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Sella R, Reitblat O, Durnford KM, Pettey JH, Olson RJ, Hahn TE, Bernhisel AA, Afshari NA. The effect of patient age on some new and older IOL power calculation formulas. Acta Ophthalmol 2024; 102:e696-e704. [PMID: 38155407 DOI: 10.1111/aos.16621] [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: 04/26/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 12/30/2023]
Abstract
PURPOSE To assess the accuracy of intraocular lens (IOL) power calculation in different age groups using various IOL calculation formulas. METHODS Data from 421 eyes of 421 patients ≥60 years old (ages: 60-69, n = 131; 70-74, n = 105; 75-84, n = 158 and ≥85, n = 27), who underwent uneventful cataract surgery with SN60WF IOL implantation at John A. Moran Eye Center, Salt Lake City, USA, were retrospectively obtained. The SD of the prediction error (PE), median and mean absolute PEs and the percentage of eyes within ±0.25, ±0.50, ±0.75 and ±1.00 D were calculated after constant optimizations for the following formulas: Barrett Universal II (BUII), Emmetropia Verifying Optical (EVO) 2.0, Haigis, Hoffer Q, Hoffer QST, Holladay 1, Kane, Radial Basis Function (RBF) 3.0 and SRK/T. Results were compared between the different age groups. RESULTS Predictability rates within 0.25D were lower for the eldest age group compared with the other groups using the EVO 2.0 (33% vs. 37%-53%, p = 0.045), Kane (26% vs. 35%-50%, p = 0.034) and SRK/T (22% vs. 31%-49%, p = 0.002). Higher median absolute refractive errors for all formulas were observed in the oldest group [range: 0.39 D (Haigis, Hoffer QSR)-0.48 D (Kane)], followed by the youngest group [range: 0.30 D (RBF 3.0)-0.39 D (Holladay 1, SRK/T)] but did not reach statistical significance. No significant differences between the groups in the distribution parameter were seen. CONCLUSION Current IOL power calculation formulas may have variable accuracy for different age groups. This should be taken into account when planning cataract surgery to improve refractive outcomes.
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Affiliation(s)
- Ruti Sella
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
| | - Olga Reitblat
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Jeff H Pettey
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Randall J Olson
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Tara E Hahn
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Ashlie A Bernhisel
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Natalie A Afshari
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
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Hao Y, Fu J, Huang J, Chen D. Comparing the accuracy of intraocular lens power calculation formulas using artificial intelligence and traditional formulas in highly myopic patients: a meta-analysis. Int Ophthalmol 2024; 44:242. [PMID: 38904666 DOI: 10.1007/s10792-024-03227-1] [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: 12/21/2023] [Accepted: 06/18/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE The accuracy of intraocular lens (IOL) calculations is one of the key indicators for determining the success of cataract surgery. However, in highly myopic patients, the calculation errors are relatively larger than those in general patients. With the continuous development of artificial intelligence (AI) technology, there has also been a constant emergence of AI-related calculation formulas. The purpose of this investigation was to evaluate the accuracy of AI calculation formulas in calculating the power of IOL for highly myopic patients. METHODS We searched the relevant literature through August 2023 using three databases: PubMed, EMBASE, and the Cochrane Library. Six IOL calculation formulas were compared: Kane, Hill-RBF, EVO, Barrett II, Haigis, and SRK/T. The included metrics were the mean absolute error (MAE) and percentage of errors within ± 0.25 D, ± 0.50 D, and ± 1.00 D. RESULTS The results showed that the MAE of Kane was significantly lower than that of Barrett II (mean difference = - 0.03 D, P = 0.02), SRK/T (MD = - 0.08 D, P = 0.02), and Haigis (MD = - 0.12 D, P < 0.00001). The percentage refractive prediction errors for Kane at ± 0.25 D, ± 0.50 D, and ± 1.00 D were significantly greater than those for SRK/T (P = 0.007, 0.003, and 0.01, respectively) and Haigis (P = 0.009, 0.0001, and 0.001, respectively). No statistically significant differences were noted between Hill-RBF and Barret, but Hill-RBF was significantly better than SRK/T and Haigis. CONCLUSION The AI calculation formulas showed more accurate results compared with traditional formulas. Among them, Kane has the best performance in calculating IOL degrees for highly myopic patients.
