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    Reducing IOL prediction error

    Venice, FL—Intraoperative aberrometry guidance significantly improves refractive outcomes with toric IOL implantation after phacoemulsification in post-refractive surgery eyes, according to a study conducted by P. Dee G. Stephenson, MD.

    The research included data from a series of 20 consecutive patients (32 eyes) with a history of prior corneal refractive surgery. All eyes had potential postoperative distance best-corrected visual acuity (BCVA) of 20/32 or better, and no preoperative ocular pathology, explained Dr. Stephenson, associate professor of ophthalmology, University of South Florida, Tampa, and private practice, Venice, FL.

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    Mean preoperative keratometric astigmatism for the group was 1.39 ± 0.98 D.  

    IOL spherical power, cylinder power, and axis of placement were determined preoperatively and refined by intraoperative aberrometry (ORA with VerifEye, Alcon Laboratories).

    Analyses showed that the mean absolute value of the prediction error was significantly reduced using ORA guidance compared with the preoperative calculation (0.30 ± 0.23 D versus 0.64 ± 0.48 D). In addition, ORA guidance increased the proportion of eyes with a prediction error ≤0.50 D (80% versus 60%).

    Data from manifest refraction measured at least 1 month after surgery showed refractive astigmatism averaged 0.23 ± 0.40 D, was ≤0.25 D in 75% of eyes, and ≤0.50 D in 85% of eyes, Dr. Stephenson said.

    “This is a relatively small study, and a larger randomized, prospective, observer-masked trial would allow for a more detailed analysis of all endpoints,” she said. “Nevertheless, these are impressive outcomes for a challenging group of eyes.”

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