Evaluation of 9 IOL power calculation formulas using a heteroscedastic statistical method and a new method of IOL constant optimization

Abstract

Purpose

To evaluate the prediction accuracy of 9 IOL power calculation formulas using a heteroscedastic statistical analysis and a novel method for IOL constant optimization.

Design

Retrospective case series.

Methods

The LenStar LS900 (Haag-Streit, Koeniz, Switzerland) was used for the preoperative biometry. The predicted SE refraction of the implanted IOL were calculated for: Barrett Universal II, EVO-2.0, Hill RBF-3.0, Hill-RBF 2.0, Kane, PEARL-DGS, SRK-T, Hoffer-Q and Holladay-1. IOL constants were optimized prior to the analysis. A heteroscedastic statistical method was used to compare the standard deviation (SD) of prediction errors (PE).

Results

Two hundred seventy-eight eyes of 278 patients were included. The SD of the Kane was 0.4214D and was the lowest in this database. The SD of the PE of the Kane and EVO 2.0 were significantly lower than the SRK-T, Holladay 1, and Hoffer-Q. The SD of the PE of the PEARL formula was significantly lower than the SRK-T and Hoffer-Q. The SD of the PE of the Hill-RBF 3.0 was not significantly different to the Hill-RBF 2.0, Kane, EVO 2.0, Barrett Universal II and PEARL. No significant difference was found between the SD of the PE of the new generation formulas analysed.

Conclusions

the lowest SD of the prediction error was provided by Kane, followed by EVO 2.0 and PERL-DGS formulas. However, no statistically significant differences were found between the SD of the PE of new generation formulas. Further studies are necessary to evaluate the accuracy of these formulas in extreme eyes.

Keywords

IOL power calculation Evaluation of IOL power calculation formulas

Get full access to this article

View all access options for this article.

References

Melles

Holladay

Chang

. Accuracy of intraocular Lens calculation formulas. Ophthalmology 2018; 125: 169–178. doi:https://doi.org/10.1016/j.ophtha.2017.08.027.

Cooke

. Comparison of 9 intraocular lens power calculation formulas. J Cataract Refract Surg 2016; 42: 1157–1164. doi:https://doi.org/10.1016/j.jcrs.2016.06.029.

Kane

van Heerden

Atik

, et al. Intraocular lens power formula accuracy: comparison of 7 formulas. J Cataract Refract Surg 2016; 42: 1490–1500. doi:https://doi.org/10.1016/j.jcrs.2016.07.021.

Holladay

Wilcox

Koch

, et al. Review and recommendations for univariate statistical analysis of spherical equivalent prediction error for IOL power calculations. J Cataract Refract Surg 2021; 47: 65–77. doi:https://doi.org/10.1097/j.jcrs.0000000000000370.

Wang

Koch

Hill

, et al.

Pursuing perfection in intraocular lens calculations: III. Criteria for analyzing outcomes

. J Cataract Refract Surg 2017; 43: 999–1002. doi:https://doi.org/10.1016/j.jcrs.2017.08.003.

Olsen

. Calculation of intraocular lens power: a review. Acta Ophthalmol Scand 2007; 85: 472–485. doi:https://doi.org/10.1111/j.1600-0420.2007.00879.x.

Gatinel

Debellemanière

Saad

, et al. A simplified method to minimize systematic bias of single-optimized intraocular Lens power calculation formulas. Am J Ophthalmol 2023; 253: 65–73. doi:https://doi.org/10.1016/j.ajo.2023.05.005.

Simpson

Charman

. The effect of testing distance on intraocular lens power calculation. J Refract Surg 2014; 30: 726. doi:https://doi.org/10.3928/1081597X-20141021-01.

Hill

Abulafia

Wang

, et al. Pursuing perfection in IOL calculations. II. Measurement foibles: measurement errors, validation criteria, IOL constants, and lane length. J Cataract Refract Surg 2017; 43: 869–870. doi:https://doi.org/10.1016/j.jcrs.2017.07.006.

10.

EVO IOL Calculator v2.0. https://www.evoiolcalculator.com/calculator.aspx (accessed 6 November 2022).

11.

Solver. https://iolsolver.com/regular (accessed 6 November 2022).

12.

Barrett Universal II Formula V1.05. https://calc.apacrs.org/barrett_universal2105/# (accessed 6 November 2022).

13.

Hill-RBF Calculator for IOL Power Calculations. https://rbfcalculator.com/online/index.html (accessed 6 November 2022).

14.

Kane Formula. https://www.iolformula.com/ (accessed 6 November 2022).

15.

Hoffer

. The Hoffer Q formula: a comparison of theoretic and regression formulas. J Cataract Refract Surg 1993; 19: 700–712. doi:https://doi.org/10.1016/S0886-3350(13)80338-0.

16.

Retzlaff

Sanders

, et al. Development of the SRK / T intraocular lens implant power calculation formula. J Cataract Refract Surg 1990; 16: 333–340. doi:https://doi.org/10.1016/S0886-3350(13)80705-5.

17.

Savini

Taroni

Hoffer

. Recent developments in intraocular lens power calculation methods—update 2020. Ann Transl Med 2020; 8: 1553–1553. doi:https://doi.org/10.21037/atm-20-2290.

18.

Voytsekhivskyy

Hoffer

Tutchenko

, et al. Accuracy of 24 IOL power calculation methods. J Refract Surg 2023; 39: 249–256. doi:https://doi.org/10.3928/1081597X-20230131-01.

19.

Tsessler

Cohen

Wang

, et al. Evaluating the prediction accuracy of the Hill-RBF 3.0 formula using a heteroscedastic statistical method. J Cataract Refract Surg 2022; 48: 37–43. doi:https://doi.org/10.1097/j.jcrs.0000000000000702.

20.

Wendelstein

Hoffmann

Hirnschall

, et al. Project hyperopic power prediction: accuracy of 13 different concepts for intraocular lens calculation in short eyes. Br J Ophthalmol 2022; 106: 795–801. doi:https://doi.org/10.1136/bjophthalmol-2020-318272.