 1, RBF 3.0 achieved the lowest RMSAE (0.361) and EVO 2.0 showed the highest proportion of eyes within ±0.50 diopters (85.06%). For the extreme myopia group 2, the RMSAE of the K6 (0.442) and EVO 2.0 (0.475) was significantly lower than the BU II (0.610), Kane (0.641), and HQST (0.759, P ≤ .016) formulas. In the meniscus IOL group, the K6 formula showed the lowest RMSAE (0.402) and the highest percentage within ±0.50 diopters (84.31%). CONCLUSIONS The EVO 2.0 and K6 formulas are recommended for IOL power calculation in eyes with extreme myopia. Modern artificial intelligence-based formulas should be used cautiously when the axial length is longer than 32 mm or meniscus IOLs are implanted. [J Refract Surg. 2023;39(10):705-710.].
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Scharioth GB, Duran A, Béres H. Scharioth Macula Lens for patients with high myopia: a novel approach to achieve spectacle independence (binocular trifocal monovision). Rom J Ophthalmol 2023; 67:62-68. [PMID: 37089803 PMCID: PMC10117195 DOI: 10.22336/rjo.2023.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2023] [Indexed: 04/25/2023] Open
Abstract
We aimed to test a novel concept based on multiple IOL-implantation, targeting spectacle independence for patients with high and excessive myopia (26.0 mm < axial length; 6.0 D < refractive error). Therefore, we introduced the first results of five patients with high myopia. After clear lens extraction, one eye was targeted to emmetropia, and the other to mild myopia by implanting monofocal capsular bag IOLs with appropriate refractive powers in each case. The emmetropic eye was aimed to result in magnification and improved distance vision, while the mild myopic eye was supposed to ensure good intermediate vision. Thereafter, a Scharioth Macula Lens (SML) was implanted into the emmetropic eye in order to achieve sharp near vision. Visual acuity curves and defocus curves were plotted postoperatively. According to our results, this new concept seems to be an efficient approach of achieving appropriate uncorrected vision at all distances, by creating binocular trifocal monovision.
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Affiliation(s)
- Gabor Bernd Scharioth
- Aurelios Augenzentrum Recklinghausen, Recklinghausen, Germany
- Department of Ophthalmology, University of Szeged, Szeged, Hungary
| | - Ali Duran
- Aurelios Augenzentrum Recklinghausen, Recklinghausen, Germany
| | - Hanga Béres
- Aurelios Augenzentrum Recklinghausen, Recklinghausen, Germany
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Comparing the accuracy of the new-generation intraocular lens power calculation formulae in axial myopic eyes: a meta-analysis. Int Ophthalmol 2023; 43:619-633. [PMID: 36063246 PMCID: PMC9971158 DOI: 10.1007/s10792-022-02466-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 08/15/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To compare the accuracy of the new-generation intraocular lens power calculation formulae in axial myopic eyes. METHODS Four databases, PubMed, Web of Science, EMBASE and Cochrane library, were searched to select relevant studies published between Apr 11, 2011, and Apr 11, 2021. Axial myopic eyes were defined as an axial length more than 24.5 mm. There are 13 formulae to participate in the final comparison (SRK/T, Hoffer Q, Holladay I, Holladay II, Haigis for traditional formulae, Barrett Universal II, Olsen, T2, VRF, EVO, Kane, Hill-RBF, LSF for the new-generation formulae). The primary outcomes were the percentage of eyes with a refractive prediction error in ± 0.5D and ± 1.0D. RESULTS A total of 2273 eyes in 15 studies were enrolled in the final meta-analysis. Overall, the new-generation formulae showed a relatively more accurate outcome in comparison with traditional formulae. The percentage of eyes with a predictive refraction error in ± 0.5D (± 1.0D) of Kane, EVO and LSF was higher than 80% (95%), which was only significantly different from Hoffer Q (all P < 0.05). Moreover, another two new-generation formulae, Barrett Universal II and Olsen, had higher percentages than SRK/T, Hoffer Q, Holladay I and Haigis for eyes with predictive refraction error in ± 0.5D and ± 1.0D (all P < 0.05). In ± 0.5D group, Hill-RBF was better than SRK/T (P = 0.02), and Holladay I was better than EVO (P = 0.03) and LSF (P = 0.009), and Hoffer Q had a lower percentage than EVO, Kane, Hill-RBF and LSF (P = 0.007, 0.004, 0.002, 0.03, respectively). Barrett Universal II was better than T2 (P = 0.02), and Hill-RBF was better than SRK/T (P = 0.009). No significant difference was found in other pairwise comparison. CONCLUSION The new-generation formula is more accurate in intraocular lens power calculation for axial myopic eyes in comparison with the third- or fourth-generation formula.
