Code-Free Machine Learning Approach for EVO-ICL Vault Prediction: A Retrospective Two-Center Study

Purpose: Establishing a development environment for machine learning is difficult for medical researchers because learning to code is a major barrier. This study aimed to improve the accuracy of a postoperative vault value prediction model for implantable collamer lens (ICL) sizing using machine learning without coding experience. Methods: We used Orange data mining, a recently developed open-source, code-free machine learning tool. This study included eye-pair data from 294 patients from the B&VIIT Eye Center and 26 patients from Kim's Eye Hospital. The model was developed using OCULUS Pentacam data from the B&VIIT Eye Center and was internally evaluated through 10-fold cross-validation. External validation was performed using data from Kim's Eye Hospital. Results: The machine learning model was successfully trained using the data collected without coding. The random forest showed mean absolute errors of 124.8 µm and 152.4 µm for the internal 10-fold cross-validation and the external validation, respectively. For high vault prediction (>750 µm), the random forest showed areas under the curve of 0.725 and 0.760 for the internal and external validation datasets, respectively. The developed model performed better than the classic statistical regression models and the Google no-code platform. Conclusions: Applying a no-code machine learning tool to our ICL implantation datasets showed a more accurate prediction of the postoperative vault than the classic regression and Google no-code models. Translational Relevance: Because of significant bias in measurements and surgery between clinics, the no-code development of a customized machine learning nomogram will improve the accuracy of ICL implantation.