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Sustained accuracy improvement in intraocular lens power calculation with the application of quality control circle.

ABSTRACT: Accurate intraocular lens (IOL) power calculation is always a challenge in ophthalmology, and unoptimized process may lead to inaccurate refractive outcomes. Quality control circle (QCC) has shown its success in many fields as a process management tool. However, its efficacy in ophthalmology remains unclear. Here we utilized the QCC method to optimize the process and evaluate its efficacy in improving the accuracy of IOL power calculation. After the QCC application, the percentage of eyes with achieved refractive outcomes within 0.5 diopter significantly increased from 63.2% to 80.8% calculated by Haigis formula and 59.2% to 75.8% by SRK/T formula in patients with normal axial length (AL) (22 mm ≤ AL < 26 mm). Although there were no statistically significant differences in patients with long AL by the two formulas (p = 0.886 and 0.726), we achieved an accuracy of 75% with the application of the PhacoOptics software, which was significantly higher than that using the other two formulas (p < 0.001). Our findings indicated that QCC optimized and standardized the process of IOL power calculation, thus improved the accuracy of IOL power calculation in patients who underwent cataract surgery.

SUBMITTER: Lin L

PROVIDER: S-EPMC5665969 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Accuracy of intraocular lens power calculation formulas using a swept-source optical biometer.

Project description:PURPOSE:To compare the accuracy of the five commonly used intraocular lens (IOL) calculation formulas integrated to a swept-source optical biometer, the IOLMaster 700, and evaluate the extent of bias within each formula for different ocular biometric measurements. METHODS:The study included patients undergoing cataract surgery with a ZCB00 IOL implant, using IOLMaster 700 optical biometry. A single eye per patient was included in the final analysis for a total of 324 cases. The SRK/T, Hoffer Q, Haigis, Holladay 2, and Barrett Universal II formulas were evaluated. The correlations between the refractive prediction errors calculated using the five formulas and ocular dimensions such as axial length (AL), anterior chamber depth (ACD), corneal power, and lens thickness (LT) were analyzed. RESULTS:There were significant differences in the median absolute error predicted by the five formulas after the adjustment for mean refractive prediction errors to zero (P = 0.038). The Barrett Universal II formula had the lowest median absolute error (0.263) and resulted in a higher percentage of eyes with prediction errors within ±0.50 D, ±0.75 D, and ±1.00 D (all P < 0.050). The refractive errors predicted by only the Barrett formula showed no significant correlation with the ocular dimensions: AL, ACD, corneal power, and LT. CONCLUSIONS:Overall, the Barrett Universal II formula, integrated to a swept-source optical biometer had the lowest prediction error and appeared to have the least bias for different ocular biometric measurements for the ZCB00 IOL.

| S-EPMC6959581 | biostudies-literature

Intraocular lens power calculation formulas accuracy in combined phacovitrectomy: an 8-formulas comparison study.

Project description:BackgroundOur study aimed to assess and compare the accuracy of 8 intraocular lens (IOL) power calculation formulas (Barrett Universal II, EVO 2.0, Haigis, Hoffer Q, Holladay 1, Kane and PEARL-DGS) in patients submitted to combined phacovitrectomy for vitreomacular (VM) interface disorders.MethodsRetrospective chart review study including axial-length matched patients submitted to phacoemulsification alone (Group 1) and combined phacovitrectomy (Group 2). Using optimized constants in both groups, refraction prediction error of each formula was calculated for each eye. The optimised constants from Group 1 were also applied to patients of Group 2 - Group 3. Outcome measures included the mean prediction error (ME) and its standard deviation (SD), mean (MAE) and median (MedAE) absolute errors, in diopters (D), and the percentage of eyes within ± 0.25D, ± 0.50D and ± 1.00D.ResultsA total of 220 eyes were included (Group 1: 100; Group 2: 120). In Group 1, the difference in formulas absolute error was significative (p = 0.005). The Kane Formula had the lowest MAE (0.306) and MedAE (0.264). In Group 2, Kane had the overall best performance, followed by PEARL-DGS, EVO 2.0 and Barrett Universal II. The ME of all formulas in both Groups 1 and 2 were 0.000 (p = 0.934; p = 0.971, respectively). In Group 3, a statistically significant myopic shift was observed for each formula (p < 0.001).ConclusionSurgeons must be careful regarding IOL power selection in phacovitrectomy considering the systematic myopic shift evidenced-constant optimization may help eliminating such error. Moreover, newly introduced formulas and calculation methods may help us achieving increasingly better refractive outcomes both in cataract surgery alone and phacovitrectomy.

| S-EPMC8371894 | biostudies-literature

Intraocular Lens Power Calculation after Small Incision Lenticule Extraction.

