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Network meta-analysis of intraocular lens power calculation formula accuracy for the Yamane technique
Weili Xie1, Yuman Zhang1, Siyuan Liu1
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, #7 Jinsui Road, Tianhe District, Guangzhou, 510060, China.
Purpose:
To systematically compare the accuracy of commonly used intraocular lens (IOL) power calculation formulas in eyes undergoing the Yamane technique.
Methods:
PubMed, Scopus, Web of Science, and Cochrane Library databases were searched for studies published between January 2014 and January 2026. Comparative clinical studies involving patients undergoing the Yamane technique were included if they reported mean absolute error (MAE), median absolute error (MedAE) and percentage of eyes with a prediction error (PE) within ± 0.50 or ± 1.00 diopters (D). Network meta-analysis was performed using R software. The protocol was registered in PROSPERO (CRD420261343495).
Results:
9 studies were included, involving 399 eyes and 7 calculation formulas. In pairwise analyses and the network meta-analysis, the Barrett Universal II (BUII) formula showed higher proportions of eyes with PE within ± 0.50 and ± 1.00 D, although these differences were not statistically significant. Surface under the cumulative ranking area (SUCRA) showed the BUII formula ranked first (79.1%) for the percentage of eyes with PE within ± 0.50 D. For the percentage within PE ± 1.00 D, Holladay 2 demonstrated the highest ranking (89.4%), followed by BUII (83.8%). The BUII formula had the lowest MedAE (0.43-0.73).
Conclusion:
The Yamane technique showed generally acceptable refractive outcomes across commonly used intraocular IOL formulas. Although no statistically significant differences were observed, BUII, Holladay 2, and SRK/T demonstrated relatively favorable performance across multiple refractive outcomes and may be preferred in clinical practice. These findings may help guide formula selection and refractive planning in Yamane fixation eyes. Further multicenter studies are warranted to confirm the optimal formulas for the Yamane technique.