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ASCRS SYMPOSIA ASCRS ASOA ANNUAL MEETING by Vanessa Caceres EyeWorld Contributing Writer are further analyzing the formula. By the fall, the formula will take into account more than 22,000 eyes measured by optical biometry and offer improved accuracy with unusual measurements, Dr. Hill said. Editors' note: Dr. Abulafia has financial interests with Carl Zeiss Meditec, Haag-Streit, and Hoya. Dr. Barrett has financial interests with Alcon, Bausch + Lomb, and Carl Zeiss Meditec. Dr. Hill has financial interests with Alcon, Carl Zeiss Meditec, and Haag-Streit. Dr. Holladay has finan- cial interests with Alcon, Carl Zeiss Meditec, and other ophthalmic compa- nies. Dr. Koch has financial interests with Alcon, Carl Zeiss Meditec, Perfect Lens, and other ophthalmic companies. Dr. Olsen has financial interests with Haag-Streit, IOL Innovations, and other ophthalmic companies. Dr. Wang has financial interests with Alcon and Carl Zeiss Meditec. geons glean further understanding of IOL calculations, 95% accuracy or larger may one day be possible, Dr. Koch said. Thomas Olsen, MD, Aarhus, Denmark, focused his re- marks on the power of ray tracing. Understanding ocular optics gives surgeons the power to make real predictions, even in unusual cases, he said. Warren Hill, MD, Mesa Arizona, presented on the role of artificial intelligence in IOL power calculation. Artificial intelligence (AI) is already used in various as- pects of ophthalmology, including diabetic retinopathy screening, he said. Within IOL power calcula- tions, the Hill-RBF formula uses some of the same technology that is already part of facial and finger- print recognition. Studies under- way since 2016 with the AI-based Hill-RBF formula have continued to fine tune the formula's results. In 2016, the formula's accuracy was 91% in all eyes. Right now, 41 investigators in 19 countries myopic or hyperopic LASIK or PRK. The True K Toric is another resource, he said. Adi Abulafia, MD, Jerusa- lem, Israel, shared several pearls to choose toric IOLs, including the following: 1) validate your data, 2) use several measuring devices, 3) take the posterior cornea into account, 4) don't use mathemat- ical models with total corneal measurement, and 5) don't rely on mathematical models in unusual corneas. Surgeons also should optimize their personal surgically induced astigmatism and improve toric IOL alignment, Dr. Abulafia advised. With numerous advances in technology and formulas related to IOL calculations, Douglas Koch, MD, Houston, provided a summary of cutting-edge options available now or in the future. These include advances in the abil- ity to maximize the ocular surface, postop adjustments to IOLs, and the use of software that provides automated data analysis. As sur- W hen it comes to refractive accuracy, the median per- centage of cataract patients who are within plus or mi- nus 0.5 D is 75%, said Jack Holladay, MD, Hous- ton, during Saturday's session, "Nailing the Best IOL Refractive Outcomes." Yet that percentage can get even higher, said Dr. Holladay and fellow presenters, who focused on the latest approaches to help improve IOL calculations. Dr. Holladay presented in- formation on a formula for total surgically induced astigmatism that he published in the March issue of the Journal of Cataract & Refractive Surgery. The formula can help surgeons improve toric IOL outcomes. Deciding on IOL power for long and short eyes is an area that can lead to calculation confusion, and Li Wang, MD, Houston, addressed some more effective approaches. With short eyes, the effective lens position (ELP) is a critical measurement to help address this. Dr. Wang advised the use of formulas that address the anterior chamber depth in the ELP, such as the Hill-RBF, Hol- laday 1, and the Barrett. In long eyes, the Wang-Koch formula with Holladay 1 as well as the Barrett formula and Hill-RBF are useful. Further studies are underway to better understand Chinese long eyes, she added. Another calculation conun- drum takes place with corneas that have had prior surgical adjust- ments, said Graham Barrett, MD, Perth, Australia. He shared information on the Barrett True K Formula that can help with calculations in eyes that have had Pearls to improve IOL refractive outcomes Dr. Holladay presents on total surgically induced astigmatism. 38 | EYEWORLD DAILY NEWS | MAY 6, 2019

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