Patient-Driven Grouping Model and Home Health Use Among Traditional Medicare Beneficiaries.

Fuchs endothelial corneal dystrophy (FECD) is a leading cause of corneal endothelial decompensation and is commonly treated with Descemet membrane endothelial keratoplasty (DMEK), in which the diseased endothelium and Descemet membrane are selectively replaced by donor tissue []. Owing to rapid visual rehabilitation, favourable refractive stability and low graft rejection rates, DMEK has become the preferred surgical technique for FECD [, , ]. A substantial proportion of FECD patients present with clinically significant cataract at the time of surgery. In such cases, combined phacoemulsification with intraocular lens (IOL) implantation and DMEK (“triple DMEK”) is frequently performed, allowing simultaneous management of corneal endothelial pathology and opacities of the crystalline lens [, , ]. However, several studies have reported a postoperative hyperopic shift following triple DMEK surgery, resulting in deviation from the intended refractive target [, , ]. Accurate IOL power calculation is therefore critical in this patient population [, , , , ]. While modern‐generation formulas such as the Barrett Universal II (BUII) have demonstrated good overall performance, they rely on simplified corneal power estimations based primarily on anterior corneal curvature [, ]. Ray‐tracing–based formulas incorporate measured anterior and posterior corneal curvature and corneal thickness, potentially offering improved accuracy in eyes with altered corneal anatomy, such as keratoconus or FECD. After a triple Descemet membrane endothelial keratoplasty (triple DMEK) surgery, the corneal anatomy typically undergoes structural changes characterised by a reduction in corneal oedema, thinning of the central cornea, and restoration of posterior corneal curvature. These changes can affect both anterior and posterior corneal surfaces and may alter shifts in corneal power and refractive outcomes during the postoperative healing phase [, ]. The OKULIX Ray‐tracing software builds a specific optical model of patients' eyes using biometric and corneal topography or tomography data and simulates the distribution of light rays through the ocular media to determine retinal image quality and the optimal IOL power [, ]. In contrast to conventional formula‐based methods, the algorithm incorporates a full optical model of the eye, including measurements of the anterior and posterior corneal surfaces, central corneal thickness (CCT), axial length, anterior chamber depth (ACD) and white‐to‐white distance, thereby enabling a more individualised and physics‐based IOL power prediction []. However, it remains unclear whether ray‐tracing‐based formulas provide clinically meaningful advantages over modern vergence‐based formulas in triple DMEK eyes.