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| S-EPMC7136233 | biostudies-literature

Predictive accuracy of partial coherence interferometry and swept-source optical coherence tomography for intraocular lens power calculation.

Project description:The purpose of this study is to compare the predictive accuracy of intraocular lens (IOL) calculations made with partial coherence interferometry (PCI, IOLMaster, version 5) and swept-source optical coherence tomography (SS-OCT, Argos). Axial length (AL), mean keratometry value (K), and anterior chamber depth (ACD) were obtained using PCI and SS-OCT optical biometers. Intraocular lens (IOL) power calculations were made using the Barret-Universal II, Haigis, Hoffer Q, SRK/T, and T2 formulas and compared the predictive accuracy between biometers. In 153 eyes (153 patients), axial length measurements made with PCI (24.65?±?2.35?mm) and SS-OCT (24.62?±?2.29?mm) were significantly different (P?<?0.001). Corneal power (P?=?0.97) and anterior chamber depth (P?=?0.51) were not significantly different between biometer. The mean absolute error was not significantly different between the five IOL power calculation formulas for either PCI or SS-OCT measurements. When AL was 24.5-26.0?mm, mean absolute error derived from SS-OCT was smaller than mean absolute error derived from PCI for all five IOL power calculation formulas (all P?<?0.05). In conclusion, predictive accuracy of PCI and SS-OCT were nearly the same. However, in medium-long eyes, the predictive accuracy of SS-OCT for IOL calculations was higher.

| S-EPMC6137182 | biostudies-literature

Accuracy of Intraocular Lens Power Calculation Formulas in Pediatric Cataract Patients: A Systematic Review and Meta-Analysis.

Project description:Background: Among the various intraocular lens (IOL) power calculation formulas available in clinical settings, which one can yield more accurate results is still inconclusive. We performed a meta-analysis to compare the accuracy of the IOL power calculation formulas used for pediatric cataract patients. Methods: Observational cohort studies published through April 2021 were systematically searched in PubMed, Web of Science, and EMBASE databases. For each included study, the mean differences of the mean prediction error and mean absolute prediction error (APE) were analyzed and compared using the random-effects model. Results: Twelve studies involving 1,647 eyes were enrolled in the meta-analysis, and five formulas were compared: Holladay 1, Holladay 2, Hoffer Q, SRK/T, and SRK II. Holladay 1 exhibited the smallest APE (0.97; 95% confidence interval [CI]: 0.92-1.03). For the patients with an axial length (AL) less than 22 mm, SRK/T showed a significantly smaller APE than SRK II (mean difference [MD]: -0.37; 95% CI: -0.63 to -0.12). For the patients younger than 24 months, SRK/T had a significantly smaller APE than Hoffer Q (MD: -0.28; 95% CI: -0.51 to -0.06). For the patients aged 24-60 months, SRK/T presented a significantly smaller APE than Holladay 2 (MD: -0.60; 95% CI: -0.93 to -0.26). Conclusion: Due to the rapid growth and high variability of pediatric eyes, the formulas for IOL calculation should be considered according to clinical parameters such as age and AL. The evidence obtained supported the accuracy and reliability of SRK/T under certain conditions. Systematic Review Registration: PROSPERO, identifier: INPLASY202190077.

| S-EPMC8661900 | biostudies-literature

Estimation of intraocular lens position from full crystalline lens geometry: towards a new generation of intraocular lens power calculation formulas.

Project description:In a cataract surgery, the opacified crystalline lens is replaced by an artificial intraocular lens (IOL). To optimize the visual quality after surgery, the intraocular lens to be implanted must be selected preoperatively for every individual patient. Different generations of formulas have been proposed for selecting the intraocular lens dioptric power as a function of its estimated postoperative position. However, very few formulas include crystalline lens information, in most cases only one-dimensional. The present study proposes a new formula to preoperatively estimate the postoperative IOL position (ELP) based on information of the 3-dimensional full shape of the crystalline lens, obtained from quantitative eye anterior segment optical coherence tomography imaging. Real patients were measured before and after cataract surgery (IOL implantation). The IOL position and the postoperative refraction estimation errors were calculated by subtracting the preoperative estimations from the actual values measured after surgery. The proposed ELP formula produced lower estimation errors for both parameters -ELP and refraction- than the predictions obtained with standard state-of-the-art methods, and opens new avenues to the development of new generation IOL power calculation formulas that improve refractive and visual outcomes.

| S-EPMC6026180 | biostudies-literature

Considerations on the Castrop formula for calculation of intraocular lens power.

