Performance Evaluation of a Simple Strategy to Optimize Formula Constants for Zero Mean or Minimal Standard Deviation or Root-Mean-Squared Prediction Error in Intraocular Lens Power Calculation

Abstract

PURPOSE: To investigate the performance of a simple prediction scheme for the formula constants optimized for a mean (MPE), standard deviation (SDPE) or root-meansquared refractive prediction error (RMSPE). • DESIGN: Retrospective cross-sectional study. • METHODS: Using IOLMaster 700 biometric data from 888 eyes treated with the Hoya Vivinex lens and 821 eyes treated with the Alcon SA60AT lens, plus the power of the implanted lens and postoperative spherical equivalent refraction, optimized constants for SRKT, Hoffer Q, Holladay 1, Haigis, and K6 formulae were calculated using an iterative nonlinear optimization for zero MPE and minimal SDPE and RMSPE. Start values were detuned by ±1.5 from the MPE optimized constants and formula constants generated using the simple prediction scheme were compared to the corresponding directly optimized constants. • RESULTS: For all 5 formulae under test and with both datasets, constants optimized using the simple scheme showed excellent agreement with those from the iterative method with either MPE or RMSPE used as the optimization metric and good agreement with SDPE as the metric. Constants optimized for zero MPE or minimal RMSPE agreed within 0.05, whereas constants for minimal SDPE could be systematically off by up to 0.6 from the MPE values, making SDPE unsuitable as an optimization metric. • CONCLUSIONS: This simple formula constant optimization scheme performs excellently for 4 disclosed formulae and one nondisclosed formula in our 2 monocentric datasets with zero MPE or minimal RMSPE as metrics. Multicentric studies with other study populations and biometers are required to further investigate the clinical applicability.