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

ABSTRACT: 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.

SUBMITTER: Zhong Y

PROVIDER: S-EPMC8661900 | biostudies-literature |

REPOSITORIES: biostudies-literature

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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

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

Accuracy of intraocular lens calculation formulas based on swept-source OCT biometer in cataract patients with phakic intraocular lens.

Project description:PurposeTo research the accuracy of intraocular lens (IOL) calculation formulas and investigate the effect of anterior chamber depth (ACD) and lens thickness (LT) measured by swept-source optical coherence tomography biometer (IOLMaster 700) in patients with posterior chamber phakic IOL (PC-pIOL).MethodsRetrospective case series. The IOLMaster 700 biometer was used to measure axial length (AL) and anterior segment parameters. The traditional formulas (SRK/T, Holladay 1 and Haigis) with or without Wang-Koch (WK) AL adjustment, and new-generation formulas (Barret Universal II [BUII], Emmetropia Verifying Optical [EVO] v2.0, Kane, Pearl-DGS) were utilized in IOL power calculation.ResultsThis study enrolled 24 eyes of 24 patients undergoing combined PC-pIOL removal and cataract surgery at Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China. The median absolute prediction error in ascending order was EVO 2.0 (0.33), Kane (0.35), SRK/T-WKmodified (0.42), Holladay 1-WKmodified (0.44), Haigis-WKC1 (0.46), Pearl-DGS (0.47), BUII (0.58), Haigis (0.75), SRK/T (0.79), and Holladay 1 (1.32). The root-mean-square absolute error in ascending order was Haigis-WKC1 (0.591), Holladay 1-WKmodified (0.622), SRK/T-WKmodified (0.623), EVO (0.673), Kane (0.678), Pearl-DGS (0.753), BUII (0.863), Haigis (1.061), SRK/T (1.188), and Holladay 1 (1.513). A detailed analysis of ACD and LT measurement error revealed negligible impact on refractive outcomes in BUII and EVO 2.0 when these parameters were incorporated or omitted in the formula calculation.ConclusionThe Kane, EVO 2.0, and traditional formulas with WK AL adjustment displayed high prediction accuracy. Furthermore, the ACD and LT measurement error does not exert a significant influence on the accuracy of IOL power calculation formulas in highly myopic eyes implanted with PC-pIOL.

| S-EPMC11299284 | biostudies-literature

The accuracy of intraocular lens power calculation formulas based on artificial intelligence in highly myopic eyes: a systematic review and network meta-analysis.

Project description:ObjectiveTo systematically compare and rank the accuracy of AI-based intraocular lens (IOL) power calculation formulas and traditional IOL formulas in highly myopic eyes.MethodsWe 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.ResultsTwelve 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.ConclusionsThe 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 registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022335969.

| S-EPMC10670805 | biostudies-literature

A systemic review and network meta-analysis of accuracy of intraocular lens power calculation formulas in primary angle-closure conditions.

Project description:BackgroundFor primary angle-closure and angle-closure glaucoma, the fact that refractive error sometimes deviates from predictions after intraocular lens (IOL) implantation is familiar to cataract surgeons. Since controversy remains in the accuracy of IOL power calculation formulas, both traditional and network meta-analysis on formula accuracy were conducted in patients with primary angle-closure conditions.MethodsA comprehensive literature search was conducted through Aug 2022, focusing on studies on intraocular lens power calculation in primary angle-closure (PAC) and primary angle-closure glaucoma (PACG). A systemic review and network meta-analysis was performed. Quality of studies were assessed. Primary outcomes were the mean absolute errors (MAE) and the percentages of eyes with a prediction error within ±0.50 diopiters (D) or ±1.00 D (% ±0.50/1.00 D) by different formulas.ResultsSix retrospective studies involving 419 eyes and 8 formulas (Barrett Universal II, Kane, SRK/T, Hoffer Q, Haigis, Holladay I, RBF 3.0 and LSF) were included. SRK/T was used as a reference as it had been investigated in all the studies included. Direct comparison showed that none of the involved formula outperformed or was defeated by SRK/T significantly in terms of either MAE or % ±0.50/1.00 D (all P>0.05). Network comparison and ranking possibilities disclosed BUII, Kane, RBF 3.0 with statistically insignificant advantage. No significant publication bias was detected by network funnel plot.ConclusionsNo absolute advantage was disclosed among the formulas involved in this study for PAC/PACG eyes. Further carefully designed studies are warranted to evaluate IOL calculation formulae in this target population.Trail registrationRegistration: PROSEPRO ID: CRD42022326541.

| S-EPMC9565378 | biostudies-literature

Accuracy of intraocular lens power calculation formulae in short eyes: A systematic review and meta-analysis.

