Anterior Segment and Refractive Surgery Department, Rothschild Foundation Hospital, Paris, France.
Memira Eye Center, Oslo, Norway.
Transl Vis Sci Technol. 2024 Oct 1;13(10):22. doi: 10.1167/tvst.13.10.22.
In cataract surgery, accurate intraocular lens (IOL) power calculations are crucial for optimal postoperative refractive outcomes. This study explores the impact of prioritizing the reduction of the standard deviation (SD) of prediction errors before mean prediction error (PE) adjustment on IOL calculation formula precision and accuracy.
We conducted a retrospective analysis of 4885 eyes from 2611 patients, all implanted with the same IOL model, comparing four traditional IOL power calculation formulas: SRK/T, Holladay 1, Haigis, and Hoffer Q. We introduced new constants aiming to minimize the SD of PE (new_const) against traditionally optimized constants (classic_const), using a heteroscedastic statistical method for comparison. Validation of precision improvements used a secondary dataset of 262 eyes from 132 patients.
We observed significant reductions in mean absolute error (MAE) across training and test sets for Hoffer Q, Holladay, and Haigis formulas, indicating accuracy enhancements. Optimized constants significantly reduced SDs for Haigis from 0.3255 to 0.3153 and for Hoffer Q from 0.3521 to 0.3387. These optimizations also increased the proportion of eyes achieving PE within ±0.25 D. SRK/T showed improved SD from 0.3596 to 0.3585. However, Holladay 1 showed minimal change with no significant improvement. In the test dataset, significant reductions in SD were observed for Haigis and Hoffer Q.
Prioritizing SD minimization before adjusting mean PE significantly improves the precision of selected IOL power formulas, enhancing postoperative refractive outcomes. The effectiveness varies among formulas, underscoring the need for formula-specific adjustments.
The study presents a novel two-step approach for optimizing IOL power calculations.
在白内障手术中，准确的眼内人工晶状体（IOL）屈光力计算对于获得最佳术后屈光效果至关重要。本研究探讨了在平均预测误差（PE）调整之前，优先降低预测误差（PE）标准差（SD）对 IOL 计算公式精度和准确性的影响。
我们对 2611 例 4885 只眼进行了回顾性分析，所有眼均植入同一型 IOL，比较了 4 种传统的 IOL 屈光力计算公式：SRK/T、Holladay 1、Haigis 和 Hoffer Q。我们采用异方差统计方法，引入了新的常数，目的是使 PE 的 SD 最小化（new_const），与传统优化常数（classic_const）进行比较。精度改进的验证使用了来自 132 例 262 只眼的二次数据集。
我们观察到 Hoffer Q、Holladay 和 Haigis 公式在训练集和测试集中的平均绝对误差（MAE）均显著降低，表明准确性提高。优化常数显著降低了 Haigis 公式的 SD，从 0.3255 降至 0.3153，Hoffer Q 公式的 SD 从 0.3521 降至 0.3387。这些优化还增加了 PE 落在±0.25 D 内的眼数比例。SRK/T 的 SD 从 0.3596 提高到 0.3585。然而，Holladay 1 的 SD 变化最小，没有显著改善。在测试数据集，Haigis 和 Hoffer Q 的 SD 显著降低。
在调整平均 PE 之前优先降低 SD，可显著提高选定 IOL 屈光力计算公式的精度，改善术后屈光效果。各公式的效果不同，强调了需要进行公式特异性调整。
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