Purpose: To develop a prediction model based on machine learning to calculate the postoperative vault and the ideal implantable collamer lens (ICL) size, considering for the first time the implantation orientation in a White population. Setting: Arruzafa Ophthalmological Hospital (Cordoba, Spain) and Barraquer Ophthalmology Center (Barcelona, Spain). Design: Multicenter, randomized, retrospective study. Methods: Anterior segment biometric data from 235 eyes of patients who underwent ICL lens implantation surgery were collected using the anterior segment optical coherence tomography CASIA II to train and validate 5 types of multiple regression models based on advanced machine learning techniques. To perform an external validation, a dataset of 45 observations was used. Results: The Pearson correlation coefficient between observed and predicted values was similar in the 5 models in the external validation, with least absolute shrinkage and selection operator regression being the highest (r = 0.62, P < .001), followed by random forest regression model (r = 0.60, P < .001) and backward stepwise regression (r = 0.58, ρ < 0.001). In addition, the predictions generated by the different models showed closer agreement with the actual vault compared with the Nakamura formulas. Using the new methods, about 70% of the observations had a prediction error below 150 μm. Conclusions: Advanced forms of regressions models based on machine learning allow satisfactory calculation of the ideal lens size, offering greater precision to surgeons customizing surgery according to implant orientation.

Background/Objectives: This study aimed to evaluate the visual quality and symptomatology of a non-diffractive extended depth-of-focus (EDoF) intraocular lens (IOL), the Elon 877PEY (Medicontur, Zsámbék, Hungary), three months after implantation. Methods: A cross-sectional case series study was conducted, with measurements taken three months post-implantation of the Elon IOL. A total of 56 implanted eyes from 28 patients (mean age: 64.5 ± 9.5 years) were included in the statistical analysis. The variables analyzed to assess the effectiveness of the Elon IOL included high-contrast visual acuity, contrast sensitivity, the defocus curve, and visual symptoms. Results: Three months after implantation, the mean residual sphere was 0.00 ± 0.33 D, while the mean residual cylinder was −0.25 ± 0.41 D. Without correction, patients achieved monocular decimal visual acuity values of 0.94 ± 0.26 for distance, 0.79 ± 0.17 for intermediate, and 0.58 ± 0.15 for near vision. The mean uncorrected contrast sensitivity was 1.61 ± 0.15 log. The defocus curve showed visual acuity exceeding 0.80 decimal (0.10 logMAR) over a 2.00 D range and above 0.63 decimal (0.20 logMAR) over a 2.50 D range. The most frequently reported symptoms, with mild severity and bothersomeness, were glare, starbursts, halos, and focusing difficulties. Conclusions: Patients implanted with the Elon IOL achieved satisfactory visual quality at all distances, comparable to outcomes reported for other EDoF IOLs in the scientific literature.