1. Edmondo Borasio Moorfields Eye Hospital Dubai Results of BESSt 2 biometry and Borasio Myopic/Hyperopic Regression (BMR / BHR) IOL POWER CLUB – 9 th ANNUAL MEETING – 12 Oct 2013 © EB EYE 2013

2. Borasio IOLMaster Regression IOLMaster K reading (post LRS) Borasio Myopic Regression Borasio Hyperopic Regression New K value SRK/T IOL Power Without dK adj © EB EYE 2013

3. (N=136) Myopia (N=102) Hyperopia (N=34) Different IOL types; different laser platforms used. 136 eyes undergoing Phaco after Laser Ref. Sx: Study population: © EB EYE 2013

4. Formulas with NO prior DATA compared 1.BESSt 1 2.BESSt 2 Myopia Pentacam IOLMaster MYOPIAHYPERMETROPIA 1.BESSt 1 2.BESSt 2 Hypermetropia 1.Borasio Hyperopic Regr. (BHR) 1.Haigis-L 2.Borasio Myopic Regr. (BMR) 1.Shammas PL Myopia1.Shammas PL Hyperopia Other regressions © EB EYE 2013

5. Demographics MYOPIC LRS eyes: KALAConstIOL implanted MEAN39.1026.96118.7018.26 SD2.402.270.374.07 MEDIAN38.8326.93118.5019.00 MAX44.6334.59119.4030.00 MIN34.5420.85118.102.00 © EB EYE 2013

6. KALAConstIOL implanted MEAN45.2722.66118.4122.40 SD2.591.200.053.91 MEDIAN44.8822.73118.4021.50 MAX50.9124.66118.6030.00 MIN40.9719.71118.4015.50 Demographics HYPEROPIC LRS eyes: © EB EYE 2013

7. For Haigis L, ALL constants (a0, a1, a2) were optimized © EB EYE 2013

8. RESULTS © EB EYE 2013

9. Myopic LRS p: 0.016 p: 0.004 * * p: 0.000 * SD:1.231.061.301.231.120.99 Note: errors at IOL plane MAE:0.98 ±0.91 0.92 ±0.86 1.07 ±0.73 1.23 ±0.891.32 ±0.790.69 ±0.73 © EB EYE 2013

10. Hypermetropic LRS p: 0.002 p: 0.000 * * * SD:1.081.000.991.140.81 Note: errors at IOL plane MAE : 0.83 ±0.69 0.99 ±0.761.06 ±0.600.83 ±0.760.70 ±0.48 © EB EYE 2013

16. 18% delta Myopic LRS 16% delta12% delta Note: errors at IOL plane © EB EYE 2013

17. 6% delta Myopic LRS - safety Note: errors at IOL plane © EB EYE 2013

18. Hypermetropic LRS 9% delta Note: errors at IOL plane © EB EYE 2013

19. Hypermetropic LRS - safety 9% delta Note: errors at IOL plane © EB EYE 2013

20. Formula accuracy (no prior data): More accurate MYOPIAHYPEROPIA BORASIO Myopic Regression (BMR Poly) BESSt 2 Myopia BESSt 1 + Std SRK/T SHAMMAS PL Myopia HAIGIS L (a0,a1,a2 optim) BORASIO Hyperopic Regression (BHR Lin) SHAMMAS PL Hyperopia BESSt 2 Hyperopia P <0.01 P: 0.02 P: 0.03 © EB EYE 2013

21. BMR/BHR: simple formula based on IOLMaster K values BORASIO MYOPIC REGRESSION - BMR Poly More accurate than: BESSt 1 (p <0.001) and BESSt 2 (p: 0.033) Shammas PL-Myopia (p <0.001) Haigis L (p <0.001) Lowest SD between all formulas compared: 0.99 D Potentially 30% more eyes <0.50 D compared to BESSt 2 and BESSt 1 BORASIO HYPEROPIC REGRESSION - BHR Lin More accurate than: BESSt 1 (p <0.001) Shammas PL-Hyperopia (p: 0.030) BESSt 2 (n.s.) Lowest SD between all formulas compared: 0.81 D Potentially 13% more eyes <0.50 D compared to BESSt 2, 50% vs BESSt 1 Summary © EB EYE 2013

22. BMR / BHR Mean Error Results: MYOPIC LRS eyes:0.07 ±0.99 (= emmetropia) HYPEROPIC LRS eyes:0.28 ±0.81 (= towards hypermetropia) Recommendations: © EB EYE 2013 RECOMMENDATION: Best to ADD 0.25 D to the BMR Poly IOL to reduce risk of Hyperopia. Best to ADD 0.50 D to the BHR Lin IOL to reduce risk of Hyperopia. NOTE: THE MEAN ERRORS SHOWN HERE WERE CALCULATED AT THE IOL PLANE. THE ACTUAL ERRORS AT THE SPECTACLE PLANE ARE LOWER