{"title":"Comparative Accuracy of Five Modern Toric IOL Formulas.","authors":"Soonwon Yang, Hyoji Han, Hyun Soo Lee","doi":"10.1016/j.ajo.2025.02.028","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical accuracy of five modern toric intraocular lens (IOL) calculation formulas-Barrett, EVO, Naeser/Savini combined with Hoffer QST, Kane, and Abulafia-Koch combined with Hill RBF-in predicting postoperative refractive outcomes in cataract patients with astigmatism.</p><p><strong>Design: </strong>Retrospective, comparative analysis of IOL formula accuracy.</p><p><strong>Subjects: </strong>One hundred forty-six eyes from 146 cataract patients with toric IOL implantation.</p><p><strong>Methods: </strong>Biometric measurements were obtained using the Lenstar LS900, with personalized surgically induced astigmatism values applied for each surgeon. Postoperative outcomes, including mean absolute prediction error (MAE), centroid error, and the proportion of eyes within a prediction error of ±0.50 D and ±0.75 D, were evaluated. Subgroup analyses were performed for with-the-rule (WTR), against-the-rule (ATR), and oblique astigmatism. Statistical significance was assessed using non-parametric and multivariate tests.</p><p><strong>Setting: </strong>Eunpyeong St.Mary's Hospital, Seoul, Republic of Korea RESULTS: No significant differences in MAE were observed among the formulas in the overall cohort (p > 0.05). The proportion of eyes with a prediction error ≤ ±0.50 D was highest for EVO (71.92%), followed by Kane and Abulafia-Koch with Hill RBF (70.55%), Naeser/Savini with Hoffer QST (69.18%), and Barrett (67.12%). Among ATR cases, EVO, Abulafia-Koch with Hill RBF, and Naeser/Savini with Hoffer QST demonstrated statistically lower MAEs compared to Barrett (p < 0.05).</p><p><strong>Conclusion: </strong>All five toric IOL calculation formulas demonstrated excellent overall accuracy, with slight variations observed in specific subgroups. The EVO formula showed superior precision in ATR astigmatism. These findings provide real-world insights to enhance refractive outcomes and optimize formula selection in toric IOL surgery.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1000,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ajo.2025.02.028","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To compare the clinical accuracy of five modern toric intraocular lens (IOL) calculation formulas-Barrett, EVO, Naeser/Savini combined with Hoffer QST, Kane, and Abulafia-Koch combined with Hill RBF-in predicting postoperative refractive outcomes in cataract patients with astigmatism.
Design: Retrospective, comparative analysis of IOL formula accuracy.
Subjects: One hundred forty-six eyes from 146 cataract patients with toric IOL implantation.
Methods: Biometric measurements were obtained using the Lenstar LS900, with personalized surgically induced astigmatism values applied for each surgeon. Postoperative outcomes, including mean absolute prediction error (MAE), centroid error, and the proportion of eyes within a prediction error of ±0.50 D and ±0.75 D, were evaluated. Subgroup analyses were performed for with-the-rule (WTR), against-the-rule (ATR), and oblique astigmatism. Statistical significance was assessed using non-parametric and multivariate tests.
Setting: Eunpyeong St.Mary's Hospital, Seoul, Republic of Korea RESULTS: No significant differences in MAE were observed among the formulas in the overall cohort (p > 0.05). The proportion of eyes with a prediction error ≤ ±0.50 D was highest for EVO (71.92%), followed by Kane and Abulafia-Koch with Hill RBF (70.55%), Naeser/Savini with Hoffer QST (69.18%), and Barrett (67.12%). Among ATR cases, EVO, Abulafia-Koch with Hill RBF, and Naeser/Savini with Hoffer QST demonstrated statistically lower MAEs compared to Barrett (p < 0.05).
Conclusion: All five toric IOL calculation formulas demonstrated excellent overall accuracy, with slight variations observed in specific subgroups. The EVO formula showed superior precision in ATR astigmatism. These findings provide real-world insights to enhance refractive outcomes and optimize formula selection in toric IOL surgery.
期刊介绍：
The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect.
The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports.
Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.
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