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Affiliation(s)
- Yuxu Hao
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, No. 270, Xueyuan Road, Wenzhou, 325000, Zhejiang, China
| | - Jin Fu
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, No. 270, Xueyuan Road, Wenzhou, 325000, Zhejiang, China
| | - Jin Huang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, No. 270, Xueyuan Road, Wenzhou, 325000, Zhejiang, China
| | - Ding Chen
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, No. 270, Xueyuan Road, Wenzhou, 325000, Zhejiang, China.
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Jin A, Zhang J, Tan X, Jin K, Zhang Y, Han X, Chen X, Jin G, Luo L, Liu Y. Effect of Posterior Keratometry on the Accuracy of 10 Intraocular Lens Calculation Formulas: Standard Keratometry versus Total Keratometry. Graefes Arch Clin Exp Ophthalmol 2024; 262:1829-1838. [PMID: 38197993 DOI: 10.1007/s00417-023-06367-9] [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: 08/14/2023] [Revised: 11/01/2023] [Accepted: 12/23/2023] [Indexed: 01/11/2024] Open
Abstract
PURPOSE To investigate the effect of posterior keratometry (PK) on the accuracy of 10 intraocular lens (IOL) power calculation formulas using standard keratometry (K) and total keratometry (TK). METHODS This is a retrospective consecutive case-series study. The IOL power was calculated using K and TK measured by IOLMaster 700 in 6 new-generation formulas (Barrett Universal II, Emmetropia Verifying Optical (EVO) 2.0, RBF Calculator 3.0, Hoffer QST, Kane, and Ladas Super Formula) and 4 traditional formulas (Haigis, Hoffer Q, Holladay 1, and SRK/T). The arithmetic prediction error (PE) and mean absolute PE (MAE) were evaluated. The locally-weighted scatterplot smoothing was performed to assess the relationship between PE and PK. RESULTS A total of 576 patients (576 eyes) who underwent cataract surgery were included. Compared with using K, all formulas using TK showed a hyperopic shift in the whole group. Specifically, for eyes with PK exceeding -5.90 D, all formulas using TK exhibited a hyperopic shift (all P < 0.001), while eyes with PK less than -5.90 D showed a myopic shift (all P < 0.001). The MAE of new-generation formulas calculated with TK and K showed no statistical differences, while the MAE of traditional formulas with TK was larger (TK: 0.34 ~ 0.43 D; K: 0.33 ~ 0.42 D, all P < 0.05). CONCLUSIONS The prediction bias of formulas with TK increased as PK deviated from -5.90 D. TK did not improve the prediction accuracy of new-generation formulas, and even performed worse in traditional formulas.
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Affiliation(s)
- Aixia Jin
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Jiaqing Zhang
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xuhua Tan
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Kangxin Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Yifan Zhang
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaoyun Chen
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, China.
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, China.
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Mo ER, Chen Z, Feng KE, Zhu Z, Xu J, Zhu C, Chang P, Li J, Zhao YE. Accuracy of Modern Intraocular Lens Formulas in Highly Myopic Eyes Implanted With Plate-Haptic Intraocular Lenses. Am J Ophthalmol 2024; 265:105-116. [PMID: 38703800 DOI: 10.1016/j.ajo.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/14/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
PURPOSE To evaluate the predictive accuracy of modern intraocular lens (IOL) formulas and axial length (AL) adjusted traditional IOL formulas, including Wang-Koch and Cooke-modified AL (CMAL) method, in long eyes with plate-haptic IOLs, and to compare refractive prediction error variances with C-loop IOLs. DESIGN Retrospective consecutive case series study. METHODS Data from 391 eyes with Zeiss 509 M and 302 eyes with Alcon SN6CWS implants in highly myopic patients, following cataract surgery from January 2019 to November 2023, were collected. One eye per patient was selected. Predictive outcomes of 15 modern formulas (Barrett