Clinical Ophthalmology (May 2024)
Accuracy of the Majority Voting Method with Multiple IOL Power Formulae
Abstract
Yukihito Kato,1,* Takashi Kojima,1,2 Akeno Tamaoki,3 Yoshiki Tanaka,1,* Naoki Yamamoto,4,5,* Kazuo Ichikawa1 1Chukyo Eye Clinic, Nagoya, Aichi, Japan; 2Nagoya Eye Clinic, Nagoya, Aichi, Japan; 3Department of Ophthalmology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Aichi, Japan; 4Center for Society-Academia Collaboration, Research Promotion Headquarters, Fujita Health University, Toyoake, Aichi, Japan; 5International Center for Cell and Gene Therapy, Research Promotion Headquarters, Fujita Health University, Toyoake, Aichi, Japan*These authors contributed equally to this workCorrespondence: Kazuo Ichikawa, Chukyo Eye Clinic, 12-22, Sanbonmatsu-cho, Atsuta-ku, Nagoya-city, Aichi, Japan, Tel +81 52 884 7976, Fax +81 52 884 7977, Email [email protected]: This study aimed to evaluate the efficacy of a majority decision algorithm that integrates intraoperative aberrometry (IA) and two intraocular lens (IOL) frequency formulas. The primary objective was to compare the accuracy of three formulas (IA; Sanders, Retzlaff, and Kraff/Theoretical (SRK/T); and Barrett Universal II (BUII)), in achieving emmetropia in eyes implanted with TFNT lenses (Alcon).Patients and Methods: A total of 145 eyes of 145 patients were included in the evaluation. Preoperative data were obtained from IOLMaster 700, while intraoperative data were collected from ORA SYSTEMTM. Visual acuity ≥ 0.8 at the 3-month post-surgery mark was confirmed. We assessed refractive prediction error (RPE), which is the difference between predicted refraction (PR) and postoperative subjective refraction. This evaluation aimed to identify the optimal IOL power with the implemented algorithm.Results: Among the 145 eyes evaluated, 55.9%, 78.7%, and 97.2% achieved postoperative subjective refraction within ± 0.13 Diopters (D), ± 0.25 D, and ± 0.50 D, respectively. The percentages of eyes within ± 0.25 D of PR varied by formula type, with values of 57%, 57%, and 54% for IA, BUII, and SRK/T, respectively. For eyes with short to medium axial length (AL< 26.00 mm), the percentages within ± 0.25 D of RPE were 52%, 58%, and 58% for IA, SRK/T, and BUII, respectively. In contrast, for eyes with long axial length (≥ 26.00 mm) the percentages were 68%, 52%, and 45% for IA, BUII, and SRK/T, respectively.Conclusion: The proposed majority decision algorithm incorporating IA and two IOL frequency formulas was effective in reducing postoperative refractive error. IA was particularly beneficial for eyes with long axial length. These findings suggest the algorithm has potential to optimize IOL power selection to improve quality of life of patients and clinical practice outcomes.Keywords: multifocal intraocular lens, cataract, intraocular lens power calculation, axial length, optimum visual acuity
