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Clinical Advancements in Intraocular Lens Power Calculation Methods

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 12 June 2026 | Viewed by 2293

Special Issue Editors


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Guest Editor
Department of Ophthalmology, Goethe-Universität Frankfurt am Main, Frankfurt, Germany
Interests: IOL; IOL power calculation; refractive surgery; lens exchange; cataract surgery; presbyopia; multifocal IOL; effective lens position; biometry; strabismus; oculoplastic; neuro-ophthalmology; orbital surgery

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Guest Editor
Department of Ophthalmology, University Hospital Goethe University, Frankfurt, Germany
Interests: refractive surgery; IOL; cataract surgery; refractive lens exchange; presbyopia; phakic IOL; presbyopia correcting IOL; EDOF; multifocal IOL

Special Issue Information

Dear Colleagues,

Cataract surgery is one of the most common performed procedures worldwide. Additionally, patients are becoming more demanding in terms of refractive outcome and, therefore, hitting target refraction is more and more important. This is why the calculation of the optimal intraocular lens is a crucial factor for the success of cataract and refractive lens surgery and one of the main parameters for post-op patient satisfaction. This Special Issue is meant to highlight recent advances in IOL calculation, presenting innovative algorithms, biometric measurement techniques, and personalized calculation approaches.

Possible key technologies to optimize lens power selection could be artificial intelligence and machine learning. Additionally, new formulas such as the Barrett Universal II, Hill-RBF, and Kane formulas are already outperforming older generations of formulas, showing higher predictability for a wider range of eyes. The impact of cutting-edge biometric devices, including swept-source OCT technology, on calculation accuracy is also one factor of the current advancements in meeting postop expectations.

Beyond technological advancements, practical recommendations for improving postoperative refractive accuracy, particularly in patients with previous procedures such as corneal refractive surgery of silicone oil fill in retinal detachment eyes, are needed. In this Special Issue, we invite experts to submit studies on IOL calculation using modern or AI formulas, comparing biometry, and giving recommendations on which calculation method to use in complex eyes like those post-refractive surgery.

Dr. Christoph Martin Lwowski
Prof. Dr. Thomas Kohnen
Guest Editors

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Keywords

  • emmetropia
  • IOL power calculation
  • effective lens position
  • refractive lens exchange
  • IOL
  • refractive surgery
  • biometry

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Published Papers (2 papers)

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Research

12 pages, 535 KB  
Article
Real-World Visual and Refractive Results of Two Different Presbyopia Correcting Intraocular Lenses
by Sarah Hinterberger, Cornelia Artmayr, Karanpreet Multani, Kamran M. Riaz, Seth M. Pantanelli, Klemens P. Kaiser, Achim Langenbucher, Matthias Bolz and Jascha A. Wendelstein
J. Clin. Med. 2025, 14(22), 8259; https://doi.org/10.3390/jcm14228259 - 20 Nov 2025
Viewed by 511
Abstract
Background/Objectives: To investigate visual acuity, refractive outcomes and the predictive accuracy of modern intraocular lens (IOL) power calculation formulas in eyes implanted with two presbyopia-correcting IOLs: trifocal Zeiss AT LISA TRI and the nondiffractive EDOF Teleon Comfort. Methods: This retrospective consecutive [...] Read more.
Background/Objectives: To investigate visual acuity, refractive outcomes and the predictive accuracy of modern intraocular lens (IOL) power calculation formulas in eyes implanted with two presbyopia-correcting IOLs: trifocal Zeiss AT LISA TRI and the nondiffractive EDOF Teleon Comfort. Methods: This retrospective consecutive chart review included 115 patients who underwent uncomplicated bilateral cataract surgery and received either the LISA TRI (n = 56) or Comfort (n = 59). Biometric measurements were obtained preoperatively, and refractive outcomes were assessed 1, 3, and 6 months postoperatively. Postoperative spherical equivalent (SEQ) was compared to predicted SEQ using the ESCRS calculator and IOLCON platform. Outcome measures included mean prediction error and mean absolute error (MAE). Distance-corrected visual acuity (VA), uncorrected VA, defocus curves, preferred viewing distances, contrast sensitivity, and photopic reading speed were also analyzed. Results: All formulas performed better in the LISA TRI group, with significantly lower MAE and higher proportions of eyes within ±0.50 diopters (D). Systematic prediction error offsets were observed for three formulas (K6, Castrop, Hoffer QST) in the LISA TRI group and for all five formulas in the MF15 group. Refractive stability was achieved by 3 months for the LISA TRI, while 20% of Comfort eyes continued to show SEQ shifts > 0.50 D at 3 months. Defocus equivalent (DEQ) had lower proportions of eyes within ±0.50 D than SEQ. Conclusions: The LISA TRI demonstrated superior predictive accuracy, faster refractive stabilization, and stronger near performance than the Comfort. These findings support the importance of IOL-specific constant optimization and highlight the need for incorporating DEQ into routine refractive outcome evaluation. Full article
(This article belongs to the Special Issue Clinical Advancements in Intraocular Lens Power Calculation Methods)
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15 pages, 1407 KB  
Article
Evaluation of a Simple and Accurate Method for Intraocular Lens Constant Optimization Using Linear Interpolation
by Sumitaka Miyamoto and Kazutaka Kamiya
J. Clin. Med. 2025, 14(13), 4543; https://doi.org/10.3390/jcm14134543 - 26 Jun 2025
Viewed by 1442
Abstract
Objectives: We devised a simple and practical method for optimizing intraocular lens (IOL) constants using linear interpolation, based on the IOL power calculation study protocol proposed by Hoffer et al., and evaluated its effectiveness. Methods: This retrospective study included 188 eyes [...] Read more.
Objectives: We devised a simple and practical method for optimizing intraocular lens (IOL) constants using linear interpolation, based on the IOL power calculation study protocol proposed by Hoffer et al., and evaluated its effectiveness. Methods: This retrospective study included 188 eyes from 188 Japanese patients who underwent cataract surgery with the implantation of CNA0T0 (Alcon) between June 2022 and September 2024. Preoperative biometric data were obtained using ARGOS (Alcon) and OA-2000 (Tomey). Predicted refractions were calculated using the European Society of Cataract and Refractive Surgeons’ (ESCRS) IOL Web Calculator with the EVO, Hill-RBF 3.0 (Hill), and Kane formulas, using both A-constants of 119.1 and 119.33. The mean prediction error (MPE) was calculated as the difference between the predicted and postoperative spherical equivalent at 3 months. Linear interpolation was applied to the paired results to derive optimized A-constants yielding MPE = 0 and to correct each case’s predicted refraction values (“corrected values”). Additionally, predicted refractions were recalculated using the optimized A-constants with the ESCRS IOL Web Calculator to obtain “actual values”. Both corrected and actual values achieved an MPE of 0 and were compared using the Friedman test and Cochran’s Q test. Results: The optimized A-constants for ARGOS were 119.540 (EVO), 119.733 (Hill), and 119.563 (Kane); for OA-2000, they were 119.388, 119.532, and 119.417, respectively. No significant differences were found between corrected and actual values under any condition. Conclusions: This method is simple, accurate, and applicable to new IOLs, devices, and formulas, with potential to improve the precision of clinical IOL power calculations. Full article
(This article belongs to the Special Issue Clinical Advancements in Intraocular Lens Power Calculation Methods)
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