Using the First-Eye Back-Calculated Effective Lens Position to Improve Refractive Outcome of the Second Eye

The present study is a retrospective, monocentric case series that aims to compare the second-eye IOL power calculation precision using the back-calculated lens position (LP) as a lens position predictor versus using a predetermined correction factor (CF) for thin- and thick-lens IOL calculation for...

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Main Authors: Nicole Mechleb, Guillaume Debellemanière, Mathieu Gauvin, Avi Wallerstein, Alain Saad, Damien Gatinel
Format: Article
Language:English
Published: MDPI AG 2022-12-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/12/1/184
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author Nicole Mechleb
Guillaume Debellemanière
Mathieu Gauvin
Avi Wallerstein
Alain Saad
Damien Gatinel
author_facet Nicole Mechleb
Guillaume Debellemanière
Mathieu Gauvin
Avi Wallerstein
Alain Saad
Damien Gatinel
author_sort Nicole Mechleb
collection DOAJ
description The present study is a retrospective, monocentric case series that aims to compare the second-eye IOL power calculation precision using the back-calculated lens position (LP) as a lens position predictor versus using a predetermined correction factor (CF) for thin- and thick-lens IOL calculation formulas. A set of 878 eyes from 439 patients implanted with Finevision IOLs (BVI PhysIOL, Liège, Belgium) with both operated eyes was used as a training set to create Haigis-LP and PEARL-LP formulas, using the back-calculated lens position of the contralateral eye as an effective lens position (ELP) predictor. Haigis-CF, Barrett-CF, and PEARL-CF formulas using an optimized correction factor based on the prediction error of the first eye were also designed. A different set of 1500 eyes from 1500 patients operated in the same center was used to compare the basal and enhanced formula performances. The IOL power calculation for the second eye was significantly enhanced by adapting the formulas using the back-calculated ELP of the first eye or by using a correction factor based on the prediction error of the first eye, the latter giving slightly higher precision. A decrease in the mean absolute error of 0.043D was observed between the basal PEARL and the PEARL-CF formula (<i>p</i> < 0.001). The optimal correction factor was close to 60% of the first-eye prediction error for every formula. A fixed correction factor of 60% of the postoperative refractive error of the first operated eye improves the second-eye refractive outcome better than the methods based on the first eye’s effective lens position back-calculation. A significant interocular biometric dissimilarity precludes the enhancement of the second-eye IOL power calculation according to the first-eye results.
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spelling doaj.art-3b22b5ad60574136a7719493167745292023-11-16T15:42:35ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-0112118410.3390/jcm12010184Using the First-Eye Back-Calculated Effective Lens Position to Improve Refractive Outcome of the Second EyeNicole Mechleb0Guillaume Debellemanière1Mathieu Gauvin2Avi Wallerstein3Alain Saad4Damien Gatinel5Department of Ophthalmology, Rothschild Foundation Hospital, 75019 Paris, FranceDepartment of Ophthalmology, Rothschild Foundation Hospital, 75019 Paris, FranceDepartment of Ophthalmology and Visual Sciences, McGill University, Montréal, QC H3A 0G4, CanadaDepartment of Ophthalmology and Visual Sciences, McGill University, Montréal, QC H3A 0G4, CanadaDepartment of Ophthalmology, Rothschild Foundation Hospital, 75019 Paris, FranceDepartment of Ophthalmology, Rothschild Foundation Hospital, 75019 Paris, FranceThe present study is a retrospective, monocentric case series that aims to compare the second-eye IOL power calculation precision using the back-calculated lens position (LP) as a lens position predictor versus using a predetermined correction factor (CF) for thin- and thick-lens IOL calculation formulas. A set of 878 eyes from 439 patients implanted with Finevision IOLs (BVI PhysIOL, Liège, Belgium) with both operated eyes was used as a training set to create Haigis-LP and PEARL-LP formulas, using the back-calculated lens position of the contralateral eye as an effective lens position (ELP) predictor. Haigis-CF, Barrett-CF, and PEARL-CF formulas using an optimized correction factor based on the prediction error of the first eye were also designed. A different set of 1500 eyes from 1500 patients operated in the same center was used to compare the basal and enhanced formula performances. The IOL power calculation for the second eye was significantly enhanced by adapting the formulas using the back-calculated ELP of the first eye or by using a correction factor based on the prediction error of the first eye, the latter giving slightly higher precision. A decrease in the mean absolute error of 0.043D was observed between the basal PEARL and the PEARL-CF formula (<i>p</i> < 0.001). The optimal correction factor was close to 60% of the first-eye prediction error for every formula. A fixed correction factor of 60% of the postoperative refractive error of the first operated eye improves the second-eye refractive outcome better than the methods based on the first eye’s effective lens position back-calculation. A significant interocular biometric dissimilarity precludes the enhancement of the second-eye IOL power calculation according to the first-eye results.https://www.mdpi.com/2077-0383/12/1/184biometryIOL power calculationsecond eyeeffective lens positioncorrection factor
spellingShingle Nicole Mechleb
Guillaume Debellemanière
Mathieu Gauvin
Avi Wallerstein
Alain Saad
Damien Gatinel
Using the First-Eye Back-Calculated Effective Lens Position to Improve Refractive Outcome of the Second Eye
Journal of Clinical Medicine
biometry
IOL power calculation
second eye
effective lens position
correction factor
title Using the First-Eye Back-Calculated Effective Lens Position to Improve Refractive Outcome of the Second Eye
title_full Using the First-Eye Back-Calculated Effective Lens Position to Improve Refractive Outcome of the Second Eye
title_fullStr Using the First-Eye Back-Calculated Effective Lens Position to Improve Refractive Outcome of the Second Eye
title_full_unstemmed Using the First-Eye Back-Calculated Effective Lens Position to Improve Refractive Outcome of the Second Eye
title_short Using the First-Eye Back-Calculated Effective Lens Position to Improve Refractive Outcome of the Second Eye
title_sort using the first eye back calculated effective lens position to improve refractive outcome of the second eye
topic biometry
IOL power calculation
second eye
effective lens position
correction factor
url https://www.mdpi.com/2077-0383/12/1/184
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