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Moshirfar M, Durnford KM, Jensen JL, Beesley DP, Peterson TS, Darquea IM, Ronquillo YC, Hoopes PC. Accuracy of Six Intraocular Lens Power Calculations in Eyes with Axial Lengths Greater than 28.0 mm. J Clin Med 2022; 11:jcm11195947. [PMID: 36233812 PMCID: PMC9572881 DOI: 10.3390/jcm11195947] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/30/2022] [Accepted: 10/02/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to compare the accuracy of several intraocular (IOL) lens power calculation formulas in long eyes. This was a single-site retrospective consecutive case series that reviewed patients with axial lengths (AL) > 28.0 mm who underwent phacoemulsification. The Wang−Koch (WK) adjustment and Cooke-modified axial length (CMAL) adjustment were applied to Holladay 1 and SRK/T. The median absolute error (MedAE) and the percentage of eyes with prediction errors ±0.25 diopters (D), ±0.50 D, ±0.75 D, and ±1.00 D were used to analyze the formula’s accuracy. This study comprised a total of 35 eyes from 25 patients. The Kane formula had the lowest MedAE of all the formulas, but all were comparable except Holladay 1, which had a significantly lower prediction accuracy with either AL adjustment. The SRK/T formula with the CMAL adjustment had the highest accuracy in predicting the formula outcome within ±0.50 D. The newer formulas (BU-II, EVO, Hill-RBF version 3.0, and Kane) were all equally predictable in long eyes. The SRK/T formula with the CMAL adjustment was comparable to these newer formulas with better outcomes than the WK adjustment. The Holladay 1 with either AL adjustment had the lowest predictive accuracy.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision, HDR Research Center, Draper, UT 84020, USA
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, Salt Lake City, UT 84132, USA
- Utah Lions Eye Bank, Murray, UT 84107, USA
- Correspondence: ; Tel.: +1-801-568-0200
| | | | - Jenna L. Jensen
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA
| | | | - Telyn S. Peterson
- College of Osteopathic Medicine, Rocky Vista University, Ivins, UT 80112, USA
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Chu YC, Huang TL, Chang PY, Ho WT, Hsu YR, Chang SW, Wang JK. Predictability of 6 Intraocular Lens Power Calculation Formulas in People With Very High Myopia. Front Med (Lausanne) 2022; 9:762761. [PMID: 35462991 PMCID: PMC9024044 DOI: 10.3389/fmed.2022.762761] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 03/08/2022] [Indexed: 12/05/2022] Open
Abstract
Purpose To investigate the accuracy of 6 intraocular lens (IOL) power calculation formulas in predicting refractive outcomes in extremely long eyes. Setting Department of Ophthalmology, Far Eastern Memorial Hospital, Taiwan. Design Retrospective comparative study. Methods In this retrospective single-center study, we reviewed 70 eyes of 70 patients with axial length (AL) ≥ 28 mm who had received an uneventful 2.2 mm corneal wound phacoemulsification and in-the-bag IOL placement. The actual postoperative refractive results were compared to the predicted refraction calculated with 6 formulas (Haigis, Hoffer Q, Holladay 1, SRK/T, T2, Barrett Universal II formulas) using IOLMaster 500 as optical biometry in the User Group for Laser Interference Biometry (ULIB) constants. Results Overall, the Haigis and Barrett formulas achieved the lowest level of mean prediction error (PE) and median absolute error (MedAE). Hoffer Q, Holladay 1, SRK/T, and T2 had hyperopic prediction errors (p < 0.05). The Hoffer Q and Holladay 1 had significantly more MedAE between the 6 formulas. After the mean PE was zeroed out, the MedAE had no significant difference between each group. The absolute error tends to be larger in patients with longer AL. The absolute errors were 30.0–37.1% and 60.0–64.3% within 1.0 D of all patients compared to predicted refraction calculated using various formulas. Conclusion The Haigis and Barrett Universal II formulas had a better success rate in predicting IOL power in high myopic eyes with AL longer than 28 mm using the ULIB constant in this study. The postoperative refractive results were inferior to the benchmark standards, which indicated that the precision of IOL power calculation in patients with high myopia still required improvement.
