Evaluation of the Accuracy of IOL Calculation from the Standpoint of the Medical and Social Model of Health in Patients with Visually Intense Work and Bilateral Cataracts

Purpose: to compare the accuracy of IOL calculation from the standpoint of the social model of health (based on the study of “quality of life”, QOL) in patients with visually intense work (VIW) and bilateral cataract.

Methods. We observed 108 patients with binocular cataract (216 eyes) aged 40 to 69 years (mean age 55.9 ± 1.4 years), everyday activities were characterized as VIW (at least 4 hours per day). All patients underwent (sequentially on both eyes) ultrasound phacoemulsification using the standard technique. All patients were operated on by the same surgeon (N.I. Ovechkin). To correct aphakia, a monofocal IOL “Flex HB Medicontur” (Switzerland) with a predicted emmetropic “target refraction” (TR) was implanted. All patients were divided into two groups: a group of patients (56 patients, 112 eyes) in which the IOL calculation was performed using the Kane formula (KF); a group of patients (52 patients, 104 eyes) in which the IOL calculation was performed using the Barrett Universal II formula (BU-II). The patients were examined 3 months after the second surgery based on a comparative study of refraction between the RC and the calculated one. The basic research method in relation to the target objectives of the work was a study of QOL using two questionnaires — Catquest-9SF and FEC22.

Results. The data obtained indicate an insignificant, statistically insignificant trend towards improvement in traditional refraction indices and QOL according to the Catquest-9SF questionnaire when calculating IOL using the KF compared to BU-II. At the same time, these differences in relation to the assessment of QOL using the FEK-22 questionnaire are characterized by pronounced (by 2.3 %), statistically significant (p < 0.05) differences.

Conclusion. The use (based on the original FEK-22 questionnaire) of the “medical and social” health model in the context of assessing the effectiveness of IOL calculation in VIW patients indicates a higher accuracy of the Kane formula compared to the Barrett Universal II formula. The identified differences are due to the fact that calculations using the Kane formula are performed in a comprehensive manner based on basic eye parameters, theoretical optics, regression analysis and, most importantly, artificial intelligence.

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