Intraocular Lens Power Calculation in Eyes After Myopic Laser Refractive Surgery and Radial Keratotomy: Bayesian Network Meta-analysis

Xiaoying Pan; Yuyao Wang; Zhaohui Li; Zi Ye

doi:10.1016/j.ajo.2023.09.026

Intraocular Lens Power Calculation in Eyes After Myopic Laser Refractive Surgery and Radial Keratotomy: Bayesian Network Meta-analysis

Am J Ophthalmol. 2023 Oct 20:262:48-61. doi: 10.1016/j.ajo.2023.09.026. Online ahead of print.

Authors

Xiaoying Pan¹, Yuyao Wang², Zhaohui Li³, Zi Ye⁴

Affiliations

¹ From the School of Medicine, Nankai University, Tianjin (X.P.); Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China.
² Department of Ophthalmology, Medical School of Chinese People's Liberation Army, Beijing (Y.W.); Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China.
³ Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China.
⁴ Department of Ophthalmology, the Chinese People's Liberation Army General Hospital, Beijing (X.P., Y.W., Z.L., Z.Y.), China. Electronic address: yeziclover@163.com.

PMID: 37865389
DOI: 10.1016/j.ajo.2023.09.026

Abstract

Purpose: To compare the accuracy of formulas for calculating intraocular lens power in eyes after myopic laser refractive surgery or radial keratotomy.

Design: Bayesian network meta-analysis.

Methods: PubMed, Embase, the Cochrane Data Base of Systematic Reviews, and the Cochrane Central Register of Controlled Trials databases were searched for retrospective and prospective clinical studies published from January 1, 2012, to August 24, 2022. The outcome measurement was the percentage of eyes with a predicted error within the target refractive range (±0.50 diopter [D] or ±1.00 D).

Results: Our meta-analysis includes 24 studies of 1172 eyes after myopic refractive surgery that use 12 formulas for intraocular lens power calculation. (1) A network meta-analysis showed that Barrett true-K no history, the optical coherence tomography (OCT) formula, and the Masket formula had a significantly higher percent of eyes within ±0.50 D of the goal than the Haigis-L formula, whereas the Wang-Koch-Maloney formula showed the poor predictability. Using an error criterion of within ±1.00 D, the same 3 formulas performed slightly better than the Haigis-L formula. Based on performance using both prediction error criteria, the Barrett true-K no history formula, OCT formula, and Masket formula showed the highest probability of ranking as the top 3 among the 12 methods. (2) A direct meta-analysis with a subset of 4 studies and 5 formulas indicated that formulas did not differ in percent success for either the ±0.5 D or ±1.0 D error range in eyes that had undergone radial keratotomy.

Conclusions: The OCT, Masket, and Barrett true-K no history formulas are more accurate for eyes with previous myopic laser refractive surgery, whereas no significant difference was found among the formulas for eyes that had undergone radial keratotomy.

Publication types

Review