Eagle Eye Refractive Laser Nomogram Builder

LASIK & PRK (AQUARIUZ) · CLEAR (Z8) — internal outcome audit & nomogram tool
Internal clinical audit tool only. Not a replacement for individual surgical planning, validated laser nomograms, biometry / topography quality control, or clinical judgement.

Case Entry

Enter a single laser refractive case. Spherical equivalents, attempted / achieved correction, correction ratio and prediction error are calculated automatically.
Patient / Case data
Preoperative refraction & cornea
Treatment plan
Eye status
Postoperative outcome
Enter target refraction and postop sphere/cylinder to see the prediction error and correction ratio.

Dataset

All entered cases. Click a row to load it back into the Case Entry form.

Outcome Analysis

Automatically computed on included cases with a valid prediction error.

Nomogram Generator

Prediction error analysed by procedure and subgroup, with a suggested treatment adjustment in 0.25 D steps and a confidence level per subgroup.

Procedure & Parameter Comparison

Performance by procedure/platform, by optical zone, by surgeon, and by procedure + correction range.

Data Quality

Flags cases that may be unsuitable for the nomogram, with an overview and recommendations.

Export / Import

All data is stored locally in your browser. Nothing is sent anywhere.

Internal Audit Report

A formatted text report of the current included dataset.
No report generated yet.

Methodology

How the numbers are defined and how to use them responsibly.

Spherical equivalent

SEQ = sphere + cylinder / 2

Attempted, achieved and correction ratio

Attempted SEQ = preop SEQ − target refraction Achieved SEQ = preop SEQ − postop SEQ Correction ratio = achieved / attempted

A correction ratio below 1.0 indicates undercorrection (the laser delivered less than intended); above 1.0 indicates overcorrection. The ratio is only shown when at least 1.0 D of correction was attempted, because small denominators are unstable.

Prediction error

Prediction error = postop SEQ − target refraction

Positive values mean the eye landed more hyperopic than intended (overcorrected myopia); negative values mean more myopic than intended (undercorrected / regressed). Absolute error is its magnitude and drives the ±0.25/±0.50/±1.00 D predictability percentages.

Treatment adjustment logic

Because achieved correction tracks the programmed treatment, the average prediction error is the shortfall or excess to compensate. If a subgroup is on average undercorrected, the suggestion is to increase the programmed correction by the rounded mean error (0.25 D steps); if overcorrected, to reduce it. These are candidate directions to validate, not values to apply directly.

Efficacy and safety

Efficacy index = mean postop UDVA / mean preop CDVA Safety index = mean postop CDVA / mean preop CDVA

Lines of CDVA change use logMAR = −log₁₀(decimal VA). Losing ≥2 lines is a safety concern. Indices are only shown when the relevant visual acuities are entered as decimals.

Procedure-specific stability

Refractive results stabilise at different rates. LASIK and CLEAR are usually stable by ~1 month; PRK typically requires ~3 months because of epithelial remodelling and potential regression. The Data Quality tab flags refractions taken before these windows so that early, unstable results do not bias the nomogram.

Why clinic-specific nomograms matter

Two surgeons on the same platform can achieve different outcomes because of differences in laser calibration and environment (humidity, temperature), flap or cap creation, epithelial handling, hydration, ablation profile, optical zone, and patient population. A nomogram optimised elsewhere does not necessarily transfer.

Why not to correct too early, and why not by ethnicity

Small samples create false signals; validate prospectively before implementing a subgroup correction. Corrections should never be applied on the basis of ethnicity alone. Instead this tool analyses measurable variables — attempted correction magnitude, keratometry, corneal thickness, optical zone, age and procedure — so that any real population difference becomes visible through physiology rather than assumption.

Note on astigmatism

This version reports refractive-astigmatism outcomes (residual cylinder magnitude and predictability). Full Alpins vector analysis (correction index, angle of error, index of success) is not yet included and would be a sensible next step for a dedicated toric/astigmatic nomogram.