EVALUATION OF A NEW SOFTWARE ALGORITHM FOR THE CALCULATION OF TRIFOCAL, MULTIFOCAL, AND SPIRAL INTRAOCULAR LENSES

To evaluate the accuracy, reliability, and clinical performance of a newly developed DUDO Software algorithm designed for the selection and power calculation of premium intraocular lenses (IOLs), including trifocal, multifocal, and spiral designs.

The study was conducted at iClinic s.r.o., Ophthalmology Clinic, Bratislava, Slovakia, and iDoctor, Ophthalmology Center, Klagenfurt am Wörthersee, Austria — tertiary referral centers specializing in cataract and refractive surgery. All surgeries and postoperative assessments were performed between January 2025 and October 2025 by the same surgical team under standardized conditions.

A total of 60 eyes of 45 patients who underwent cataract extraction with implantation of premium IOLs were included. IOL power was calculated using the new DUDO Software, which incorporates multiple advanced optical parameters: analysis of corneal optical zones and asphericity, modeling of higher-order aberrations (HOAs), simulation of IOL defocus curves for different lens types, and personalized correction based on anterior and posterior corneal curvature data. The outcomes obtained with DUDO Software were compared to those calculated using Barrett Universal II, Kane, and Pearl-DGS formulas. Patients were classified according to axial length — short (<22.0 mm), normal (22.0–25.0 mm), and long (>25.0 mm) — to assess consistency across different eye anatomies. Postoperative outcomes were evaluated at 1 and 3 months, including refractive prediction error (RPE), mean absolute error (MAE), best-corrected visual acuity (BCVA), and patient satisfaction.

The DUDO Software demonstrated the highest level of refractive predictability among all compared methods. 86% of eyes achieved a postoperative spherical equivalent within ±0.25 D of the intended refraction, compared to 72% with conventional formulas. The mean absolute error (MAE) was 0.18 ± 0.09 D with DUDO Software versus 0.29 ± 0.12 D using standard approaches (p < 0.01). Particularly in short and long eyes, the DUDO algorithm minimized systematic hyperopic and myopic shifts by refining effective lens position (ELP) estimation and accounting for individual corneal morphology. Patients also reported greater visual satisfaction, especially with trifocal and spiral IOLs, due to reduced photic phenomena and improved intermediate vision.

The newly developed DUDO Software represents a significant step forward in the precision of premium IOL power calculation. By combining corneal topographic mapping, HOA prediction, and individualized defocus simulation, the algorithm delivers improved refractive accuracy and visual quality across a wide range of eye anatomies. This technology has the potential to enhance surgical planning, optimize refractive outcomes, and increase patient satisfaction in the implantation of trifocal, multifocal, and spiral intraocular lenses.