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Analysis of the ESCRS calculator's prediction accuracy
Nir Sorkin1, Rotem Zadok, Hashem Totah
1From the Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel (Sorkin); Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Sorkin, Zadok); Department of Ophthalmology, Shaare Zedek Medical Center and the Hebrew University-Hadassah Medical School, Jerusalem, Israel (Totah, Abulafia); IRCCS Bietti Foundation, Rome, Italy (Savini); Departement of Ophthalmology, Hospital da Luz de Lisboa, Lisbon University, Lisbon, Portugal (Ribeiro); Vienna Institute for Research in Ocular Surgery (VIROS), Department of Ophthalmology, Hanusch Hospital, Vienna, Austria (Findl); Centro Buonsanti, Buenos Aires, Argentina (Buonsanti); Department of Ophthalmology, Unidade Local de Saúde de Coimbra, Coimbra, Portugal (Raimundo).
The ESCRS online intraocular lens (IOL) calculator shows high prediction accuracy for cataract surgery. Total keratometry (TK) did not improve accuracy and tended toward hyperopia, warranting further study in specific eye lengths.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Clinical Optics
Background:
- Accurate intraocular lens (IOL) power calculation is crucial for achieving desired refractive outcomes after cataract surgery.
- The European Society of Cataract and Refractive Surgery (ESCRS) provides an online calculator with multiple formulas to aid in this process.
- Evaluating the performance of these formulas using different keratometry measurements, standard keratometry (K) and total keratometry (TK), is essential for optimizing surgical planning.
Purpose of the Study:
- To assess and compare the prediction accuracy of all formulas within the ESCRS online IOL calculator.
- To determine if using total keratometry (TK) enhances prediction accuracy compared to standard keratometry (K).
Main Methods:
- A retrospective case-series study included 523 patients undergoing cataract surgery.
- The prediction error (spherical equivalent prediction error - SEQ-PE) was analyzed for trueness and accuracy across seven formulas available on the ESCRS calculator.
- Subgroup analyses investigated the impact of axial length on formula performance, comparing K-based and TK-based calculations.
Main Results:
- All ESCRS IOL calculator formulas demonstrated high prediction accuracy, with 84% to 90% of eyes having SEQ-PE within 0.50 D.
- TK-based calculations did not improve prediction accuracy over K-based calculations and consistently resulted in a hyperopic shift.
- Specific formulas showed statistically significant myopic shifts in long eyes (Pearl DGS, Hill RBF, Hoffer QST) and short eyes (EVO 2.0, Kane, Hoffer QST, Mean-All, Median-All).
Conclusions:
- The prediction accuracy of the formulas in the ESCRS online IOL calculator is high and comparable across the board.
- Utilizing TK in IOL calculations does not enhance prediction accuracy and introduces a tendency towards hyperopia.
- Further research is warranted to explore the observed formula performance differences in eyes with varying axial lengths.