Project description:BackgroundTo explain the concept of the Castrop lens power calculation formula and show the application and results from a large dataset compared to classical formulae.MethodsThe Castrop vergence formula is based on a pseudophakic model eye with 4 refractive surfaces. This was compared against the SRKT, Hoffer-Q, Holladay1, simplified Haigis with 1 optimized constant and Haigis formula with 3 optimized constants. A large dataset of preoperative biometric values, lens power data and postoperative refraction data was split into training and test sets. The training data were used for formula constant optimization, and the test data for cross-validation. Constant optimization was performed for all formulae using nonlinear optimization, minimising root mean squared prediction error.ResultsThe constants for all formulae were derived with the Levenberg-Marquardt algorithm. Applying these constants to the test data, the Castrop formula showed a slightly better performance compared to the classical formulae in terms of prediction error and absolute prediction error. Using the Castrop formula, the standard deviation of the prediction error was lowest at 0.45 dpt, and 95% of all eyes in the test data were within the limit of 0.9 dpt of prediction error.ConclusionThe calculation concept of the Castrop formula and one potential option for optimization of the 3 Castrop formula constants (C, H, and R) are presented. In a large dataset of 1452 data points the performance of the Castrop formula was slightly superior to the respective results of the classical formulae such as SRKT, Hoffer-Q, Holladay1 or Haigis.

| S-EPMC8172026 | biostudies-literature

Intraocular Lens power calculation after laser refractive surgery: A Meta-Analysis.

Project description: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.

| S-EPMC7021678 | biostudies-literature

Prediction accuracy of standard and total keratometry by swept-source optical biometer for multifocal intraocular lens power calculation.

Project description:We aimed to compare the refractive outcomes of cataract surgery with diffractive multifocal intraocular lenses (IOLs) using standard keratometry (K) and total keratometry (TK). In this retrospective observational case series study, a total of 302 patients who underwent cataract surgery with multifocal IOL implantation were included. Predicted refractive outcomes were calculated based on the current standard formulas and a new formula developed for TK using K and TK, which were obtained from a swept-source optical biometer. At 2-month postoperatively, median absolute prediction errors (MedAEs) and proportion of eyes within ± 0.50 diopters (D) of predicted postoperative spherical equivalent (SE) refraction were analyzed. There was no significant difference between MedAEs or proportion of eyes within ± 0.50D of predicted refraction from K and TK in each formula. In TFNT00 and 839MP IOL cases, there was no difference between MedAEs from K and TK using any formula. In 829MP IOL cases, MedAE from TK was significantly larger than that from K in Barrett Universal II/Barrett TK Universal II (P = 0.033). In 677MY IOL cases, MedAE from TK was significantly larger than that from K in Haigis (P = 0.020) and Holladay 2 (P = 0.006) formulas. In the subgroup analysis for IOL, there was no difference between the proportion of eyes within ± 0.50 D of predicted refraction from K and TK using any formula. TFNT00 and 839MP IOLs were favorable with TK, with 677MY IOL with K and 829MP IOL being in a neutral position, which necessitates the study that investigates the accuracy of the new TK technology.

| S-EPMC7910298 | biostudies-literature

Intraocular lens power calculation after radial keratotomy and LASIK - A case report.

Project description:PurposeTo report a challenging intraocular lens (IOL) power calculation case who received both radial keratotomy (RK) and laser-assisted in situ keratomileusis (LASIK).ObservationsA 51-year-old man had received refractive surgery with RK and later enhanced by LASIK more than 20 years ago. He developed severe cataract in left eye with best-corrected visual acuity of 20/100. The IOL power calculation was made using several methods available at the American Society of Cataract and Refractive Surgery (ASCRS) online calculator, including IOL calculation formulas for post-LASIK condition (Shammas, Haigis-L, Barrett True K no history, and Potvin-Hill Pentacam) and formulas for post-RK condition (Double K-modified Holladay 1 based on Oculus Pentacam and IOL Master, and Barrett True K). Haigis-L, Shammas and Barrett true K no history were found to be most accurate in predicting IOL power.ConclusionsHaigis-L, Shammas and Barrett true K no history are reliable formulas for IOL power calculation in patients who received both RK and LASIK.

| S-EPMC6584476 | biostudies-literature

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