Eyeworld

I AUGUST 2020 | EYEWORLD | 41 Contact Hill: hill@doctor-hill.com Solomon: kds@cepmd.com there with Veracity? Absolutely. Will there be other products beside Veracity? Absolutely." What's needed for AI to benefit cataract surgery Further refinements are needed to best apply AI for IOL power calculations, Dr. Hill said, ex- plaining that the main limitation is the accuracy of metrics used for model fitting. He said preop keratometry and the postop refraction are two areas with the greatest variability. He added that as technology used to collect these and other measurements becomes more accurate, artificial intelligence models will offer more predictable outcomes. Dr. Solomon said for true potential to be realized datasets also need to grow. "We have to get rid of the data that's in silos. Every office has data, whether in a paper chart, an EMR chart, sitting in your biometer, topographer, or OCT machine, we all have data on our own patients. Most of us don't have ac- cess to our own data and most of us don't have access to other people's data, and the only way we're truly going to have big data is if we can break down these silos and allow us to put this data in a cloud so we can share this information so we can all benefit from it," Dr. Solomon said. Dr. Solomon also cautioned against the notion that AI is a "computer telling me what to do." "Nothing could be further from the truth," Dr. Solomon said. "All the computer is doing is helping to assimilate a bunch of information and taking the doctor's logic and the doctor's own preferences and helping them assimilate it to simplify the decision making they would ul- timately arrive at, if they had the right informa- tion. But how would an individual practitioner be able to assimilate information from a million cases? You wouldn't." That's where AI comes in. to improve outcomes by also taking into ac- count the WTW, LT, CCT, and patient gender," he said, adding that a beta version of version 3 is now available at www.RBFCalculator.com. It will be incorporated into the LENSTAR EyeSuite software (Haag-Streit Diagnostics) this fall. In terms of accuracy, Dr. Hill said "an 'in-bounds' indication for the Hill-RBF meth- od tells us that there is sufficient data to carry out the calculation at a predicted 90% ±0.50 D accuracy level for a series of patients." Dr. Hill explained that an "out-of-bounds" indi- cation means data is insufficient to predict the outcomes at this level of accuracy. He said the pairwise boundary models for this part of the calculation were expanded with the number of out-of-bounds indications significantly reduced in version 3 of the Hill-RBF. Dr. Hill said formulas driven by artificial in- telligence are also still reliant on input of quality preop measurements. Stability of the ocular surface for keratometry, for example, is import- ant to ensure accuracy of outcomes. "An unstable ocular surface is likely to make the Ks unreliable. A 1 D error at the corneal plane is a 1 D error at the spectacle plane. In our practice, we optimize the ocular surface for several weeks prior to biometry," Dr. Hill said. While Dr. Hill's formula uses a large data- set, Dr. Solomon envisions greater potential with larger datasets that have biometry, topogra- phy, OCT, tomography, and postop outcomes. Dr. Solomon said the collection of this data is beginning with programs like Veracity Surgi- cal (Carl Zeiss Meditec). While Veracity has tens of thousands of data points to enhance surgical decision making through its program, Dr. Sol- omon said when it gets into the millions, there will be greater ability to make better decisions. "How do we get there? It has to be more widely distributed, more widely accepted, offic- es have to use it, etc. For that to occur, more of- fices have to accept it, perhaps the process has to become more streamlined and more intuitive and user friendly," he said. "Do I think we'll get

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