Instituto Superior de Tecnologías y Ciencias Aplicadas, Universidad de la Habana, la Habana, Cuba.
Instituto Cubano de Oftalmología Ramón Pando Ferrer, la Habana, Cuba.
J Cataract Refract Surg. 2019 Dec;45(12):1753-1761. doi: 10.1016/j.jcrs.2019.07.035.
To determine the capabilities of a multilayer perceptron (MLP) for calculating the power of an intraocular lens (IOL) to be implanted and in achieving a given postoperative stable refraction.
Cuban Institute of Ophthalmology, Havana, Cuba.
Retrospective review.
The study comprised data of patients who had uneventful phacoemulsification cataract surgery with implantation of a biconvex acrylic foldable IOL (type RYCF, model Ocuflex) in the capsular bag over 6 years. Exclusion criteria were previous intraocular or refractive corneal surgery, any corneal disease, pathological or complicated cataracts, intraoperative complications, preoperative astigmatism beyond 3.0 diopters (D), postoperative corrected distance visual acuity worse than 20/40, missing postoperative refractive information, eyes with an axial length (AL) shorter than 19.36 mm, eyes with an AL longer than 27.0 mm, average corneal keratometry (K) power lower than 36.0 D or higher than 50.9 D, and refractive surprises greater than ±3.0 D. The data were used to train an MLP to predict the value of the IOL power required for attaining a given postoperative refraction. Using AL, K value, and predicted and real postoperative refraction as input data, the output of the MLP was the IOL power.
The study comprised 15 728 eyes of 15 728 patients. The trained neural networks predicted the value of the implanted IOL with an error less than 0.5 D in more than 95% of patients, even for a case in which a surgeon was not included in the training process.
The accuracy attained by the trained MLP is high, indicating the feasibility of a prospective study leading to a new method of predicting the IOL power in refractive surgery with an error lower than the current prediction methods.
确定多层感知器（MLP）计算待植入人工晶状体（IOL）的功率和实现给定术后稳定屈光的能力。
古巴哈瓦那古巴眼科研究所。
回顾性研究。
该研究包括 6 年内在囊袋内植入双凸丙烯酸可折叠 IOL（RYCF 型，Ocuflex 型号）的无并发症超声乳化白内障手术患者的数据。排除标准为既往眼内或屈光性角膜手术、任何角膜疾病、病理性或复杂白内障、术中并发症、术前散光超过 3.0 屈光度（D）、术后矫正远视力低于 20/40、术后屈光信息缺失、眼轴（AL）短于 19.36 毫米、AL 长于 27.0 毫米、平均角膜屈光度（K）功率低于 36.0 D 或高于 50.9 D 以及屈光惊喜大于±3.0 D。这些数据用于训练 MLP 以预测达到给定术后屈光所需的 IOL 功率值。使用 AL、K 值以及预测和实际术后屈光作为输入数据，MLP 的输出是 IOL 功率。
该研究共包括 15728 名患者的 15728 只眼。经过训练的神经网络预测植入 IOL 的值，超过 95%的患者误差小于 0.5 D，即使在手术医生未参与训练过程的情况下也是如此。
训练后的 MLP 达到的准确性很高，表明有可能进行前瞻性研究，从而开发出一种新的预测屈光手术中 IOL 功率的方法，其误差低于当前的预测方法。