Universal II (BU II), Cooke K6 (K6), Emmetropia Verifying Optical (EVO) 2.0, Hoffer-QST, Kane, Karmona, Ladas AI, Naeser 2, Olsen, Pearl-DGS, Radial Basis Function (RBF) 3.0, T2, VRF-G, Zhu-Lu, and Z-Calc) and 4 traditional IOL formulas (Haigis, Hoffer Q, Holladay 1, and SRK/T) with AL adjusted methods, were evaluated. The mean prediction error, mean absolute prediction error (MAE), root-mean-square absolute prediction error (RMSAE) and the proportions of eyes with PEs within ±0.25 Diopter (D), ±0.50 D, ±0.75 D, and ±1.00 D were analyzed. Top 10 RMSAE-ranked formulas underwent further subgroup analysis based on AL, anterior chamber depth (ACD), and keratometry (K). RESULTS For the 509 M group, RMSAE ranking for the top 10 IOL formulas were the RBF 3.0 (0.432), Zhu-Lu (0.436), Olsen (0.436), EVO 2.0 (0.437), Pearl-DGS (0.447), K6 (0.452), VRF-G (0.454), Naeser 2 (0.464), Haigis-CMAL (0.465) and Karmona (0.477). Karmona and Naeser 2 showed poorer performance in the extremely long AL and steep K subgroups, respectively (p ≤ 0.042). Haigis-CMAL accuracy was significantly lower in shallow ACD and flat K subgroups (P ≤ .045). The SN6CWS group showed significantly lower MAE and RMSAE compared to the 509 M group for the BU II, EVO 2.0, Hoffer-QST, Kane, Pearl-DGS, and Zhu-Lu formulas (P ≤ .024). CONCLUSIONS In long eyes with plate-haptic IOLs, RBF 3.0 performed best, closely followed by Zhu-Lu, Olsen, and EVO 2.0; Karmona and Naeser 2 are discouraged for extreme AL and steep K conditions, respectively; Haigis-CMAL is not suggested for shallow ACD and flat K cases. Refractive outcomes in eyes implanted with a C-loop design IOL were more accurate than for those implanted with a plate-haptic design, for most tested formulas.
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Affiliation(s)
- E R Mo
- From the National Clinical Research Center for Ocular Diseases (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital and School of Ophthalmology and Optometry (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zexin Chen
- From the National Clinical Research Center for Ocular Diseases (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital and School of Ophthalmology and Optometry (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - K E Feng
- From the National Clinical Research Center for Ocular Diseases (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital and School of Ophthalmology and Optometry (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zehui Zhu
- From the National Clinical Research Center for Ocular Diseases (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital and School of Ophthalmology and Optometry (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jialin Xu
- From the National Clinical Research Center for Ocular Diseases (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital and School of Ophthalmology and Optometry (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chenyuan Zhu
- From the National Clinical Research Center for Ocular Diseases (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital and School of Ophthalmology and Optometry (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Pingjun Chang
- From the National Clinical Research Center for Ocular Diseases (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital and School of Ophthalmology and Optometry (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Wenzhou Medical University, Wenzhou, Zhejiang, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch (P.C., Y.E.Z.), Hangzhou, Zhejiang, China
| | - Jin Li
- From the National Clinical Research Center for Ocular Diseases (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital and School of Ophthalmology and Optometry (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Yun-E Zhao
- From the National Clinical Research Center for Ocular Diseases (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital and School of Ophthalmology and Optometry (E.M., Z.C., K.F., Z.Z., J.X., C.Z., P.C., J.L., Y.E.Z.), Wenzhou Medical University, Wenzhou, Zhejiang, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch (P.C., Y.E.Z.), Hangzhou, Zhejiang, China.
