{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:03:02Z","timestamp":1789009382730,"version":"build-2803163510"},"reference-count":26,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,1,23]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To aid doctors in selecting the optimal preoperative implantable collamer lens (ICL) size and to enhance the safety and surgical outcomes of ICL procedures, a clinical decision support system (CDSS) is proposed in our study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective study of patients after ICL surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>China Tertiary Myopia Prevention and Control Center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>2772 eyes belonging to 1512 patients after ICL surgery. Data were collected between 2018 and 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>A CDSS is constructed and used to predict vault at 1 month postoperatively and preoperative ICL dimensions using various artificial intelligence methods. Accuracy metrics as well as area under curve (AUC) parameters are used to determine the CDSS prediction methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the ICL size prediction models, conventional neural networks (CNNs) achieve the best prediction accuracy at 91.37% and exhibit the highest AUC of 0.842. Regarding the prediction model for vault values 1\u2009month after surgery, CNN surpasses the other methods with an accuracy of 85.27%, which has the uppermost AUC of 0.815. Thus, we select CNN as the prediction algorithm for the CDSS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study introduces a CDSS to assist doctors in selecting the optimal ICL size for patients while improving the safety and postoperative outcomes of ICL surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-081050","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T00:26:07Z","timestamp":1708043167000},"page":"e081050","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Clinical decision support system based on deep learning for evaluating implantable collamer lens size and vault after implantable collamer lens surgery: a retrospective study"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4897-271X","authenticated-orcid":false,"given":"Yixuan","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengqin","family":"Long","sequence":"additional","affiliation":[{"name":"Chongqing University Qianjiang Hospital, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0041-2905","authenticated-orcid":false,"given":"Wei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"key":"2025121602313993000_14.2.e081050.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2019.02.020"},{"key":"2025121602313993000_14.2.e081050.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ajo.2019.04.024","article-title":"Posterior chamber phakic intraocular lens implantation for the correction of myopia and myopic astigmatism: a retrospective 10-year follow-up study","volume":"206","author":"Nakamura","year":"2019","journal-title":"Am J Ophthalmol"},{"key":"2025121602313993000_14.2.e081050.3","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1097\/j.jcrs.0000000000000818","article-title":"U.S. military implantable collamer lens surgical outcomes: 11-year retrospective review","volume":"48","author":"Packer","year":"2022","journal-title":"J Cataract Refract Surg"},{"key":"2025121602313993000_14.2.e081050.4","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1097\/ICU.0000000000000870","article-title":"Phakic intraocular lenses: an update and review for the treatment of myopia and myopic astigmatism in the United States","volume":"33","author":"Moshirfar","year":"2022","journal-title":"Curr Opin Ophthalmol"},{"key":"2025121602313993000_14.2.e081050.5","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2021-319618"},{"key":"2025121602313993000_14.2.e081050.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12886-023-02814-7","article-title":"Development of an implantable collamer lens sizing model: a retrospective study using ANTERION swept-source optical coherence tomography and a literature review","volume":"23","author":"Kim","year":"2023","journal-title":"BMC Ophthalmol"},{"key":"2025121602313993000_14.2.e081050.7","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1016\/j.ajo.2009.01.006","article-title":"Objective vs subjective vault measurement after myopic implantable collamer lens implantation","volume":"147","author":"Alfonso","year":"2009","journal-title":"Am J Ophthalmol"},{"key":"2025121602313993000_14.2.e081050.8","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.2147\/OPTH.S111620","article-title":"Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens","volume":"10","author":"Packer","year":"2016","journal-title":"Clin Ophthalmol"},{"key":"2025121602313993000_14.2.e081050.9","doi-asserted-by":"crossref","unstructured":"Zhang D , Yang M , Liu Z , et al . The effect of implantable collamer Lens V4c on ocular biometric measurements and intraocular lens power calculation based on Pentacam-AXL and IOLMaster 500. BMC Ophthalmol 2022;22. doi:10.1186\/s12886-022-02644-z","DOI":"10.1186\/s12886-022-02644-z"},{"key":"2025121602313993000_14.2.e081050.10","doi-asserted-by":"crossref","first-page":"4861","DOI":"10.1007\/s10792-023-02888-8","article-title":"Assessing