Wiktor Stopyra

Background/Objectives: The choice of appropriate intraocular lens (IOL) power calculation formulas depends on the axial length of the eye. This study compares the accuracy of twenty formulas in medium-long eyes (24.50–25.99 mm). Methods: Data of patients with medium-long eyes, who underwent uneventful phacoemulsification between January 2018 and September 2023, were retrospectively reviewed. Preoperative IOL power was calculated using the IOLMaster 700 with six formulas: Barrett Universal II, Haigis, Hoffer Q, Holladay 1, Holladay 2, and SRK/T. Three months postoperatively, refraction was measured. Postoperative IOL power calculations were then performed using fourteen additional formulas: Castrop, EVO 2.0, Hoffer QST, K6, Kane, Karmona, Ladas Super Formula AI (LSF AI), Naeser 2, Olsen (OLCR), Olsen (standalone), PEARL-DGS, T2, VRF CMAL, and VRF-G. The main outcome measures included standard deviation (SD) of the prediction error (PE) and the percentage of eyes with PE within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D. Results: Ninety-five eyes with axial lengths ranging from 24.52 mm to 25.97 mm were included. SD values among the twenty formulas ranged from 0.179 (SRK/T) to 0.468 (Olsen OLCR). The percentage of eyes with PE within ±0.50 D ranged from 75.79% (Olsen OLCR) to 98.95% (SRK/T). The SRK/T formula, followed by Holladay 1, demonstrated significantly higher accuracy than most other formulas, while Olsen (OLCR) and Castrop were the least accurate. Conclusions: SRK/T provided the highest accuracy in medium-long eyes, with Holladay 1 performing similarly well. All evaluated formulas achieved PE within ±0.50 D in over 74% of cases.

The correct post-operative refractive outcome is a crucial aspect of phacoemulsification. Mostly, it relies of effective lens position (ELP) estimation resulting from the selection of appropriate intraocular lens (IOL) power calculation formula. ELP estimation is especially difficult in eyes that have undergone corneal refractive surgery (CRS) since quandaries in achieving an accurate corneal power. It is caused by incorrect measurement of anterior corneal curvature, changes in posterior corneal curvature and aberration of corneal refractive index (1.375). At least several dozen IOL power calculation formulas in eyes with previous CRS have been developed to date. Seventeen the most used formulas were described, and their accuracy was evaluated in this study. The trueness of the formulas was assessed using the mean absolute error (MAE), median absolute error and percentage of eyes with prediction error within ± 0.5 D and ± 1.0 D. In the most studies, Barrett True-K obtained the smallest MAE in previously hyperopic eyes. In previously myopic eyes, Barrett True-K yielded accurate results also, but the Okulix and the Triple-S formulas performed equally well. Thus, Barrett True-K usually achieves the accurate outcomes in IOL power calculation in eyes that have undergone CRS. However, there is still no consensus on the formula choice in post-refractive eyes.

Purpose: The accurate intraocular lens (IOL) power calculation is essential in phacoemulsification. The latest IOL power calculation formulas, and their new classification and method to assess their accuracy, were described and analyzed. Design: Narrative review. Methods: The manuscript includes articles on IOL power calculation published between 2019 and 2025. The following key words, such as “phacoemulsification”, “IOL power calculation formula”, “AI-based formulas”, “IOL power selection”, “IOL formulas classification”, IOL prediction” were used to identify papers by searching medical databases (Pubmed/MEDLINE, Google Scholar, Crossref). PRISMA methodology was used to select articles. Finally, 33 peer-reviewed English-language studies with a sample size of at least 120 eyes were included in the analysis. Results: Ten IOL power calculation formulas that have been introduced and published over the past 5 years were included in the study. Five of them are artificial intelligence based (Karmona, Hoffer QST, Nallasamy, Zhu-Lu and Zeiss-AI), four are vergence (Emmetropia Verifying Optical, Naeser 2, Voytsekhivskyy Regression Function-Gender and Castrop), and one is ray-tracing (the O formula). In this review, the formulas are introduced and analyzed, with a discussion of selected studies assessing the accuracy of these IOL power calculation methods. Conclusions: New IOL power calculation formulas are constantly being developed. They are mostly based on artificial intelligence. New methods are still being sought to assess the accuracy of formulas, and root mean square absolute error is one of them

Each country has its own specific requirements with regard to the visual standards applicable to drivers. The following were summarised in the appropriate tables: 1) data contained in the Ordinance of the Minister of Health from the 30th of August 2019 regarding medical examinations of applicants for driving licences and drivers; 2) Directive 2006/126/EC of the European Parliament and the Council on driving licences updated on the 22nd of July 2018; 3) the government and nonprofit websites: Advice for Medical Professionals to Follow when Assessing Drivers with Visual Disorders updated on the 4th of March 2020. Both in Poland and the UK the required visual acuity of car and motorcycle drivers is 0.5, which is in line with the EU recommendations. The visual field of both eyes for car and motorcycle drivers with limit values horizontal ≥ 120°, range ≥ 50° right and left and ≥ 20° up and down is identical in Poland and the UK and coincides with the EU recommendations. Colour vision for drivers in the UK is not required, which is consistent with the EU recommendations, whereas in Poland, car and motorcycle drivers do not have to recognise colours, but bus and lorry drivers must correctly recognise red, green and yellow. Current minimum visual requirements for drivers in Poland are closely integrated with the EU recommendations and are similar to the criteria in the UK. They are not too strict but are sufficient to maintain safe driving and there is still a possibility of their liberalization.

Purpose: To compare the accuracy of seven artificial intelligence (AI)-based intraocular lens (IOL) power calculation formulas in medium-long Caucasian eyes regarding the root-mean-square absolute error (RMSAE), the median absolute error (MedAE) and the percentage of eyes with a prediction error (PE) within ±0.5 D. Methods: Data on Caucasian patients who underwent uneventful phacoemulsification between May 2018 and September 2023 in MW-Med Eye Center, Krakow, Poland and Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Kyiv, Ukraine were reviewed. Inclusion criteria, i.e., complete biometric and refractive data, were applied. Exclusion criteria were as follows: intraoperative or postoperative complications, previous eye surgery or corneal diseases, postoperative BCVA less than 0.8, and corneal astigmatism greater than 2.0 D. Prior to phacoemulsification, IOL power was computed using SRK/T, Holladay1, Haigis, Holladay 2, and Hoffer Q. The refraction was measured three months after cataract surgery. Post-surgery intraocular lens calculations for Hill-RBF 3.0, Kane, PEARL-DGS, Ladas Super Formula AI (LSF AI), Hoffer QST, Karmona, and Nallasamy were performed. RMSAE, MedAE, and the percentage of eyes with a PE within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 were counted. Results: Two hundred fourteen eyes with axial lengths ranging from 24.50 mm to 25.97 mm were tested. The Hill-RBF 3.0 formula yielded the lowest RMSAE (0.368), just before Pearl-DGS (0.374) and Hoffer QST (0.378). The lowest MedAE was achieved by Hill-RBF 3.0 (0.200), the second-lowest by LSF AI (0.210), and the third-lowest by Kane (0.228). The highest percentage of eyes with a PE within ±0.50 D was obtained by Hill-RBF 3.0, LSF AI, and Pearl-DGS (86.45%, 85.51%, and 85.05%, respectively). Conclusions: The Hill-RBF 3.0 formula provided highly accurate outcomes in medium-long eyes. All studied AI-based formulas yielded good results in IOL power calculation.