Multiformula Prediction Range: a univariate predictor of IOL Power Calculation Accuracy

The purpose of this study was to evaluate the influence of range between the predictions of 5 different calculation formulas in IOL power calculation accuracy. General University Hospital of Elche, Spain. Retrospective Sequential Cohort. In this retrospective sequential cohort, the LenStar LS900 (Haag-Streit, Koeniz, Switzerland) was used for the preoperative biometry. The predicted spherical equivalent refraction of the implanted IOL were calculated for 5 different formulas: Barrett Universal II, Emmetropia Verifying Optical (EVO) 2.0, Hill RBF-3.0, Kane, PEARL-DGS. Multiformula Prediction Range was defined as the range of the refractive error predicted by the 5 formulas. According to the median of the Multiformula Prediction Range the sample was divided into a low and high spread group (LS and HS respectively). 278 eyes were included. The standard deviation of the prediction error was significantly lower in the LS group for all included formulas. For the Barrett Universal II, EVO 2.0, RBF-3.0, Kane and PEARL-DGS formulae, the median absolute error (MdAE) was significantly lower in the LS group compared to the HS group (p-values of 0.001, 0.027, 0.004, 0.028 and 0.035, respectively). The percentage of eyes within the ±0.50D PE range was significantly higher in the LS group for all five analyzed formulas. Multiformula Prediction Range can be a novel univariate predictor of IOL power calculation accuracy and a potential determinant for identifying patient suitable for immediate sequential cataract surgery. Accuracy was consistently higher for all five included formulas in the Low Spread group.