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Wendelstein JA, Hoffmann PC, Hoffer KJ, Langenbucher A, Findl O, Ruiss M, Bolz M, Riaz KM, Pantanelli SM, Debellemanière G, Gatinel D, Cooke DL, Galzignato A, Yeo TK, Seiler TG, Zinkernagel M, Savini G. Differences Between Keratometry and Total Keratometry Measurements in a Large Dataset Obtained With a Modern Swept Source Optical Coherence Tomography Biometer. Am J Ophthalmol 2024; 260:102-114. [PMID: 38092314 DOI: 10.1016/j.ajo.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE This study aimed to explore the concept of total keratometry (TK) by analyzing extensive international datasets representing diverse ethnic backgrounds. The primary objective was to quantify the disparities between traditional keratometry (K) and TK values in normal eyes and assess their impact on intraocular lens (IOL) power calculations using various formulas. DESIGN Retrospective multicenter intra-instrument reliability analysis. METHODS The study involved the analysis of biometry data collected from ten international centers across Europe, the United States, and Asia. Corneal power was expressed as equivalent power and astigmatic vector components for both K and TK values. The study assessed the influence of these differences on IOL power calculations using different formulas. The results were analyzed and plotted using Bland-Altman and double angle plots. RESULTS The study encompassed a total of 116,982 measurements from 57,862 right eyes and 59,120 left eyes. The analysis revealed a high level of agreement between K and TK values, with 93.98% of eyes exhibiting an absolute difference of 0.25 D or less. Astigmatism vector differences exceeding 0.25 D and 0.50 D were observed in 39.43% and 1.08% of eyes, respectively. CONCLUSIONS This large-scale study underscores the similarity between mean K and TK values in healthy eyes, with rare clinical implications for IOL power calculation. Noteworthy differences were observed in astigmatism values between K and TK. Future investigations should delve into the practicality of TK values for astigmatism correction and their implications for surgical outcomes.
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Affiliation(s)
- Jascha A Wendelstein
- From the Institut für Refraktive und Ophthalmo-Chirurgie (IROC) (J.A.W., T.G.S.), Zurich, Switzerland; Department for Ophthalmology and Optometry (J.A.W., M.B.), Kepler University Hospital GmbH, Linz, Austria; Johannes Kepler University Linz (J.A.W., M.B.), Linz, Austria; Institute of Experimental Ophthalmology (J.A.W., A.L.), Saarland University, Homburg, Germany.
| | | | - Kenneth J Hoffer
- Stein Eye Institute (K.J.H.), University of California, Los Angeles, California, CA, USA; St. Mary's Eye Center (K.J.H.), Santa Monica, California, CA, USA
| | - Achim Langenbucher
- Institute of Experimental Ophthalmology (J.A.W., A.L.), Saarland University, Homburg, Germany
| | - Oliver Findl
- Department of Ophthalmology (O.F., M.R.), Hanusch Hospital, Vienna Institute for Research in Ocular Surgery (VIROS), Vienna, Austria
| | - Manuel Ruiss
- Department of Ophthalmology (O.F., M.R.), Hanusch Hospital, Vienna Institute for Research in Ocular Surgery (VIROS), Vienna, Austria
| | - Matthias Bolz
- Department for Ophthalmology and Optometry (J.A.W., M.B.), Kepler University Hospital GmbH, Linz, Austria; Johannes Kepler University Linz (J.A.W., M.B.), Linz, Austria
| | - Kamran M Riaz
- Dean A. McGee Eye Institute, University of Oklahoma (K.M.R.), Oklahoma City, OK, USA
| | - Seth M Pantanelli
- Department of Ophthalmology (S.M.P.), Penn State College of Medicine, Hershey, PA, USA
| | | | - Damien Gatinel
- Rothschild Foundation Hospital (G.D., D.G.), Department of Ophthalmology, Paris, France
| | - David L Cooke
- Great Lakes Eye Care (D.L.C.), Saint Joseph, MI, USA; Department of Neurology and Ophthalmology (D.L.C.), Michigan State University, College of Osteopathic Medicine, East Lansing, MI, USA
| | | | - Tun Kuan Yeo
- Tan Tock Seng Hospital (T.K.Y.), Department of Ophthalmology, Singapore, Singapore
| | - Theo G Seiler
- From the Institut für Refraktive und Ophthalmo-Chirurgie (IROC) (J.A.W., T.G.S.), Zurich, Switzerland; Inselspital Bern (T.G.S., M.Z.), Universitätsklinik für Augenheilkunde, Bern, Switzerland; Klinik für Augenheilkunde (T.G.S.), Universitätsklinikum Düsseldorf, Duesseldorf, Germany
| | - Martin Zinkernagel
- Inselspital Bern (T.G.S., M.Z.), Universitätsklinik für Augenheilkunde, Bern, Switzerland
