Results of BESSt 2 biometry and Borasio MyopicHyperopic

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Results of BESSt 2 biometry and Borasio Myopic/Hyperopic Regression (BMR / BHR) Edmondo Borasio

Results of BESSt 2 biometry and Borasio Myopic/Hyperopic Regression (BMR / BHR) Edmondo Borasio Moorfields Eye Hospital Dubai IOL POWER CLUB – 9 th ANNUAL MEETING – 12 Oct 2013 © EB EYE 2013

Borasio IOLMaster Regression IOLMaster K reading (post LRS) Borasio Myopic Regression IOL Power New

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 d. K adj © EB EYE 2013

Study population: (N=136) 136 eyes undergoing Phaco after Laser Ref. Sx: • Myopia (N=102)

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

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

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

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 (a 0, a 1, a 2) were optimized ©

For Haigis L, ALL constants (a 0, a 1, a 2) were optimized © EB EYE 2013

RESULTS © EB EYE 2013

RESULTS © EB EYE 2013

Myopic LRS Note: errors at IOL plane SD: * * p: 0. 000 *

Myopic LRS Note: errors at IOL plane SD: * * p: 0. 000 * p: 0. 004 p: 0. 016 1. 23 1. 06 1. 30 MAE: 0. 98 ± 0. 91 0. 92 ± 0. 86 1. 07 ± 0. 73 1. 23 ± 0. 89 1. 12 1. 32 ± 0. 79 0. 99 0. 69 ± 0. 73 © EB EYE 2013

Hypermetropic LRS © EB EYE 2013 Note: errors at IOL plane * p: 0.

Hypermetropic LRS © EB EYE 2013 Note: errors at IOL plane * p: 0. 002 * p: 0. 000 SD: 1. 08 MAE: 0. 83 ± 0. 69 1. 00 0. 99 1. 14 0. 81 0. 99 ± 0. 76 1. 06 ± 0. 60 0. 83 ± 0. 76 0. 70 ± 0. 48

© EB EYE 2013

© EB EYE 2013

© EB EYE 2013

© EB EYE 2013

© EB EYE 2013

© 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 ©

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

Myopic LRS - safety 6% delta Note: errors at IOL plane © EB EYE 2013

Hypermetropic LRS 9% delta Note: errors at IOL plane © EB EYE 2013

Hypermetropic LRS 9% delta Note: errors at IOL plane © EB EYE 2013

Hypermetropic LRS - safety 9% delta Note: errors at IOL plane © EB EYE

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)

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 (a 0, a 1, a 2 optim) © EB EYE 2013

Summary BMR/BHR: simple formula based on IOLMaster K values BORASIO MYOPIC REGRESSION - BMR

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 ±

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