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Affiliation(s)
- Yi-Ching Chu
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Tzu-Lun Huang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Pei-Yao Chang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
- Department of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wei-Ting Ho
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yung-Ray Hsu
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shu-Wen Chang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jia-Kang Wang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
- Department of Medicine, National Taiwan University, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Department of Healthcare Administration and Department of Nursing, Oriental Institute of Technology, New Taipei, Taiwan
- *Correspondence: Jia-Kang Wang
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Ersan I, Kilic S, Işik S. Evaluation of ocular surface epithelial and stromal thicknesses in psoriasis using anterior segment optical coherence tomography. Int Ophthalmol 2022; 42:3037-3043. [PMID: 35389173 DOI: 10.1007/s10792-022-02289-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/12/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the epithelial and stromal thicknesses of conjunctiva and cornea in psoriatic patients with anterior segment optical coherence tomography (AS-OCT), METHODS: In this cross-sectional study, 61 patients with psoriasis and 42 age-matched, healthy individuals were enrolled. The epithelial and stromal thicknesses of both inferotemporal bulbar conjunctiva and central cornea were measured using AS-OCT. RESULTS Both the tear breakup time and Schirmer-1 test values were significantly lower in the psoriasis group compared with the controls (p < 0.05). The epithelial thickness of conjunctiva and cornea did not differ between psoriasis and control groups (p > 0.05). The central corneal stroma was significantly thicker in the psoriasis group (p = 0.04). PASI was positively correlated with the thickness of central cornea stroma (r = 0.442, p = 0.006) in the nail psoriasis group. CONCLUSIONS Psoriasis is not associated with altered epithelial thicknesses of the cornea and conjunctiva. It is accompanied by the stromal thickening of the cornea without conjunctival stromal involvement.
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Affiliation(s)
- Ismail Ersan
- Department of Ophthalmology, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
| | - Sevilay Kilic
- Department of Dermatology, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Selda Işik
- Department of Dermatology, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
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Recurring themes during cataract assessment and surgery. Eye (Lond) 2021; 35:2482-2498. [PMID: 33927353 DOI: 10.1038/s41433-021-01548-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 03/01/2021] [Accepted: 04/09/2021] [Indexed: 02/06/2023] Open
Abstract
The aim of this review was to discuss frequently encountered themes such as cataract surgery in presence of age-related macular degeneration (AMD), dementia, Immediate Sequential Bilateral Cataract Surgery (ISBCS), discussing non-standard intraocular lens (IOL) options during consultation in the National Health Services (NHS) and the choice of the biometric formulae based on axial length. Individual groups of authors worked independently on each topic. We found that cataract surgery does improve visual acuity in AMD patients but the need for cataract surgery should be individualised. In patients with dementia, cataract surgery should be considered 'sooner rather than later' as progression may prevent individuals presenting for surgery. This should be planned after discussion of patients' best interests with any carers; multifocal IOLs are not proven to be the best option in these patients. ISBCS gives comparable outcomes to delayed sequential surgeries with a low risk of bilateral endophthalmitis and it can be cost-saving and efficient. Patients are entitled to know all suitable IOL options that can improve their quality of life. Deliberately withholding this information or pressuring patients to choose a non-standard IOL is inappropriate. However, one should be mindful of the not spending inappropriate amounts of time discussing these in the NHS setting which may affect care of other NHS patients. Evidence suggests Hoffer Q, Haigis, Hill-RBF and Kane formulae for shorter eyes; Barrett Universal II (BU II), Holladay II, Haigis and Kane formulae for longer eyes and BU II, Hill-RBF and Kane formulae for medium axial length eyes.
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Bernardes J, Raimundo M, Lobo C, Murta JN. A Comparison of Intraocular Lens Power Calculation Formulas in High Myopia. J Refract Surg 2021; 37:207-211. [PMID: 34038295 DOI: 10.3928/1081597x-20201123-01] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To comparatively evaluate the accuracy of newer intraocular lens (IOL) calculation formulas and common third-generation formulas after Wang-Koch adjustment in the prediction of postoperative refraction in highly myopic eyes. METHODS This was a retrospective study including eyes with high myopia that had uncomplicated cataract surgery with implantation of an AcrySof MA60MA IOL (power range: -5.00 to +5.00 diopters [D]) (Alcon Laboratories, Inc). All patients underwent optical biometry (Carl Zeiss IOLMaster 500 and IOLMaster 700, and Allegro Biograph) and the postoperative spherical equivalent for the implanted IOL was estimated using SRK/T, Holladay 1 (both Wang-Koch adjusted), Haigis, Barrett Universal II, Kane, Ladas, and Hill-RBF v2.0 formulas. Outcomes included the median absolute prediction error (MedAE) and the proportion of eyes within ±0.25, ±0.50, and ±1.00 D of the preoperative prediction. RESULTS Eighty-two eyes with a mean axial length of 30.89 ± 1.85 mm were included. The MedAE in ascending order was Hill-RBF v2.0 0.31 D, Kane 0.33 D, Barrett 0.36 D, Holladay Iwk 0.37 D, SRK/Twk 0.37 D, Holladay Iwk 0.43 D, HaigisULIB 0.54 D, and Ladas 0.61 D. The formula with the lowest MedAE (Hill-RBF v2.0) yielded a prediction error within ±0.25, ±0.50, and ±1.00 D in 43.1%, 70.6%, and 94.1% of cases, respectively. CONCLUSIONS Recent formulas such as Barrett Universal II, Kane, and Hill-RBF v2.0 and Wang-Koch adjusted formulas perform well in this subset of patients with high myopia. The Hill-RBF v2.0 formula had the lowest MedAE and highest proportion of eyes within ±0.25, ±0.50, and ±1.00 D of the predicted target. [J Refract Surg. 2021;37(3):207-211.].
