Abstract

AimTo evaluate the potential of the Support Vector Machine Regression model (SVM-RM) and Multilayer Neural Network Ensemble model (MLNN-EM) to improve the intraocular lens (IOL) power calculation for clinical workflow.BackgroundCurrent IOL power calculation methods are limited in their accuracy with the possibility of decreased accuracy especially in eyes with an unusual ocular dimension. In case of an improperly calculated power of the IOL in cataract or refractive lens replacement surgery there is a risk of re-operation or further refractive correction. This may create potential complications and discomfort for the patient.MethodsA dataset containing information about 2,194 eyes was obtained using data mining process from the Electronic Health Record (EHR) system database of the Gemini Eye Clinic. The dataset was optimized and split into the selection set (used in the design for models and training), and the verification set (used in the evaluation). The set of mean prediction errors (PEs) and the distribution of predicted refractive errors were evaluated for both models and clinical results (CR).ResultsBoth models performed significantly better for the majority of the evaluated parameters compared with the CR. There was no significant difference between both evaluated models. In the ±0.50 D PE category both SVM-RM and MLNN-EM were slightly better than the Barrett Universal II formula, which is often presented as the most accurate calculation formula.ConclusionIn comparison to the current clinical method, both SVM-RM and MLNN-EM have achieved significantly better results in IOL calculations and therefore have a strong potential to improve clinical cataract refractive outcomes.

Highlights

  • Cataract surgery is the principal lens replacement refractive surgical procedure performed in adults and is one of the most commonly performed surgical procedures today (Abell & Vote, 2014; Frampton et al, 2014; Wang et al, 2017b)

  • This paper aims to describe the methodology for selecting and optimizing a dataset for Support Vector Machine Regression model (SVM-RM) and Multilayer Neural Network Ensemble model (MLNN-EM) training, to describe a methodology for evaluating the accuracy of the model, to evaluate support vector machine (SVM)-RM and Multilayer neural networks (MLNN)-EM for intraocular lens (IOL) power prediction and to compare the accuracy of both models with the current calculation method used in clinical practice

  • The overall percentage of eyes with prediction errors (PEs) between ±0.25, ±0.50, ±0.75 and ±1.00 D compared to clinical results (CR) was significantly higher for both models (SVM-RM P±0.25 = 7.860e-7, P±0.50 = 0, P±0.75 = 1.443e-15, P±1.00 = 4.823e-7 and MLNN-EM P±0.25 = 2.140e-7, P±0.50 = 0, P±0.75 = 1.110e-16, P±1.00 = 2.992e-7)

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Summary

Introduction

Cataract surgery is the principal lens replacement refractive surgical procedure performed in adults and is one of the most commonly performed surgical procedures today (Abell & Vote, 2014; Frampton et al, 2014; Wang et al, 2017b). More than 11 million eyes undergo intraocular lens (IOL) implantation worldwide. Improving clinical refractive results of cataract surgery by machine learning. Phacoemulsification with IOL implantation is currently the most common method of treating cataracts and many refractive vision errors for which other conventional methods are not suitable (Linebarger et al, 1999). Since significant developments have been made in cataract and refractive surgeries over the past 20 years we are even closer to meeting this target, there are still areas in which improvements can be made

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