Transcript Slide 1

Results of BESSt 2 biometry
and
Borasio Myopic/Hyperopic Regression
(BMR / BHR)
Edmondo Borasio
Moorfields Eye Hospital Dubai
IOL POWER CLUB – 9th ANNUAL MEETING – 12 Oct 2013
© EB EYE 2013
Borasio IOLMaster Regression
IOLMaster K reading
(post LRS)
Borasio
Myopic
Regression
IOL Power
New K value
Borasio
Hyperopic
Regression
New K value
SRK/T
Without dK adj
© EB EYE 2013
Study population:
(N=136)
136 eyes undergoing Phaco after Laser Ref. Sx:
• Myopia (N=102)
• Hyperopia (N=34)
Different IOL types; different laser platforms used.
© EB EYE 2013
Formulas with NO prior DATA compared
MYOPIA
HYPERMETROPIA
Pentacam
1. BESSt 1
2. BESSt 2 Myopia
1. BESSt 1
2. BESSt 2 Hypermetropia
IOLMaster
1. Haigis-L
2. Borasio Myopic Regr.
(BMR)
1. Borasio Hyperopic Regr.
(BHR)
Other regressions
1. Shammas PL Myopia
1. Shammas PL Hyperopia
© EB EYE 2013
Demographics MYOPIC LRS eyes:
K
AL
AConst
IOL implanted
MEAN
39.10
26.96
118.70
18.26
SD
2.40
2.27
0.37
4.07
MEDIAN
38.83
26.93
118.50
19.00
MAX
44.63
34.59
119.40
30.00
MIN
34.54
20.85
118.10
2.00
© EB EYE 2013
Demographics HYPEROPIC LRS eyes:
K
AL
AConst
IOL implanted
MEAN
45.27
22.66
118.41
22.40
SD
2.59
1.20
0.05
3.91
MEDIAN
44.88
22.73
118.40
21.50
MAX
50.91
24.66
118.60
30.00
MIN
40.97
19.71
118.40
15.50
© EB EYE 2013
For Haigis L, ALL constants
(a0, a1, a2) were optimized
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RESULTS
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Myopic LRS
Note: errors at IOL plane
*
*
p: 0.000
p: 0.016
* p: 0.004
SD:
MAE:
1.23
0.98
±0.91
1.06
0.92
±0.86
1.30
1.07
±0.73
1.23
1.23 ±0.89
1.12
1.32
±0.79
0.99
0.69
±EYE
0.73
© EB
2013
Hypermetropic LRS
© EB EYE 2013
Note: errors at IOL plane
* p: 0.002
p: 0.000
*
* p: 0.000
SD:
1.08
1.00
0.99
1.14
0.81
MAE
0.83
0.99 ±0.76
1.06 ±0.60
0.83 ±0.76
0.70
© EB EYE 2013
© EB EYE 2013
© EB EYE 2013
© EB EYE 2013
© EB EYE 2013
Myopic LRS
18% delta
16% delta
12% delta
Note: errors at IOL plane
© EB EYE 2013
Myopic LRS - safety
6% delta
Note: errors at IOL plane
© EB EYE 2013
Hypermetropic LRS
9% delta
Note: errors at IOL plane
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Hypermetropic LRS - safety
9% delta
Note: errors at IOL plane
© EB EYE 2013
Formula accuracy (no prior data):
More accurate
MYOPIA
HYPEROPIA
BORASIO Myopic
Regression (BMR Poly)
P <0.01
BESSt 2 Myopia
BORASIO Hyperopic
Regression (BHR Lin)
P: 0.03
BESSt 1 + Std SRK/T
SHAMMAS PL Hyperopia
P <0.01
SHAMMAS PL Myopia
BESSt 2 Hyperopia
P: 0.02
HAIGIS L (a0,a1,a2 optim)
© EB EYE 2013
Summary
BMR/BHR: simple formula based on IOLMaster K values
BORASIO MYOPIC REGRESSION - BMR Poly
More accurate than:
• BESSt 1 (p <0.001) and BESSt 2 (p: 0.033)
• Shammas PL-Myopia (p <0.001)
• Haigis L (p <0.001)
Lowest SD between all formulas compared: 0.99 D
Potentially 30% more eyes <0.50 D compared to BESSt 2 and BESSt 1
BORASIO HYPEROPIC REGRESSION - BHR Lin
More accurate than:
• BESSt 1 (p <0.001)
• Shammas PL-Hyperopia (p: 0.030)
• BESSt 2 (n.s.)
Lowest SD between all formulas compared: 0.81 D
Potentially 13% more eyes <0.50 D compared to BESSt 2, 50% vs BESSt 1
© EB EYE 2013
Recommendations:
BMR / BHR Mean Error Results:
•MYOPIC LRS eyes:
0.07 ±0.99
•HYPEROPIC LRS eyes: 0.28 ±0.81
(= emmetropia)
(= towards hypermetropia)
RECOMMENDATION:
Best to ADD 0.25 D to the BMR Poly IOL to reduce risk of Hyperopia.
Best to ADD 0.50 D to the BHR Lin IOL to reduce risk of Hyperopia.
NOTE: THE MEAN ERRORS SHOWN HERE WERE CALCULATED AT THE IOL
PLANE. THE ACTUAL ERRORS AT THE SPECTACLE PLANE ARE LOWER
© EB EYE 2013