Abstract
This retrospective study was aimed to compare prediction errors from various combinations of biometric data generated using optical coherence tomography (OCT) and develop a new intraocular lens (IOL) formula using biometric data. 145 eyes from 145 patients who underwent femtosecond laser-assisted cataract surgery (FLACS) were enrolled to the present study and they were divided into a training set (n = 92) and a test set (n = 53). Preoperative axial length (AL) and corneal radius were measured using partial coherence interferometry. The anterior chamber depth (ACD), lens meridian parameter (LMP), lens thickness (LT), thickness of anterior and posterior parts of the crystalline lens (aLT and pLT), and anterior segment length were measured by OCT. From a training set, we developed eight regression equations and analyzed the predictive accuracy. The regression equation using AL, LMP, and pLT (-1.143 + 0.148*AL + 0.428*LMP + 0.254*pLT) showed the strongest correlation with effective lens position (ELP) and smallest standard deviation of ELP prediction error. IOL formula generated using AL, LMP, and pLT yielded the highest predictive accuracy. In a test set, the new IOL formula also produced narrowest range of prediction error, smallest median absolute error, and highest percentages within ±0.25, ±0.50 than existing IOL formulas. The IOL formula considering AL, LMP and pLT will help to improve predictive accuracy in FLACS.
Highlights
Modern cataract surgery is considered to be a combined rehabilitative and refractive procedure, and is known as refractive cataract surgery
Instead of the anterior chamber depth (ACD) that is used in the existing Haigis formula, combinations involving lens meridian parameter (LMP) showed a stronger association in multiple linear regression analysis
The new combinations generated using parameters provided by Catalys 3D-optical coherence tomography (OCT) enhanced the predictive accuracy comparing with the existing intraocular lens (IOL) formulas
Summary
Modern cataract surgery is considered to be a combined rehabilitative and refractive procedure, and is known as refractive cataract surgery. Patient expectations for optimal refractive outcomes have increased along with improvements in surgical techniques and intraocular lens (IOL) technology. The postoperative refractive outcome is the most important factor for patient satisfaction [1]. An effective lens position (ELP) is not a physical distance with thin lens formulas and cannot be measured, as it is the distance between the cornea and the secondary principal plane of the IOL. The prediction of an ELP is the most important process in IOL power calculation [2]. The distance from the iris plane to the IOL is known as the surgeon factor (SF) and is specific to each lens. The Haigis formula, one of the fourth-generation IOL formulas, used preoperative ACD measurements to predict ELP instead of corneal steepness
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