the efficacy of four methods established by four parameters in ICL size selection and relevant influencing factors: a prospective cohort study","volume":"43","author":"Tang","year":"2023","journal-title":"Int Ophthalmol"},{"key":"2025121602313993000_14.2.e081050.11","doi-asserted-by":"crossref","DOI":"10.1155\/2021\/8988479","article-title":"Effect of implantable collamer lens on anterior segment measurement and intraocular lens power calculation based on IOLMaster 700 and Sirius","volume":"2021","author":"Chen","year":"2021","journal-title":"J Ophthalmol"},{"key":"2025121602313993000_14.2.e081050.12","doi-asserted-by":"crossref","first-page":"2403","DOI":"10.1007\/s00417-023-06016-1","article-title":"Analysis of vault prediction in phakic implantable phakic collamer lenses: manufacturer\u2019s calculator vs theoretical formulae vs clinical practice","volume":"261","author":"Beltr\u00e1n-Murcia","year":"2023","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"2025121602313993000_14.2.e081050.13","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/j.jcrs.2018.07.053","article-title":"Third- and fourth-generation formulas for intraocular lens power calculation before and after phakic intraocular lens insertion in high myopia","volume":"44","author":"Amro","year":"2018","journal-title":"J Cataract Refract Surg"},{"key":"2025121602313993000_14.2.e081050.14","doi-asserted-by":"crossref","first-page":"456","DOI":"10.3928\/1081597X-20230605-01","article-title":"Evaluation of the performance of two nomograms and four vault prediction formulas for implantable collamer lens size selection","volume":"39","author":"Tang","year":"2023","journal-title":"J Refract Surg"},{"key":"2025121602313993000_14.2.e081050.15","doi-asserted-by":"publisher","DOI":"10.1592\/phco.2005.25.8.1116"},{"key":"2025121602313993000_14.2.e081050.16","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.18-25325"},{"key":"2025121602313993000_14.2.e081050.17","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.16-19964"},{"key":"2025121602313993000_14.2.e081050.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2019.07.024"},{"key":"2025121602313993000_14.2.e081050.19","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2016.2528162"},{"key":"2025121602313993000_14.2.e081050.20","doi-asserted-by":"crossref","first-page":"132306","DOI":"10.1016\/j.physd.2019.132306","article-title":"Fundamentals of recurrent neural network (RNN) and long short-term memory (LSTM) network","volume":"404","author":"Sherstinsky","year":"2020","journal-title":"Physica D: Nonlinear Phenomena"},{"key":"2025121602313993000_14.2.e081050.21","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1016\/j.proeng.2012.01.1162","article-title":"Prediction of water quality time series data based on least squares support vector machine","volume":"31","author":"Tan","year":"2012","journal-title":"Procedia Engineering"},{"key":"2025121602313993000_14.2.e081050.22","doi-asserted-by":"crossref","DOI":"10.1155\/2023\/6992441","article-title":"Clinical decision support system for diabetic patients by predicting type 2 diabetes using machine learning algorithms","volume":"2023","author":"Islam","year":"2023","journal-title":"J Healthc Eng"},{"key":"2025121602313993000_14.2.e081050.23","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1097\/j.jcrs.0000000000001134","article-title":"Characteristics and factors associated with the position of the haptic after ICL V4C implantation","volume":"49","author":"Tan","year":"2023","journal-title":"J Cataract Refract Surg"},{"key":"2025121602313993000_14.2.e081050.24","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ajo.2021.02.006","article-title":"Prediction of phakic intraocular lens vault using machine learning of anterior segment optical coherence tomography metrics","volume":"226","author":"Kamiya","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"2025121602313993000_14.2.e081050.25","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ajo.2023.06.024","article-title":"Predicting vault and size of posterior chamber phakic intraocular lens using sulcus to sulcus-optimized artificial intelligence technology","volume":"255","author":"Chen","year":"2023","journal-title":"Am J Ophthalmol"},{"key":"2025121602313993000_14.2.e081050.26","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1007\/s00417-012-1957-0","article-title":"Long-term evaluation of the central vault after phakic Collamer\u00ae lens (ICL) implantation using OCT","volume":"250","author":"Alfonso","year":"2012","journal-title":"Graefes Arch Clin Exp Ophthalmol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-081050","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T10:31:49Z","timestamp":1765881109000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-081050"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":26,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2,15]]},"published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1136\/bmjopen-2023-081050"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-081050","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]}}}