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    Intraoperative aberrometry providing ‘tighter’ outcomes

    But predicting a patient’s eventual refractive outcome has still been somewhat of a guessing game, said Robert J. Cionni, MD.

    Interoperative aberrometry can improve surgical outcomes and reduce the likelihood of needing to perform enhancements, said Dr. Cionni during ASCRS 2016.

    Sponsored: 5 reasons toric IOLs manage astigmatism most effectively

    When calculating IOL powers for primary cataract surgery, most surgeons will use manual or optical biometry (and most use the latter) during preoperative evaluations.

    “As we all know, errors in those initial measurements can have a negative effect on refractive outcomes,” Dr. Cionni said. “Our goal is to get it right the first time.”

    Related: Femtosecond laser or manual cataract removal for accomodating IOLs?

    Intraoperative aberrometry has been used successfully to improve cataract outcomes in post-refractive surgery eyes, and many surgeons have begun incorporating the technology into “standard” cataract procedures.

    Dr. Cionni evaluated the postoperative mean absolute value of predicted error (MAVPE) and absolute prediction error distribution after surgical procedures using intraoperative aberrometry (ORA, Alcon Laboratories) to guide IOL power selection.

    All eyes were evaluated about 21 to 35 days after surgery and all eyes underwent surgery with the VerifEye or VerifEye Plus system.

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    “This was a prospective, multicenter, masked study,” Dr. Cionni said, where readers were masked to both lens type and surgical technique (e.g., corneal relaxing incisions). The ORA is designed to perform aphakic and pseudophakic measurements in real time to help ensure the correct IOL power was chosen. The system captures sphere, cylinder, and axis information in seconds and conveys the data to the surgeon.

    The ORA uses an infrared light and Talbot-Moiré interferometry optimized for the aphakic state to perform a “whole eye” assessment of the optical system. The device is capable of capturing 40 measurements in less than a few minutes, and displays the scans in sequence. The device then combines and analyzes data from the central 4 mm to determine the optimal IOL power for the eye.

    In complicated cases, it has been reported the aphakic measurements produce a different suggested IOL power than preoperative measurements.

    Study outcomes

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