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      VRF-G, a New Intraocular Lens Power Calculation Formula: A 13-Formulas Comparison Study

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          Abstract

          Purpose

          To compare the accuracy of a newly developed intraocular lens (IOL) power formula (VRF-G) with twelve existing formulas (Barret Universal II, EVO 2.0, Haigis, Hill-RBF 2.0, Hoffer Q, Holladay 1, Kane, Næeser 2, PEARL-DGS, SRK/T, T2 and VRF).

          Methods

          Retrospective case series including 828 patients having uncomplicated cataract surgery with the implantation of a single IOL model (SN60WF). Using optimised constants, refraction prediction error of each formula was calculated for each eye. Subgroup analysis was performed based on the axial length (short ≤22.0mm; medium >22.0mm to <26.0mm; long ≥26.0mm). Main outcomes included mean prediction error (ME) mean (MAE) and median absolute error (MedAE), in diopters (D), and the percentage of eyes within ±0.25D, ±0.50D, ±0.75D and ±1.00D.

          Results

          Formulas absolute errors were statistically different among them (p<0.001), with Kane having the lowest MAE of all formulas, followed by EVO 2.0 and VRF-G, which had the lowest MedAE. The Kane formula had the highest percentage of eyes within ±0.25D (47.0%) and ±1.00D (97.7%) and the VRF-G formula had the highest percentage of eyes within ±0.50D (79.5%). For all AL subgroups, Kane, EVO 2.0 and VRF-G formulas had the most accurate performances (lowest MAE).

          Conclusion

          New generation formulas may help us in achieving better refractive results, lowering the variance in accuracy in extreme eyes – Kane, EVO 2.0 and VRF-G formulas are promising candidates to fulfil that goal.

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          Most cited references22

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          Comparison of immersion ultrasound biometry and partial coherence interferometry for intraocular lens calculation according to Haigis.

          W Haigis, B. Schneider, B Lege … (2000)
          The precision of intraocular lens (IOL) calculation is essentially determined by the accuracy of the measurement of axial length. In addition to classical ultrasound biometry, partial coherence interferometry serves as a new optical method for axial length determination. A functional prototype from Carl Zeiss Jena implementing this principle was compared with immersion ultrasound biometry in our laboratory. In 108 patients attending the biometry laboratory for planning of cataract surgery, axial lengths were additionally measured optically. Whereas surgical decisions were based on ultrasound data, we used postoperative refraction measurements to calculate retrospectively what results would have been obtained if optical axial length data had been used for IOL calculation. For the translation of optical to geometrical lengths, five different conversion formulas were used, among them the relation which is built into the Zeiss IOL-Master. IOL calculation was carried out according to Haigis with and without optimization of constants. On the basis of ultrasound immersion data from our Grieshaber Biometric System (GBS), postoperative refraction after implantation of a Rayner IOL type 755 U was predicted correctly within +/- 1 D in 85.7% and within +/- 2 D in 99% of all cases. An analogous result was achieved with optical axial length data after suitable transformation of optical path lengths into geometrical distances. Partial coherence interferometry is a noncontact, user- and patient-friendly method for axial length determination and IOL planning with an accuracy comparable to that of high-precision immersion ultrasound.
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            Accuracy of Intraocular Lens Calculation Formulas.

            Ronald B Melles, Jack Holladay, William J Chang (2018)
            To compare the accuracy of intraocular lens (IOL) calculation formulas (Barrett Universal II, Haigis, Hoffer Q, Holladay 1, Holladay 2, Olsen, and SRK/T) in the prediction of postoperative refraction using a single optical biometry device.
            Article 0 comments Cited 153 times – based on 0 reviews     Review now
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              The Hoffer Q formula: a comparison of theoretic and regression formulas.

              Barry Hoffer (1993)
              A new formula, the Hoffer Q, was developed to predict the pseudophakic anterior chamber depth (ACD) for theoretic intraocular lens (IOL) power formulas. It relies on a personalized ACD, axial length, and corneal curvature. In 180 eyes, the Q formula proved more accurate than those using a constant ACD (P < .0001) and equal (P = .63) to those using the actual postoperative measured ACD (which is not possible clinically). In 450 eyes of one style IOL implanted by one surgeon, the Hoffer Q formula was equal to the Holladay (P = .65) and SRK/T (P = .63) and more accurate than the SRK (P < .0001) and SRK II (P = .004) regression formulas using optimized personalization constants. The Hoffer Q formula may be clinically more accurate than the Holladay and SRK/T formulas in eyes shorter than 22.0 mm. Even the original nonpersonalized constant ACD Hoffer formula compared with SRK I (using the most valid possible optimized personal A-constant) has a better mean absolute error (0.56 versus 0.59) and a significantly better range of IOL prediction error (3.44 diopters [D] versus 7.31 D). The range of error of the Hoffer Q formula (3.59 D) was half that of SRK I (7.31 D). The highest IOL power errors in the 450 eyes were in the SRK II (3.14 D) and SRK I (6.14 D); the power error was 2.08 D using the Hoffer Q formula. The series using overall personalized ACD was more accurate than using an axial length subgroup personalized ACD in each axial length subgroup. The results strongly support replacing regression formulas with third-generation personalized theoretic formulas and carefully evaluating the Holladay, SRK/T, and Hoffer Q formulas.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): opth
                Journal ID (pmc): clinop
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date (Electronic): 16 December 2020
                Publication date Collection: 2020
                Volume: 14
                Pages: 4395-4402
                Affiliations
                [1 ]Department of Ophthalmology, Centro Hospitalar Universitário De Lisboa Central , Lisbon 1169-050, Portugal
                [2 ]Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute , Singapore
                [3 ]Department of Ophthalmology, Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center , Medical City, Kyiv 03680, Ukraine
                Author notes
                Correspondence: Diogo Hipólito-Fernandes Department of Ophthalmology, Centro Hospitalar Universitário De Lisboa Central, Alameda De Santo António Dos Capuchos , Lisbon1169-050, PortugalTel +351 21 313 6300 Email cdiogo777@gmail.com
                Author information
                http://orcid.org/0000-0002-5972-4068
                http://orcid.org/0000-0002-9361-089X
                http://orcid.org/0000-0002-5279-2041
                Article
                Publisher ID: 290125
                DOI: 10.2147/OPTH.S290125
                PMC ID: 7751728
                PubMed ID: 33364744
                SO-VID: b605cc4f-dba7-478a-8c53-e467b893b6bb
                Copyright © © 2020 Hipólito-Fernandes et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 09 November 2020
                Date accepted : 02 December 2020
                Page count
                Figures: 2, Tables: 5, References: 27, Pages: 8
                Funding
                Funded by: funding;
                No funding or grant support.
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: intraocular lens power calculation formulas,biometry,cataract,phacoemulsification,formulas accuracy
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: intraocular lens power calculation formulas, biometry, cataract, phacoemulsification, formulas accuracy

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