Edmondo Borasio Moorfields Eye Hospital Dubai Results of BESSt 2 biometry and Borasio...

Edmondo BorasioEdmondo Borasio

Moorfields Eye Hospital DubaiMoorfields Eye Hospital Dubai

Results of BESSt 2 biometryand

Borasio Myopic/Hyperopic Regression (BMR / BHR)

IOL POWER CLUB IOL POWER CLUB –– 9 9thth ANNUAL MEETING – 12 Oct 2013 ANNUAL MEETING – 12 Oct 2013

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Borasio IOLMaster Regression

IOLMaster K reading(post LRS)

BorasioMyopic

Regression

BorasioHyperopicRegression

New K value New K value

SRK/T

IOL Power

Without dK adj

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(N=136)

• Myopia (N=102)

• Hyperopia (N=34)

Different IOL types; different laser platforms used.

136 eyes undergoing Phaco after Laser Ref. Sx:

Study population:

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Formulas with NO prior DATA compared

1. BESSt 12. BESSt 2 Myopia

Pentacam

IOLMaster

MYOPIA HYPERMETROPIA

1. BESSt 12. BESSt 2 Hypermetropia

1. Borasio Hyperopic Regr. (BHR)

1. Haigis-L2. Borasio Myopic Regr.

(BMR)

1. Shammas PL Myopia 1. Shammas PL Hyperopia

Other regressions

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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

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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

Demographics HYPEROPIC LRS eyes:

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For Haigis L, ALL constants (a0, a1, a2) were optimized

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RESULTS

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Myopic LRS

p: 0.016

p: 0.004

*

*

p: 0.000*

SD:

1.23 1.06 1.30 1.23 1.12 0.99

Note: errors at IOL plane

MAE: 0.98 ±0.91

0.92 ±0.86

1.07 ±0.73

1.23 ±0.89 1.32 ±0.79

0.69 ±0.73© EB EYE © EB EYE

20132013

Hypermetropic LRS

p: 0.002

p: 0.000

**

p: 0.000*

SD: 1.08 1.00 0.99 1.14 0.81

Note: errors at IOL plane

MAE:

0.83 ±0.69

0.99 ±0.76 1.06 ±0.60

0.83 ±0.76 0.70 ±0.48

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© EB EYE © EB EYE 20132013

© EB EYE © EB EYE 20132013

© EB EYE © EB EYE 20132013

© EB EYE © EB EYE 20132013

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18% delta

Myopic LRS

16% delta 12% delta

Note: errors at IOL plane

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6% delta

Myopic LRS - safety

Note: errors at IOL plane

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Hypermetropic LRS

9% delta

Note: errors at IOL plane

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Hypermetropic LRS - safety

9% delta

Note: errors at IOL plane

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Formula accuracy (no prior data):More accurateMYOPIA HYPEROPIA

BORASIO MyopicRegression (BMR Poly)

BESSt 2 Myopia

BESSt 1 + Std SRK/T

SHAMMAS PL Myopia

HAIGIS L (a0,a1,a2 optim)

BORASIO HyperopicRegression (BHR Lin)

SHAMMAS PL Hyperopia

BESSt 2 Hyperopia

P <0.01

P <0.01

P: 0.02

P: 0.03

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BMR/BHR: simple formula based on IOLMaster K values

BORASIO MYOPIC REGRESSION - BMR PolyMore 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 DPotentially 30% more eyes <0.50 D compared to BESSt 2 and BESSt 1

BORASIO HYPEROPIC REGRESSION - BHR LinMore 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 DPotentially 13% more eyes <0.50 D compared to BESSt 2, 50% vs BESSt 1

Summary

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BMR / BHR Mean Error Results:•MYOPIC LRS eyes: 0.07 ±0.99 (= emmetropia)•HYPEROPIC LRS eyes: 0.28 ±0.81 (= towards hypermetropia)

Recommendations:

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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