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Zhang C, Dai G, Pazo EE, Xu L, Wu X, Zhang H, Lin T, He W. Accuracy of intraocular lens calculation formulas in cataract patients with steep corneal curvature. PLoS One 2020; 15:e0241630. [PMID: 33216749 PMCID: PMC7678954 DOI: 10.1371/journal.pone.0241630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/16/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To compare the accuracy of five kinds of intraocular lens calculation formulas (SRK/T, Haigis, Hoffer Q, Holladay and Barrett Universal Ⅱ) in cataract patients with steep curvature cornea ≥ 46.0 diopters. METHODS This is a retrospective study of cataract phacoemulsification combined with intraocular lens implantation in patients with steep curvature cornea (corneal curvature ≥ 46D). The refractive prediction errors of IOL power calculation formulas (SRK/T, Haigis, Holladay, Hoffer Q, and Barrett Universal II) using User Group for Laser Interference Biometry (ULIB) constants were evaluated and compared. Objective refraction results were assessed at one month postoperatively. According to axial length (AL), all patients were divided into three groups: short AL group (<22mm), normal AL group (>22 to ≤24.5mm) and long AL group (>24.5mm). Calculate the refractive error and absolute refractive error (AE) between the actual postoperative refractive power and the predicted postoperative refractive power. The covariance analysis was used for the comparison of five formulas in each group. The correlation between the absolute refractive error and AL from every formula were analyzed by Pearson correlation test, respectively. RESULT Total 112 eyes of 83 cataract patients with steep curvature cornea were collected. The anterior chamber depth (ACD) was a covariate in the short AL group in the covariance analysis of absolute refractive error (P<0.001). The SRK/T and Holladay formula had the lowest mean absolute error (MAE) (0.47D), there were statistically significant differences in MAE between the five formulas for short AL group (P = 0.024). The anterior chamber depth had no significant correlation in the five calculation formulas in the normal AL group and long AL group (P = 0.521, P = 0.609 respectively). In the normal AL group, there was no significant difference in MAE between the five calculation formulas (P = 0.609). In the long AL group, Barrett Universal II formula had the lowest MAE (0.35), and there were statistically significant differences in MAE between the five formulas (P = 0.012). Over the entire AL range, the Barrett Universal II formula had the lowest MAE and the highest percentage of eyes within ± 0.50 D, ± 1.00 D, and ± 1.50 D (69.6%, 93.8%, and 98.2% respectively). CONCLUSION Compared to SRK/T, Haigis, Hoffer Q, and Holladay, Barrett Universal Ⅱ formula is more accurate in predicting the IOL power in the cataract patients with steep curvature cornea ≥ 46.0 diopters.
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Affiliation(s)
- Chenguang Zhang
- Department of Ophthalmology, He Eye Specialists Hospitals, Shenyang, China
| | - Guangzheng Dai
- Department of Ophthalmology, He Eye Specialists Hospitals, Shenyang, China
| | - Emmanuel Eric Pazo
- Department of Ophthalmology, He Eye Specialists Hospitals, Shenyang, China
| | - Ling Xu
- Department of Ophthalmology, He Eye Specialists Hospitals, Shenyang, China
| | - Xianwei Wu
- Department of Ophthalmology, He Eye Specialists Hospitals, Shenyang, China
| | - Hongda Zhang
- Department of Ophthalmology, He Eye Specialists Hospitals, Shenyang, China
| | - Tiezhu Lin
- Department of Ophthalmology, He Eye Specialists Hospitals, Shenyang, China
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- * E-mail: (TL); (WH)
| | - Wei He
- Department of Ophthalmology, He Eye Specialists Hospitals, Shenyang, China
- * E-mail: (TL); (WH)
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Effect of microinterventional endocapsular nucleus disassembly using centripetal loop fragmentation on refractive outcomes after cataract surgery. J Cataract Refract Surg 2020; 46:1515-1521. [DOI: 10.1097/j.jcrs.0000000000000320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Comparison of Predictability Using Barrett Universal II and SRK/T Formulas according to Keratometry. J Ophthalmol 2020; 2020:7625725. [PMID: 32655942 PMCID: PMC7321508 DOI: 10.1155/2020/7625725] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 05/25/2020] [Accepted: 05/28/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose To compare the predictability of intraocular lens (IOL) power calculation using the Barrett Universal II and the SRK/T formulas, according to the keratometry. Methods We retrospectively reviewed the clinical charts of 335 consecutive eyes undergoing standard cataract surgery. IOL power calculations were performed using the Barrett Universal II and the SRK/T formulas. We compared the prediction error, the absolute error, and the percentages within ±0.25, ±0.5, and ±1.0 D of the targeted refraction, 1 month postoperatively, and also investigated the relationship of these outcomes with the keratometric readings, using the two formulas. Results The prediction error using the SRK/T formula was significantly more myopic than that using the Barrett Universal II formula (the paired t-test, p < 0.001). The absolute error using the SRK/T formula was significantly larger than that using the Barrett Universal II formula (p=0.006). We found a significant correlation between the prediction error and the keratometric readings using the SRK/T formula (Pearson correlation coefficient, r = −0.522, p < 0.001), but there was no significant correlation between them using the Barrett Universal II formula (r = −0.031, p=0.576). Conclusions The Barrett Universal II formula provides a better predictability of IOL power calculation and is less susceptible to the effect of the corneal shape, than the SRK/T formula. The Barrett Universal formula, instead of the SRK/T formula, may be clinically helpful for improving the refractive accuracy, especially in eyes with steep or flat corneas.
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Ohr MP, Wisely CE. Refractive outcomes and accuracy of IOL power calculation with the SRK/T formula for sutured, scleral-fixated Akreos AO60 intraocular lenses. Graefes Arch Clin Exp Ophthalmol 2020; 258:2125-2129. [PMID: 32504099 DOI: 10.1007/s00417-020-04721-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/17/2020] [Accepted: 04/23/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Scleral fixation of intraocular lenses has become a popular procedure for treating aphakia in the absence of capsular support. However, the lens formulas used to predict refractive outcomes were designed for in-the-bag lens placement. This study evaluates the accuracy of the SRK/T formula in predicting a target postoperative refraction when suturing a scleral-fixated intraocular lens (IOL) implant 3 mm posterior to the limbus. METHODS This is a retrospective, case series including 20 eyes of 20 patients who underwent scleral fixation of Akreos AO60 IOLs (Bausch & Lomb, Rochester, NY) by a single surgeon at the OSU Wexner Medical Center. Preoperative measurements were performed with optical biometry, and IOL power was calculated with the SRK/T formula. Following surgery, the actual refractive spherical equivalent (SE) was performed and compared with the preoperative prediction. Prediction error (PE), defined as the deviation of actual postoperative SE refraction in diopters (D) from preoperative predicted SE refraction, was the primary outcome measure. RESULTS The mean attempted (predicted) SE was - 1.12 D (± 0.87). Mean achieved SE was - 0.96 D (± 1.04). Mean PE (actual postoperative SE versus predicted preoperative SE) was 0.16 D (± 0.69). A total of 9 eyes (45%) were within ± 0.5 D of the predicted SE, 16 eyes (80%) were within ± 1.0 D, and all 20 eyes (100%) were within ± 1.5 D. CONCLUSION IOL power calculation using the SRK/T formula with optical biometry demonstrates reliable postoperative refractive outcomes in patients undergoing scleral fixation of an IOL (Akreos AO60). Further studies are needed to refine the predictive value of the SRK/T and other formulas for application in scleral fixation of IOLs.
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Affiliation(s)
- Matthew P Ohr
- Department of Ophthalmology, The Ohio State University, 915 Olentangy River Road Suite 5000, Columbus, OH, 43212, USA.
| | - C Ellis Wisely
- Department of Ophthalmology, Duke University, Durham, NC, USA
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Goh JHL, Lim ZW, Fang X, Anees A, Nusinovici S, Rim TH, Cheng CY, Tham YC. Artificial Intelligence for Cataract Detection and Management. Asia Pac J Ophthalmol (Phila) 2020; 9:88-95. [PMID: 32349116 DOI: 10.1097/01.apo.0000656988.16221.04] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The rising popularity of artificial intelligence (AI) in ophthalmology is fuelled by the ever-increasing clinical "big data" that can be used for algorithm development. Cataract is one of the leading causes of visual impairment worldwide. However, compared with other major age-related eye diseases, such as diabetic retinopathy, age-related macular degeneration, and glaucoma, AI development in the domain of cataract is still relatively underexplored. In this regard, several previous studies explored algorithms for automated cataract assessment using either slit lamp of color fundus photographs. However, several other study groups proposed or derived new AI-based calculation for pre-cataract surgery intraocular lens power. Along with advancements in digitization of clinical data, data curation for future cataract-related AI developmental work is bound to undergo significant improvements in the foreseeable future. Even though most of these previous studies reported early promising performances, limitations such as lack of robust, high-quality training data, and lack of external validations remain. In the next phase of work, apart from algorithm's performance, it will also be pertinent to evaluate deployment angles, feasibility, efficiency, and cost-effectiveness of these new cataract-related AI systems.
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Affiliation(s)
- Jocelyn Hui Lin Goh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- School of Chemical and Biomedical Engineering, Division of Bioengineering, Nanyang Technological University, Singapore
| | - Zhi Wei Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Xiaoling Fang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology, Shanghai Eye Disease Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Ayesha Anees
- Institute of High Performance Computing, A∗STAR, Singapore
| | - Simon Nusinovici
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tyler Hyungtaek Rim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
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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. [PMID: 32081868 PMCID: PMC7035253 DOI: 10.1038/s41598-020-59919-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/30/2020] [Indexed: 12/15/2022] Open
Abstract
This prospective cross-sectional study aimed to evaluate the agreement of two new biometers for measuring ocular biometric parameters in young healthy eyes. Ocular biometric parameters were measured using IOLMaster 700 and OA-2000. Power vector analyses of Cartesian (J0) and oblique (J45) components of corneal astigmatism were performed. The right eyes of 103 healthy volunteers were analyzed. The 95% limits of agreement ranged from −0.03 to 0.03 mm, −0.08 to 0.07 mm, −0.18 to 0.18 diopters (D), −1.09 to 1.16 D, −1.18 to 1.15 D for axial length (AL), anterior chamber depth (ACD), mean keratometry, J0 and J45 respectively, which were all comparable between the two biometers, while significant differences were detected in lens thickness (LT), central corneal thickness (CCT), white-to-white (WTW) and pupil diameter (PD). Predicted intraocular lens (IOL) powers were comparable between the two biometers by Haigis and Barrett Universal II formulas, while not by SRK/T, Hoffer Q and Holladay 2. Excepting CCT, WTW and PD meaurements, IOLMaster 700 and OA-2000 have excellent agreement on ocular biometric measurements and astigmatism power vectors, which provides more options for ocular biometric measurements and enables constant optimization for IOL power calculation.
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Affiliation(s)
- Xuan Liao
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.,Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China
| | - Yue Peng
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.,Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China
| | - Bo Liu
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.,Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China
| | - Qing-Qing Tan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.,Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China
| | - Chang-Jun Lan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China. .,Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China.
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Intraocular Lens power calculation after laser refractive surgery: A Meta-Analysis. Sci Rep 2020; 10:2645. [PMID: 32060303 PMCID: PMC7021678 DOI: 10.1038/s41598-020-59487-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/23/2020] [Indexed: 01/11/2023] Open
Abstract
There are an increasing number of people who have had refractive surgery now developing cataract. To compare the accuracy of different intraocular lens (IOL) power calculation formulas after laser refractive surgery (photorefractive keratectomy or laser in situ keratomileusis), a comprehensive literature search of PubMed and EMBASE was conducted to identify comparative cohort studies and case series comparing different formulas: Haigis-L, Shammas-PL, SRK/T, Holladay 1 and Hoffer Q. Seven cohort studies and three observational studies including 260 eyes were identified. There were significant differences when Hoffer Q formula compared with SRK/T, Holladay 1. Holladay 1 formula produced less prediction error than SRK/T formula in double-K method. Hoffer Q formula performed best among SRK/T and Holladay 1 formulas in total and single-K method. In eyes with previous data, it is recommended to choose double-K formula except SRK/T formula. In eyes with no previous data, Haigis-L formula is recommended if available, if the fourth formula is unavailable, single-k Hoffer Q is a good choice.
