ESCRS - PP13.07 - Clinical Feasibility Of The Escrs Iol Power Calculato

Clinical Feasibility Of The Escrs Iol Power Calculato

Published 2025 - 43rd Congress of the ESCRS

Reference: PP13.07 | Type: Free paper | DOI: 10.82333/apav-j796

Authors: Norbert Koerber* 1 , Simon Ondrejka 1

1Augencentrum Köln-Porz,Köln,Germany

Purpose

To evaluate the mean absolute error (MAE) of classical and modern intraocular lens (IOL) power calculation formulae to assess the feasibility of the ESCRS IOL Calculator. Additionally, to develop a new approach to IOL calculation by combining the predictive outputs of all seven formulas included in the ESCRS Calculator.

Setting

Department of Ophthalmology, Johannes Kepler University and Kepler University Clinic Linz, Austria
Department of Ophthalmology, Medical University Graz, Austria Methods

Methods

This study included 337 eyes of 337 patients who underwent implantation of a monofocal IOL (PCB00, Johnson & Johnson, USA). Classical IOL calculation formulae provided by the biometry device (Barrett Universal II, Haigis, SRK/T, Hoffer Q) and modern formulae implemented in the ESCRS calculator (Barrett Universal II, Cooke K6, EVO, Hill-RBF, HofferQST, Kane, Pearl-DGS) were evaluated. The mean absolute error (MAE), the proportion of eyes within ±0.5, ±1.0, ±1.5, and ±2.0 diopters of target refraction, the agreement of proposed IOL power among ESCRS formulae, and the input time for the ESCRS calculator were analyzed. Additionally, a novel approach combining all formula predictions aimed to improve refractive outcomes in outlier eyes.

Results

The best-performing ESCRS formulas were Kane, EVO, and BUII, with an MAE (SD) of 0.37 (0.30), 0.37 (0.32), and 0.38 (0.32) diopters, respectively. While the ESCRS formulas showed a lower (but not significant) MAE compared to biometry formulas, a significant difference was observed between HofferQST and all other formulas (p<0.01 for all). Excluding HofferQST, a significant difference between ESCRS and biometry formulas was identified (p=0.004). The combined approach demonstrated improved outcomes in very short and long eyes compared to the Kane and EVO formulas, although without statistical significance. Detailed results will be presented at the ESCRS meeting in September 2025.

Conclusions

The ESCRS calculator allows efficient and up-to-date IOL calculations in routine clinical practice. The predictive accuracy of the ESCRS calculator is superior compared to older biometric formulae.