Enhancing The Estimation Of Postoperative Intraocular Lens Position Using Optical Coherence Tomography
Published 2025 - 43rd Congress of the ESCRS
Reference: FP21.09 | Type: Free paper | DOI: 10.82333/0a1c-g954
Authors: Asaf Laks 1 , Biana Dubinsky-Pertzov 2 , Arad Dotan 3 , Anat Maytal 2 , Adi Einan - Lifshitz* 2
1Shamir Medical Center,Be’er Ya’akov,Israel;Faculty of Medicine,Tel Aviv University,Tel Aviv,Israel, 2Ophthalmology,Shamir Medical Center,Be’er Ya’akov,Israel;Faculty of Medicine,Tel Aviv University,Tel Aviv,Israel, 3Sheba Medical Center,Tel-Hashomer,Israel;Faculty of Medicine,Tel Aviv University,Tel Aviv,Israel
Purpose
Cataract is a leading cause of low vision worldwide. The surgical treatment is to remove the opaque lens and replace it by an artificial intraocular lens (IOL). The power of this IOL is preoperatively calculated based on patient’s biometric parameters to achieve the preferred refractive outcome. Different generations of formulas are available to estimate the postoperative effective lens position (ELP), which remains the most important cause of error since it cannot be measured preoperatively. The purpose of this study is to enhance the accuracy of the estimated ELP by utilizing preoperative anterior segment optical coherence tomography (AS-OCT).
Setting
This study was performed in the University Hospital Antwerp, from June 2021 to June 2024. We enrolled patients planned for cataract surgery with the ‘bag-in-the-lens’ technique to undergo a preoperative AS-OCT examination, as well as 5-weeks postoperatively.
Methods
The following parameters were assessed: lens radius of curvature (front and back), lens equatorial position (distance between anterior cornea and the widest edge of the lens), lens diameter and postoperative anterior chamber depth (distance from the anterior corneal surface to anterior IOL surface). The estimation of the new IOL power calculation formula was performed using stepwise multiple linear regression, a process in which initially all predicting parameters are considered and the least significant term is iteratively removed until all remaining terms are significant at a level of p < 0.05. The results of our regressions were compared with currently used formulas.
Results
The best estimator of the ELP found was based on axial length, lens equatorial position, lens depth and anterior chamber depth. We describe three new formulas to predict ELP, based on these parameters. The regression formulas we propose had a coefficient of determination (r2) of 0.70, 0.66 and 0.58 compared to the postoperative IOL position measured by AS-OCT. For reference, the corresponding coefficients of determination for frequently used formulas (SRK/T, Haigis, and Olsen) resulted in values of 0.25, 0.46 and 0.42, respectively.
Conclusions
The new estimator of the effective lens position using AS-OCT shows great promise and has potential to enhance the precision of IOL power calculations.