Refractive outcomes of second‐eye adjustment methods on intraocular lens power calculation in second eye.

Background: To investigate the refractive outcomes of second‐eye adjustment (SEA) methods in different intraocular lens (IOL) power calculation formulas for second eye following bilateral sequential cataract surgery. Methods: This retrospective consecutive case‐series study included 234 eyes from 234 patients who underwent bilateral sequential phacoemulsification and implantation of enVista MX60 in a hospital setting. Postoperative refraction outcomes calculated by standard formulas (SRK/T and Barrett Universal II, BUII) with SEA method were compared with those calculated by an artificial intelligence‐based IOL power calculation formula (PEARL DGS) under second eye enhancement (SEE) method. The median absolute error (MedAE), mean absolute error (MAE) and percentage prediction errors (PE) of eyes within ±0.25 diopters (D), ±0.50 D, ±0.75 D and ± 1.00 D were determined. Results: Overall, the improvement in MedAE after SEA was significant for PEARL DGS (p < 0.01), SRK/T (p < 0.001) and BUII (p = 0.031), which increased from 74.36, 71.37, and 77.78% to 83.33, 80.34, and 79.49% of eyes within a PE of ±0.50 D, respectively. For first eyes with a medium axial length (22–26 mm), PEARL DGS with SEE had the lowest MedAE (0.21 D). For a first‐eye MAE over 0.50 D, SEA method led to significant improvement in the second eye (p < 0.01). Interocular axis length differences exceeding 0.3 mm were associated with weaker effects using SEA in the studied formulas (p > 0.05). Conclusions: Either SEA method with SRK/T and BUII formulas or second‐eye enhancement method based on the PEARL DGS formula can improve postoperative refractive outcomes in second eye. [ABSTRACT FROM AUTHOR]