Abstract
Purpose :
Optiwave Refractive Analysis (ORA) has become widely used in cataract extraction for its intraoperative refraction measurement using anterior and posterior corneal astigmatism. ORA is thought to be especially useful in post-LASIK patients, who pose a challenge for accurate conventional intraocular lens (IOL) measurement. This study examines the effective change in choice of implanted lens power after ORA measurements in post-LASIK patients.
Methods :
We conducted a retrospective chart review of post-myopic LASIK patients undergoing cataract surgery between September 2017 and October 2018 with ORA. In 38 eyes, the following information was collected: pre-operative calculated (planned) lens, ORA aphakic refraction and suggested lens, implanted lens, and 1-month post-operative visual acuity. To assess the impact of ORA on choice of lens power, the planned lens and ORA were each correlated to implanted lens power. A chi-square test compared the rate of disagreement between planned vs implanted lens power and ORA vs implanted lens power.
Results :
Females represented 55% of the patients; average age was 67±6 years (range 56-79). Correlations between planned lens power and ORA with implanted lens power were r=0.96 (p<0.001) and r = 0.98 (p<0.001), respectively. The rate of disagreement between planned vs implanted lens power was 74%, and the rate of disagreement between ORA vs implanted lens power was 63%; however, these rates were not significantly different (Χ2 = 0.974, p = 0.324). In 31 eyes seen at 1-month follow-up, 75% had a visual acuity of 20/25 or better, and 13% had a visual acuity worse than 20/30. In 4 eyes with vision worse than 20/30, the implanted lens power was matched to ORA in 2 patients and adjusted to an intermediate power in the other 2 patients.
Conclusions :
Although the ORA-suggested vs implanted lens powers had higher correlation than planned vs implanted lens powers, this difference was not statistically significant. ORA may not significantly influence surgeon’s final choice of lens or post-operative visual acuity. However, further investigations in larger series are needed to delineate ORA’s influence on surgical decision-making and subsequent visual acuity in post-LASIK patients.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.