The accuracy of intraocular lens power calculation formulas based on artificial intelligence in highly myopic eyes: a
Yi Zhou1,2,3, Minhui Dai1,2,3, Lingyu Sun1,2,3
1Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China.
Objective:
To systematically compare and rank the accuracy of AI-based intraocular lens (IOL) power calculation formulas and traditional IOL formulas in highly myopic eyes.
Methods:
We 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.
Results:
Twelve 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.
Conclusions:
The 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 Registration:
https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022335969.
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