Work

Accuracy of the European Society of Cataract and Refractive Surgeons Online Calculator for Enhanced Monofocal Intraocular Lens Power Calculation

Year: 2026

Type: article

Abstract: PURPOSE: To evaluate the refractive accuracy of the European Society of Cataract and Refractive Surgeons (ESCRS) online intraocular lens (IOL) calculator for enhanced monofocal IOLs and to compare its performance with commonly used IOL formulas, including Barrett Universal II (BUII), SRK/T, and Haigis. METHODS: This retrospective case series included 95 eyes from 95 patients who underwent uneventful phacoemulsification with ICB00 IOL. IOL power was calculated using the ESCRS calculator (Cooke K6, Emmetropia Verifying Optical [EVO] 2.0, Hill Radial-Basis-Function [RBF] 3.0, Hoffer Q Savini/Taroni, Kane, and Pearl DGS), and BUII, SRK/T, and Haigis formulas using IOLMaster 700. Prediction error (PE), mean absolute error, median absolute error (MedAE), the proportion of eyes with a PE within ±0.50 diopters (D) of target refraction, and the formula performance index (FPI) were evaluated at 3 months postoperatively with and without constant optimization. RESULTS: Without constant optimization, the Kane formula achieved the lowest MedAE (0.22 D) and the highest proportion of eyes with PE within ±0.50 D (85.3%). With constant optimization, the Kane and Cooke K6 formulas showed the lowest MedAE (0.18 D each), and Kane and EVO 2.0 demonstrated the highest percentage of eyes within ±0.50 D (85.3%). The proportion of eyes within ±0.50 D showed statistically significant overall differences among formulas under both conditions (p < 0.05 each), although no significant pairwise differences were observed after optimization. The highest FPI values were observed for Cooke K6, Hill-RBF 3.0, and Kane, whereas SRK/T and Haigis consistently demonstrated the lowest performance. CONCLUSIONS: The ESCRS online IOL calculator demonstrated superior MedAE and FPI compared with traditional formulas (SRK/T and Haigis), while the accuracy in achieving a postoperative refraction within ±0.50 D was comparable among eyes implanted with enhanced monofocal IOLs. These results support the clinical utility of the ESCRS calculator for accurate and efficient IOL power calculation, regardless of constant optimization status.

Source: Korean Journal of Ophthalmology

DOI: 10.3341/kjo.2026.0019

Authors: Dong Hee Lee, Min Young Kim, Hyun Jin Kim, Soo Chang Cho, Kyung Eun Han

Institutions: Ewha Womans University, Ewha Womans University Mokdong Hospital

Language: English

Topic: Intraocular Surgery and Lenses

Subfield: Ophthalmology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $250