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Artificial Intelligence, Machine Learning and Calculation of Intraocular Lens Power.

BACKGROUND AND PURPOSE
In the last decade, artificial intelligence and machine learning algorithms have been more and more established for the screening and detection of diseases and pathologies, as well as for describing interactions between measures where classical methods are too complex or fail. The purpose of this paper is to model the measured postoperative position of an intraocular lens implant after cataract surgery, based on preoperatively assessed biometric effect sizes using techniques of machine learning.


PATIENTS AND METHODS
In this study, we enrolled 249 eyes of patients who underwent elective cataract surgery at Augenklinik Castrop-Rauxel. Eyes were measured preoperatively with the IOLMaster 700 (Carl Zeiss Meditec), as well as preoperatively and postoperatively with the Casia 2 OCT (Tomey). Based on preoperative effect sizes axial length, corneal thickness, internal anterior chamber depth, thickness of the crystalline lens, mean corneal radius and corneal diameter a selection of 17 machine learning algorithms were tested for prediction performance for calculation of internal anterior chamber depth (AQD_post) and axial position of equatorial plane of the lens in the pseudophakic eye (LEQ_post).


RESULTS
The 17 machine learning algorithms (out of 4 families) varied in root mean squared/mean absolute prediction error between 0.187/0.139 mm and 0.255/0.204 mm (AQD_post) and 0.183/0.135 mm and 0.253/0.206 mm (LEQ_post), using 5-fold cross validation techniques. The Gaussian Process Regression Model using an exponential kernel showed the best performance in terms of root mean squared error for prediction of AQDpost and LEQpost. If the entire dataset is used (without splitting for training and validation data), comparison of a simple multivariate linear regression model vs. the algorithm with the best performance showed a root mean squared prediction error for AQD_post/LEQ_post with 0.188/0.187 mm vs. the best performance Gaussian Process Regression Model with 0.166/0.159 mm.


CONCLUSION
In this paper we wanted to show the principles of supervised machine learning applied to prediction of the measured physical postoperative axial position of the intraocular lenses. Based on our limited data pool and the algorithms used in our setting, the benefit of machine learning algorithms seems to be limited compared to a standard multivariate regression model.