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Alexandros Pappas, Marwa Adi, Neil Martin; The Effect of Intraoperative Wavefront Aberrometry on Surgical Decision Making. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1819. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the influence on surgical decision making as well as post-operative spherical accuracy to target refraction when using intraoperative wavefront aberrometry on intraocular lens (IOL) power selection in cataract surgery.
A retrospective study of 88 eyes undergoing cataract surgery using the Optiwave Refractive Analysis (ORA) Intraoperative Wavefront Aberrometer with Verifeye+ Technology from January 2016 to August 2016. Two patient groups were compared; (1) cases where final lOL selection agreed with the Intraoperative ORA recommendation (ORA-Yes), and (2) cases where IOL selection did not (ORA-No). Post-operative manifest refraction spherical equivalent accuracy to preoperative target refraction was compared between the two groups and the Barrett Formula. Patient demographics included age, sex, previous ocular history, and type of IOL selected (Monofocal, Multifocal, or Toric Lens). Target refraction was based on preoperative assessment and desire for emmetropia vs monovision correction. Main outcome measures included mean absolute error (MAE) of prediction from preoperative target refraction, and percentage of eyes within ±0.50 diopters (D) of target refraction.
Mean age was 67.9. 71 eyes were included in the ORA-Yes group, and 17 eyes in the ORA-No group. 20 of the ORA-Yes group’s final IOL choice differed from the Barrett formula. 11 of the ORA-No group’s final IOL choice agreed with the Barrett formula recommendation, while 6 did not agree with either the ORA or the Barrett formula. 12.5% of patients had a history of previous LASIK/PRK, 39.7% received a Toric IOL, 11.4% received a Multifocal IOL, and 48.9% had a monofocal IOL placed. In the ORA-Yes group, MAE was 0.27 D and 89% were within ±0.50 D to target refraction. In the ORA-No group, MAE was 0.52 D and 65% were within ±0.50 D of the target refraction. In the 20 patients from the ORA-Yes group where the final IOL selection disagreed with the Barrett formula recommendation, MAE was also 0.27 D and 85% were within ±0.50 D of the target refraction.
The ORA was found to offer reproducible and accurate intraoperative calculations of IOL power in a variety of clinical scenarios. Cases where the final IOL selection agreed with the ORA recommendation resulted in greater accuracy to target refraction. ORA has proven to be a useful tool for intraoperative assessment verifying pre-operative IOL selection in cataract surgery.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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