From 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).
J Cataract Refract Surg. 2024 Nov 1;50(11):1109-1116. doi: 10.1097/j.jcrs.0000000000001512.
To evaluate prediction accuracy of formulas included in the ESCRS online intraocular lens (IOL) calculator using standard keratometry (K) or total keratometry (TK).
Hospital-based academic practice.
Retrospective case-series.
523 patients with cataract (523 eyes) were included in this study. The outcome measures were trimmed means of the spherical equivalent prediction error (SEQ-PE, trueness), precision and absolute SEQ-PE (accuracy) of all 7 formulas available on the ESCRS online IOL calculator, as well as mean (Mean-All) and median (Median-All) of the predicted SEQ refraction of all formulas. Subgroup analyses evaluated the effect of axial length on formula accuracy.
Trimmed-mean SEQ-PE range of all formulas varied from -0.075 to +0.071 diopters (D) for K-based and from -0.003 to +0.147 D for TK-based calculations, with TK-based being more hyperopic in all formulas ( P < .001). Precision ranged from 0.210 to 0.244 D for both K-based and TK-based calculations. Absolute SEQ-PE ranged from 0.211 to 0.239 D for K-based and from 0.218 to 0.255 D for TK-based calculations. All formulas, including Mean-All and Median-All, showed high accuracy, with 84% to 90% of eyes having SEQ-PEs within 0.50 D.Myopic trimmed-mean SEQ-PEs significantly different from zero were observed in long eyes for Pearl DGS (-0.110 D, P = .005), Hill RBF (-0.120 D, P < .001), and Hoffer QST (-0.143 D, P = .001) and in short eyes for EVO 2.0 (-0.252 D, P = .001), Kane (-0.264 D, P = .001), Hoffer QST (-0.302 D, P < .001), Mean-All (-0.122 D, P = .038), and Median-All (-0.125 D, P = .043).
Prediction accuracy of all ESCRS IOL calculator formulas was high and globally comparable. TK-based calculations did not increase prediction accuracy and tended toward hyperopia. Observations indicating formula superiority in long and short eyes merit further evaluation.
评估 ESCRS 在线人工晶状体（IOL）计算器中包含的公式在使用标准角膜曲率计（K）或总角膜曲率计（TK）时的预测准确性。
基于医院的学术实践。
回顾性病例系列。
本研究纳入了 523 例白内障患者（523 只眼）。主要结局指标为 ESCRS 在线 IOL 计算器中所有 7 种公式的球镜等效预测误差（SEQ-PE，准确度）、精度和 SEQ-PE 的绝对值（准确性）的修剪均值，以及所有公式预测 SEQ 折射的均值（Mean-All）和中位数（Median-All）。亚组分析评估了眼轴长度对公式准确性的影响。
所有公式的 SEQ-PE 修剪均值范围为基于 K 的计算时为-0.075 至+0.071 屈光度（D），基于 TK 的计算时为-0.003 至+0.147 D，基于 TK 的计算结果均偏远视（P<0.001）。基于 K 和 TK 的计算时，精度范围分别为 0.210 至 0.244 D。基于 K 的计算时，绝对 SEQ-PE 范围为 0.211 至 0.239 D，基于 TK 的计算时为 0.218 至 0.255 D。所有公式，包括 Mean-All 和 Median-All，均表现出高度准确性，84%至 90%的眼的 SEQ-PE 在 0.50 D 以内。在长眼患者中，Pearl DGS（-0.110 D，P=0.005）、Hill RBF（-0.120 D，P<0.001）和 Hoffer QST（-0.143 D，P=0.001）的近视性 SEQ-PE 明显不同于零，在短眼患者中，EVO 2.0（-0.252 D，P=0.001）、Kane（-0.264 D，P=0.001）、Hoffer QST（-0.302 D，P<0.001）、Mean-All（-0.122 D，P=0.038）和 Median-All（-0.125 D，P=0.043）的近视性 SEQ-PE 明显不同于零。
所有 ESCRS IOL 计算器公式的预测准确性均较高，且全球可比性良好。基于 TK 的计算并未提高预测准确性，反而倾向于远视。在长眼和短眼患者中观察到的公式优越性表明，这些公式需要进一步评估。
