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John H Zeiter, Farhan Hussain, Chaesik Kim, James Todaro, Justin Tannir, Gabriel Sosne; Refractive Error Using Intraoperative Aberrometry Versus Traditional Measurements for Selection of Intraocular Lens Power. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2215. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine whether the refractive outcomes of cataract surgery have been improved by the use of intraoperative aberrometry (IA) in patients without prior refractive surgery.
113 adults undergoing cataract surgery at the Kresge Eye Institute between Jan 2016 and Aug 2017 were included in this retrospective study. Surgery was performed by two surgeons (GS and JT) using standard technique. Exclusion criteria were visual acuity worse than 20/40, high myopia, and prior corneal refractive surgery. Outcome measures included refractive error (RE) for all types of intraocular lenses (IOLs), residual refractive astigmatism (RRA) for toric IOLs, and percentage of patients meeting surgical success criteria. RE was defined as the absolute difference between a standard target spherical equivalent (-0.2 D) and the patient’s actual spherical equivalent as measured by manifest refraction at the patient’s one-month postoperative appointment. RRA was defined as the cylinder present in manifest refraction at a patient’s one-month postoperative appointment. Surgical success was defined as RE < 0.5 D in all patients, or RRA < 0.5 D in patients implanted with toric IOLs.
Patients in whom IA was used (n=49) had lower RE by 0.119 D when compared to patients in whom IA was not used (n=64), but this difference was not significant (p=0.119). Patients in whom toric IOLs were implanted had lower RRA by 0.152 D when IA was used (n=23) than when IA was not used (n=32), but this difference was also not significant (p=0.152). The percentage of patients meeting surgical success criteria was higher in the IA group than in the non-IA group when looking at all IOLs and also when looking exclusively at toric IOLs, but neither of these differences were significant (p=0.759 and p=0.210, respectively).
There was no significant difference in refractive outcomes when using IA with experienced surgeons in patients without prior refractive surgery. These results reflect the fact that our outcomes were excellent regardless of whether or not IA was used, and that we did not limit IA use to patients meeting a strict set of criteria. While IA did not significantly improve refractive outcomes in our study, it may reduce inter-patient variation in outcomes, and it may still provide benefit in certain subgroups of patients, such as patients who have undergone prior refractive surgery.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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