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Comparison of Formula-Specific Factors and Artificial Intelligence Formulas with Axial Length Adjustments in
Chuang Li1, Mingwei Wang1, Rui Feng1
1State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China.
Introduction:
To evaluate and compare the effectiveness for reducing the prediction error (PE) of the second eye using formula-specific factors, artificial intelligence (AI) formulas (PEARL-DGS and Kane), and the Cooke-modified axial length (CMAL) methods in bilateral cataract patients with long axial length (AL).
Methods:
A total of 98 patients with long AL who underwent sequential bilateral cataract surgeries were retrospectively enrolled. The second-eye IOL power was calculated by the formula-specific factors, AI formulas, and CMAL methods when the first eye suffered from refraction surprise. The correction factors of eight formulas were calculated by regression analysis.
Results:
There was a significant correlation between bilateral preoperative biometric parameters (P < 0.05) as well as bilateral PE (P < 0.05). The Kane formula displayed the lowest median absolute error (MedAE) and highest proportion of PE within ± 0.50 and ± 1.00 D compared with other formulas for the first eye. For the second-eye refinement, all three methods could reduce the second-eye MedAE. The formula-specific correction factors were 0.250, 0.331, 0.343, 0.394, 0.409, 0.452, 0.503, and 0.520 for Kane, Barrett Universal II (BUII), PEARL-DGS, Holladay 2, Holladay 1, Haigis, Hoffer Q, and SRK/T, respectively. The new AI-based Kane and PEARL-DGS with or without the CMAL methods could improve the refractive outcomes of the second eye in sequential bilateral cataract patients with long AL. The Kane, BUII, and PEARL-DGS with specific correction factors displayed higher accuracy compared with the other two methods (P < 0.05).
Conclusions:
The new AI-based Kane and PEARL-DGS with or without the CMAL methods could improve the refractive outcomes of the second eye in sequential bilateral cataract patients with long AL. Notably, the Kane, PEARL-DGS, and BUII with specific correction factors displayed higher accuracy.

