Accuracy of PEARL-DGS Formula for Intraocular Lens Power Calculation in Patients With Previous Myopic Laser Vision...

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Artificial Intelligence in Healthcare

Background:

• Accurate intraocular lens (IOL) power calculation is crucial for visual outcomes after cataract surgery.
• Patients with a history of myopic laser refractive surgery present unique challenges for standard IOL formulas due to altered corneal curvature.
• Novel formulas are needed to improve refractive prediction accuracy in this specific patient population.

Purpose of the Study:

• To evaluate the accuracy of the PEARLS-DGS, a novel machine learning-based open-source IOL formula.
• To compare PEARLS-DGS performance against established IOL formulas in eyes with prior myopic laser refractive surgery.
• To assess refractive prediction error and its distribution in 100 patients undergoing uncomplicated cataract surgery.

Main Methods:

• Retrospective analysis of 100 patients with a history of photorefractive keratectomy or LASIK.
• Comparison of PEARLS-DGS with Shammas, Haigis-L, Barrett True-K, ASCRS calculator average, EVO, and Hoffer QST formulas.
• Primary outcome measures included absolute refractive prediction error and cumulative distribution of error at various thresholds.

Main Results:

• EVO 2.0 demonstrated the lowest median absolute error (0.36 D), followed by Hoffer QST (0.38 D) and PEARLS-DGS (0.41 D).
• At the ±0.50 D threshold, Hoffer QST (0.65) and PEARLS-DGS (0.61) showed strong performance in cumulative distribution.
• No statistically significant differences were found between most formulas, except between Shammas and Hoffer QST at the ±0.50 D threshold.

Conclusions:

• The PEARLS-DGS IOL formula exhibits comparable accuracy to existing formulas for eyes with prior myopic laser vision correction.
• PEARLS-DGS demonstrates reliable refractive prediction error distribution, performing well against established methods like Hoffer QST.
• This study supports PEARLS-DGS as a potentially valuable tool for IOL calculations in post-refractive surgery eyes.