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Nemeth G, Modis L. Accuracy of the Hill-radial basis function method and the Barrett Universal II formula. Eur J Ophthalmol 2020; 31:566-571. [PMID: 31992069 DOI: 10.1177/1120672120902952] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE The aim was to assess the postoperative results of a biometric method using artificial intelligence (Hill-radial basis function 2.0), and data from a modern formula (Barrett Universal II) and the Sanders-Retzlaff-Kraft/Theoretical formula. METHODS Phacoemulsification and biconvex intraocular lens implantation were performed in 186 cataractous eyes. The diopters of intraocular lens were established with the Hill-radial basis function method, based on biometric data obtained using the Aladdin device. The required diopters of the intraocular lens were also calculated by the Barrett Universal II formula and with the Sanders-Retzlaff-Kraft/Theoretical formula. The differences between the manifest postoperative refractive errors and the planned refractive errors were calculated, as well as the percentage of eyes within ±0.5 D of the prediction error. The mean- and the median absolute refractive errors were also determined. RESULTS The mean age of the patients was 70.13 years (SD = 10.67 years), and the mean axial length was 23.47 mm (range = 20.72-28.78 mm). The percentage of eyes within a prediction error of ±0.5 D was 83.62% using the Hill-radial basis function method, 79.66% with the Barrett Universal II formula, and 74.01% in the case of the Sanders-Retzlaff-Kraft/Theoretical formula. The mean- and the median absolute refractive errors were not statistically different. CONCLUSION Clinical success was the highest when using the biometric method, based on pattern recognition. The results obtained using Barrett Universal II came a close second. Both methods performed better compared to a traditionally used formula.
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Affiliation(s)
- Gabor Nemeth
- Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Laszlo Modis
- Department of Ophthalmology, University of Debrecen, Debrecen, Hungary
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Zhang JQ, Zou XY, Zheng DY, Chen WR, Sun A, Luo LX. Effect of lens constants optimization on the accuracy of intraocular lens power calculation formulas for highly myopic eyes. Int J Ophthalmol 2019; 12:943-948. [PMID: 31236350 DOI: 10.18240/ijo.2019.06.10] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 11/30/2018] [Indexed: 12/19/2022] Open
Abstract
AIM To evaluate the effect of different lens constant optimization methods on the accuracy of intraocular lens (IOL) power calculation formulas for highly myopic eyes. METHODS This study comprised 108 eyes of 94 consecutive patients with axial length (AL) over 26 mm undergoing phacoemulsification and implantation of a Rayner (Hove, UK) 920H IOL. Formulas were evaluated using the following lens constants: manufacturer's lens constant, User Group for Laser Interference Biometry (ULIB) constant, and optimized constant for long eyes. Results were compared with Barrett Universal II formula, original Wang-Koch AL adjustment method, and modified Wang-Koch AL adjustment method. The outcomes assessed were mean absolute error (MAE) and percentage of eyes with IOL prediction errors within ±0.25, ±0.50, and ±1.0 diopter (D). The nonparametric method, Friedman test, was used to compare MAE performance among constants. RESULTS Optimized constants could significantly reduce the MAE of SRK/T, Hoffer Q, and Holladay 1 formulas compared with manufacturer's lens constant, whereas the percentage of eyes with IOL prediction errors within ±0.25, ±0.50, and ±1.0 D had no statistically significant differences. Optimized lens constant for long eyes alone showed non-significant refractive advantages over the ULIB constant. Barrett Universal II formula and formulas with AL adjustment showed significantly higher accuracy in highly myopic eyes (P<0.001). CONCLUSION Lens constant optimization for the subset of long eyes reduces the refractive error only to a limited extent for highly myopic eyes.
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Affiliation(s)
- Jia-Qing Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Xu-Yuan Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Dan-Ying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Wei-Rong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Ao Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Li-Xia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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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. [PMID: 30900579 PMCID: PMC6446621 DOI: 10.4103/ijo.ijo_937_18] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Purpose: Our study was conducted to evaluate and compare the accuracy of the refractive prediction determined by the calculation formulas for different intraocular lens (IOL) powers for high myopia. Methods: This study reviewed 217 eyes from 135 patients who had received cataract aspiration treatment and IOL implantation. The refractive mean numerical error (MNE) and mean absolute error (MAE) of the IOL power calculation formulas (SRK/T, Haigis, Holladay, Hoffer Q, and Barrett Universal II) were examined and compared. The MNE and MAE at different axial lengths (AL) were compared, and the percentage of every refractive error absolute value for each formula was calculated at ±0.25D, ±0.50D, ±1.00D, and ±2.00D. Results: In all, 98 patients were recruited into this study and 98 eyes of them were analyzed. We found that Barrett Universal II formula had the lowest MNE and MAE, SRK/T and Haigis formulas arrived at similar MNE and MAE, and the MNE and MAE calculated by Holladay and Hoffer Q formula were the highest. Barrett Universal II formulas have the lowest MAE among different AL patients, whereas it reached the highest percentage of refractive error absolute value within 0.5D in this study. The MAE of each formula is positively correlated with AL. Conclusion: Barrett Universal II formula rendered the lowest predictive error compared with SRK/T, Haigis, Holladay, and Hoffer Q formulas. Thus, Barrett Universal II formula may be regarded as a more reliable formula for high myopia.
