Real-World Utility Of The Escrs Online Iol Calculator: Resolving Legacy Formula Discordance In Clinical Practice

Purpose: To demonstrate the real-life use and decision-making advantages of utilizing the ESCRS Online IOL Calculator as a primary conflict-resolution tool in scenarios where traditional legacy formulas (SRK/T, Haigis, Holladay 1, and Hoffer Q) give inconclusive IOL power calculations.

Public Hospital cataract service, UK

We retrospectively analysed 100 consecutive cataract surgery cases on routine cataract surgery lists at Frimley Park Hospital, Surrey, UK . Biometry results are displayed on a medisight EPR, with the ability to toggle between the above 4 formulae. We assessed how many of the surgery biometries had agreement in the legacy formulae, and in how many where there was a significant discrepancy (>0.5D) of IOL prediction between the legacy formulae.

7% of eyes (7 cases) had non-agreement of the legacy formulae, prompting the use of the ESCRS calculator. The use of the ESCRS calculator was more often required in patients with corneal pathology or simple non-agreement of our available legacy formulae.

We found a rate of 7% for use of the ESCRS Online IOL calculator to discriminate between non-agreement of IOLMaster legacy formulae. For the modern cataract surgeon, integrating the ESCRS Online IOL Calculator into the surgical planning workflow provides more reassuring and consistent results in certain patients who are otherwise more likely to end up with a residual refractive error.