Project description:This review article attempts to evaluate the accuracy of intraocular lens power calculation formulae in short eyes. A thorough literature search of PubMed, Embase, Cochrane Library, Science Direct, Scopus, and Web of Science databases was conducted for articles published over the past 21 years, up to July 2021. The mean absolute error was compared by using weighted mean difference, whereas odds ratio was used for comparing the percentage of eyes with prediction error within ±0.50 diopter (D) and ±1.0 D of target refraction. Statistical heterogeneity among studies was analyzed by using Chi-square test and I2 test. Fifteen studies including 2,395 eyes and 11 formulae (Barrett Universal II, Full Monte method, Haigis, Hill-RBF, Hoffer Q, Holladay 1, Holladay 2, Olsen, Super formula, SRK/T, and T2) were included. Although the mean absolute error (MAE) of Barrett Universal II was found to be the lowest, there was no statistically significant difference in any of the comparisons. The median absolute error (MedAE) of Barrett Universal II was the lowest (0.260). Holladay 1 and Hill-RBF had the highest percentage of eyes within ±0.50 D and ±1.0 D of target refraction, respectively. Yet their comparison with the rest of the formulae did not yield statistically significant results. Thus, to conclude, in the present meta-analysis, although lowest MAE and MedAE were found for Barrett Universal II and the highest percentage of eyes within ±0.50 D and ±1.0 D of target refraction was found for Holladay 1 and Hill-RBF, respectively, none of the formulae was found to be statistically superior over the other in eyes with short axial length.

| S-EPMC9114558 | 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

Application of total keratometry in ten intraocular lens power calculation formulas in highly myopic eyes.

Project description:BackgroundThe accuracy of using total keratometry (TK) value in recent IOL power calculation formulas in highly myopic eyes remained unknown.MethodsHighly myopic patients who underwent uneventful cataract surgery were prospectively enrolled in this prospective comparative study. At one month postoperatively, standard deviation (SD) of the prediction errors (PEs), mean and median absolute error (MedAE) of 103 highly myopic eyes were back-calculated and compared among ten formulas, including XGboost, RBF 3.0, Kane, Barrett Universal II, Emmetropia Verifying Optical 2.0, Cooke K6, Haigis, SRK/T, and Wang-Koch modifications of Haigis and SRK/T formulas, using either TK or standard keratometry (K) value.ResultsIn highly myopic eyes, despite good agreement between TK and K (P > 0.05), larger differences between the two were associated with smaller central corneal thickness (P < 0.05). As to the refractive errors, TK method showed no differences compared to K method. The XGBoost, RBF 3.0 and Kane ranked top three when considering SDs of PEs. Using TK value, the XGboost calculator was comparable with the RBF 3.0 formula (P > 0.05), which both presented smaller MedAEs than others (all P < 0.05). As for the percentage of eyes within ± 0.50 D or ± 0.75 D of PE, the XGBoost TK showed comparable percentages with the RBF 3.0 TK formula (74.76% vs. 66.99%, or 90.29% vs. 87.38%, P > 0.05), and statistically larger percentages than the other eight formulas (P < 0.05).ConclusionsHighly myopic eyes with thinner corneas tend to have larger differences between TK and K. The XGboost enhancement calculator and RBF 3.0 formula using TK showed the most promising outcomes in highly myopic eyes.

| S-EPMC9178866 | biostudies-literature

The impact of cataract progression on accuracy of intraocular lens power measurement.

Project description:PurposeThe aim of this study was to assess the impact of cataract progression using the Haigis formula-calculated intraocular lens (IOL) power and investigate the accuracy of IOL power measured at different time points.MethodsThis prospective study was performed on 75 eyes of 75 patients who underwent uneventful cataract surgery. Preoperative ocular parameters including axial length (AL), keratometry (K), anterior chamber depth (ACD), corneal astigmatism, corrected distance visual acuity (CDVA) and uncorrected distance visual acuity (UDVA) examined at the two time points, more than 3 months preoperatively and preoperative 1 day were compared. The ocular parameters measured in the two time points were used to calculate the predicted implanted IOL power and the actual IOL power was chosen on the basis of parameters measured earlier before surgery using the Haigis formula. The mean numerical error (MNE) and mean absolute error (MAE) predicted by the two time points were also compared.ResultsThere were significant differences in the ACD, IOL power, UDVA and CDVA (P<0.01), but no statistical differences in AL, mean K and corneal astigmatism (P>0.05) during the average of 5.6 months before surgery. No statistically significant difference was detected in MNE (P>0.05), while the MAE had a significant difference in the two time points (P<0.05).ConclusionThe IOL power measured earlier before surgery might result in a higher accuracy and the postoperative refractive outcome tended towards emmetropia.

| S-EPMC7875381 | biostudies-literature

Accuracy of intraocular lens power calculation formulae after laser refractive surgery in myopic eyes: a meta-analysis.

Project description:BackgroundTo compare the accuracy of intraocular lens power calculation formulae after laser refractive surgery in myopic eyes.MethodsWe searched the databases on PubMed, EMBASE, Web of Science and the Cochrane library to select relevant studies published between Jan 1st, 2009 and Aug 11th, 2019. Primary outcomes were the percentages of refractive prediction error within ±0.5 D and ±1.0 D.ResultsThe final meta-analysis included 16 studies using seven common methods (ASCRS average, Barrett True-K no history, Double-K SRK/T, Haigis-L, OCT formula, Shammas-PL, and Wang-Koch-Maloney). ASCRS average yielded significantly higher percentage of refractive prediction error within ±0.5 D than Haigis-L, Shammas-PL and Wang-Koch-Maloney (P = 0.009, 0.01, 0.008, respectively). Barrett True-K no history also yielded significantly higher percentage of refractive prediction error within ±0.5 D than Shammas-PL and Wang-Koch-Maloney (P = 0.01, P < 0.0001, respectively), and a similar result was found when comparing OCT formula with Haigis-L and Shammas-PL (P = 0.03, P = 0.01, respectively).ConclusionThe ASCRS average or Barrett True-K no history should be used to calculate the intraocular lens power in eyes after myopic laser refractive surgery. The OCT formula if available, can also be a good alternative choice.

| S-EPMC7339492 | biostudies-literature

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