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Affiliation(s)
- Dong Zhou
- Department of Ophthalmology, The Third People's Hospital of Changzhou, Changzhou, Jiangsu Province, China, India
| | - Zhuo Sun
- Department of Ophthalmology, The Third People's Hospital of Changzhou, Changzhou, Jiangsu Province, China, India
| | - Guohua Deng
- Department of Ophthalmology, The Third People's Hospital of Changzhou, Changzhou, Jiangsu Province, China, India
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Refractive outcomes of cataract surgery in primary congenital glaucoma. Eye (Lond) 2018; 33:542-548. [PMID: 30382237 DOI: 10.1038/s41433-018-0253-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 07/20/2018] [Accepted: 08/05/2018] [Indexed: 11/08/2022] Open
Abstract
AIM To evaluate refractive outcomes of cataract surgery with intraocular lens (IOL) implantation in operated eyes of primary congenital glaucoma (PCG). DESIGN A retrospective case-control study. METHODS Patients of PCG who developed cataract following trabeculectomy with trabeculotomy were recruited. Preoperative biometry was recorded and refractive outcomes of the patients in terms of spherical equivalent (SE) and prediction error were noted at 3 and at 12 months following surgery. The refractive outcomes were compared with non-glaucomatous eyes of children in similar age group who underwent lens aspiration with IOL implantation (controls). RESULTS The median age of the children with PCG (n = 31) at the time of cataract surgery was 60 months, similar to controls (n = 29); 48 months (p = 0.3). The SE in PCG eyes at 12 months was comparable to controls (p = 0.18). The prediction error (postoperative SE - predicted SE) at 3 months (p = 0.018) and at 12 months (p = 0.03) among PCG eyes was higher and more myopic compared with controls. The range of prediction error at 12 months in PCG eyes was - 8.6 to + 5.8 D (median - 2.0 D), whereas in controls it was - 4.2 to + 6.3 D (median + 0.5 D). For each mmHg intraocular pressure (IOP) increase there was 0.42 mm increase in axial length among PCG eyes and a 0.24 mm increase among controls (p < 0.001). CONCLUSIONS After IOL implantation there was a greater prediction error and a greater myopic shift among PCG eyes. Eyes of children with PCG are more prone to refractive surprises as their axial length changes are more sensitive to IOP fluctuation.
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Nabil KM. Accuracy of minus power intraocular lens calculation using OKULIX ray tracing software. Int Ophthalmol 2018; 39:1803-1808. [PMID: 30141002 DOI: 10.1007/s10792-018-1007-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 08/17/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this retrospective study was to assess the accuracy of minus power intraocular lens calculation using partial coherence interferometry and OKULIX ray tracing software. METHODS We included 25 consecutive, myopic eyes with axial length ≥ 30 mm (25 patients, 13 males and 12 females, and 57.6 ± 10.3 years old), which underwent phacoemulsification and implantation of a minus power intraocular lens in the capsular bag. Axial length measurement and corneal topography were performed using the OA-1000 optical biometer and Topographic Modeling System TMS-5, respectively. The IOL power was calculated using SRK/T formula and OKULIX ray tracing software. The implanted IOL power was chosen based on OKULIX ray tracing software calculation aiming for - 2 diopters (D) of myopia. RESULTS SRK/T calculated IOL power (- 6.3 ± 2.8 D) showed statistically significant difference compared to OKULIX calculated IOL power (- 4.7 ± 2.6 D), rs 0.994 p < 0.001. The expected refraction with implanted IOL was - 1.7 ± 0.9 D based on OKULIX ray tracing software calculation. A statistically significant difference was reported between implanted IOL and OKULIX calculated IOL power (2.7 ± 1.4 D), rs 0.981 p < 0.001. A statistically significant difference was reported between the expected refraction with implanted IOL and the achieved spherical refraction at 1 month postoperatively (1.4 ± 0.7 D), rs 0.77 p < 0.001. The achieved spherical refraction at 1 month postoperatively was 0.2 ± 0.2 D. CONCLUSIONS Although OKULIX ray tracing software yielded more accurate minus power intraocular lens calculation in extreme myopia, compared to SRK/T formula, yet it still shows tendency toward hyperopia.
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Affiliation(s)
- Karim Mahmoud Nabil
- Department of Ophthalmology, Faculty of Medicine, University of Alexandria, 19 Amin Fekry Street, Raml station, Alexandria, 21523, Egypt.
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