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Zhou Y, Dai M, Sun L, Tang X, Zhou L, Tang Z, Jiang J, Xia X. The accuracy of intraocular lens power calculation formulas based on artificial intelligence in highly myopic eyes: a systematic review and network meta-analysis. Front Public Health 2023; 11:1279718. [PMID: 38026369 PMCID: PMC10670805 DOI: 10.3389/fpubh.2023.1279718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To systematically compare and rank the accuracy of AI-based intraocular lens (IOL) power calculation formulas and traditional IOL formulas in highly myopic eyes. Methods We screened PubMed, Web of Science, Embase, and Cochrane Library databases for studies published from inception to April 2023. The following outcome data were collected: mean absolute error (MAE), percentage of eyes with a refractive prediction error (PE) within ±0.25, ±0.50, and ±1.00 diopters (D), and median absolute error (MedAE). The network meta-analysis was conducted by R 4.3.0 and STATA 17.0. Results Twelve studies involving 2,430 adult myopic eyes (with axial lengths >26.0 mm) that underwent uncomplicated cataract surgery with mono-focal IOL implantation were included. The network meta-analysis of 21 formulas showed that the top three AI-based formulas, as per the surface under the cumulative ranking curve (SUCRA) values, were XGBoost, Hill-RBF, and Kane. The three formulas had the lowest MedAE and were more accurate than traditional vergence formulas, such as SRK/T, Holladay 1, Holladay 2, Haigis, and Hoffer Q regarding MAE, percentage of eyes with PE within ±0.25, ±0.50, and ±1.00 D. Conclusions The top AI-based formulas for calculating IOL power in highly myopic eyes were XGBoost, Hill-RBF, and Kane. They were significantly more accurate than traditional vergence formulas and ranked better than formulas with Wang-Koch AL modifications or newer generations of formulas such as Barrett and Olsen. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022335969.
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Affiliation(s)
- Yi Zhou
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Minhui Dai
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lingyu Sun
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiangyi Tang
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ling Zhou
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhiyao Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jian Jiang
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaobo Xia
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Guo D, He W, Wei L, Song Y, Qi J, Yao Y, Chen X, Huang J, Lu Y, Zhu X. The Zhu-Lu formula: a machine learning-based intraocular lens power calculation formula for highly myopic eyes. EYE AND VISION (LONDON, ENGLAND) 2023; 10:26. [PMID: 37259154 DOI: 10.1186/s40662-023-00342-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/12/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND To develop a novel machine learning-based intraocular lens (IOL) power calculation formula for highly myopic eyes. METHODS A total of 1828 eyes (from 1828 highly myopic patients) undergoing cataract surgery in our hospital were used as the internal dataset, and 151 eyes from 151 highly myopic patients from two other hospitals were used as external test dataset. The Zhu-Lu formula was developed based on the eXtreme Gradient Boosting and the support vector regression algorithms. Its accuracy was compared in the internal and external test datasets with the Barrett Universal II (BUII), Emmetropia Verifying Optical (EVO) 2.0, Kane, Pearl-DGS and Radial Basis Function (RBF) 3.0 formulas. RESULTS In the internal test dataset, the Zhu-Lu, RBF 3.0 and BUII ranked top three from low to high taking into account standard deviations (SDs) of prediction errors (PEs). The Zhu-Lu and RBF 3.0 showed significantly lower median absolute errors (MedAEs) than the other formulas (all P < 0.05). In the external test dataset, the Zhu-Lu, Kane and EVO 2.0 ranked top three from low to high considering SDs of PEs. The Zhu-Lu formula showed a comparable MedAE with BUII and EVO 2.0 but significantly lower than Kane, Pearl-DGS and RBF 3.0 (all P < 0.05). The Zhu-Lu formula ranked first regarding the percentages of eyes within ± 0.50 D of the PE in both test datasets (internal: 80.61%; external: 72.85%). In the axial length subgroup analysis, the PE of the Zhu-Lu stayed stably close to zero in all subgroups. CONCLUSIONS The novel IOL power calculation formula for highly myopic eyes demonstrated improved and stable predictive accuracy compared with other artificial intelligence-based formulas.
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Affiliation(s)
- Dongling Guo
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Ling Wei
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yunxiao Song
- University of Illinois at Urbana-Champaign, Illinois, USA
| | - Jiao Qi
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yunqian Yao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xu Chen
- Shanghai Aier Eye Hospital, Shanghai, China
| | - Jinhai Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
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