First clinical results on the feasibility, quality and reproducibility of aberrometry-based intraoperative refraction during cataract surgery

Huelle, Jan O; Katz, Toam; Druchkiv, Vasyl; Pahlitzsch, Milena; Steinberg, Johannes; Richard, Gisbert; Linke, Stephan J.

doi:10.1136/bjophthalmol-2013-304786

Cited by 23 publications

(23 citation statements)

References 22 publications

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“…First, during surgery, the patient is in a supine position. In our previous study13 changing the posture from seated to supine led to cyclotorsion and apparently also to a myopic SE shift. Second, the lid speculum may be responsible for significant changes in cylinder power and axis depending on how much the patient squeezed 14.…”

Section: Discussionmentioning

confidence: 72%

“…When three measurements of intraoperative refraction (termed M5, M6 and M713) were possible, these data were assessed through difference means plots and are presented with their limits of agreements in figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…(A) Linear regression analysis on the distribution of adjusted intraocular lens (IOL) power (calculated with Holladay's refractive vergence formula)13 and aphakic spherical equivalent. N=64 (One eye had missing k values and four eyes were lost to the 3-month follow-up).…”

Section: Resultsmentioning

confidence: 99%

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Intraoperative aberrometry-based aphakia refraction in patients with cataract: status and options

et al. 2016

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AimTo explore the application of intraoperative wavefront aberrometry (IWA) for aphakia-based biometry using three existing formulae derived from autorefractive retinoscopy and introducing new improved formulae. Methods In 74 patients undergoing cataract surgery, three repeated measurements of aphakic spherical equivalent (SE) were taken. All measurements were objectively graded for their quality and evaluated with the 'limits of agreement' approach. ORs were calculated and analysis of variance was applied. The intraocular lens (IOL) power that would have given the target refraction was back-calculated from manifest refraction at 3 months postoperatively. Regression analysis was performed to generate two aphakic SE-based formulae for predicting this IOL. The accuracy of the formulae was determined by comparing them to conventional biometry and published aphakia formulae. Results In 32 eyes, three consecutive aphakic measurements were successful. Objective parameters of IWA map quality significantly impacted measurement variability ( p<0.05). The limits of agreement of repeated aphakic SE readings were +0.66 dioptre (D) and −0.69 D. Intraoperative biometry by our formula resulted in 25% and 53% of all cases ±0.50D and ±1.00 D within SE target, respectively. A second formula that took axial length (AL) into account resulted in improved ratios of 41% and 70%, respectively. Conclusions A reliable application of IWA to calculate IOL power during routine cataract surgery may not be feasible given the high rate of measurement failures and the large variations of the readings. To enable reliable IOL calculation from IWA, measurement precision must be improved and aphakic IOL formulae need to be finetuned.

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Section: Discussionmentioning

confidence: 72%

Section: Resultsmentioning

confidence: 99%

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Intraoperative aberrometry-based aphakia refraction in patients with cataract: status and options

et al. 2016

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“…ORA measurements were obtained after the cataract was removed, and the anterior chamber was inflated to normotensive level with a cohesive viscoelastic (Healon– Abbott Medical Optics, Santa Ana, CA, USA), as previous studies have indicated successful measurements in aphakia with the presence of viscoelastic. [ 6 7 ] This study was completed with the ORA before the more recent upgrade to VerifEye+™ Technology.…”

Section: Methodsmentioning

confidence: 99%

Refractive outcomes of intraoperative wavefront aberrometry versus optical biometry alone for intraocular lens power calculation

Zhang

Thomas

Leu

et al. 2017

Indian J Ophthalmol

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Purpose:To compare the outcomes of intraoperative wavefront aberrometry versus optical biometry alone for intraocular lens (IOL) power calculation in eyes undergoing cataract surgery with monofocal IOL implantation.Methods:Preoperative data were obtained with the IOLMaster. Intraoperative aphakic measurements and IOL power calculations were obtained in some patients with the optiwave refractive analysis (ORA) system. Analysis was performed to determine the accuracy of monofocal IOL power prediction and postoperative manifest refraction at 1 month of the ORA versus IOLMaster.Results:Two hundred and ninety-five eyes reviewed, 61 had only preoperative IOLMaster measurements and 234 had both IOLMaster and ORA measurements. Of these 234 eyes, 6 were excluded, 107 had the same recommended IOL power by ORA and IOLMaster. Sixty-four percent of these eyes were within ±0.5D. 95 eyes had IOL power implantation based on ORA instead of IOLMaster. Seventy percent of these eyes were within ±0.5D of target refraction. 26 eyes had IOL power chosen based on IOLMaster predictions instead of ORA. Sixty-five percent were within ±0.5D. In the group with IOLMaster without ORA measurements, 80% of eyes were within ±0.5D of target refraction. The absolute error was statistically smaller in those eyes where the ORA and IOLMaster recommended the same IOL power based on preoperative target refraction compared to instances in which IOL selection was based on ORA or IOLMaster alone. Neither prediction errors were statistically different between the ORA and IOLMaster alone.Conclusion:Intraoperative wavefront aberrometry with the ORA system provides postoperative refractive results comparable to conventional biometry with the IOLMaster for monofocal IOL selection.

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“… 1 2 3 Wavefront analysis has expanded beyond excimer ablation and has been applied to wavefront customized lenses, visual quality assessment after ocular and multiple ocular pathologies. 4 5 6 7 8 9 …”

Section: Introductionmentioning

confidence: 99%

Comparison of ocular monochromatic Higher-order aberrations in normal refractive surgery candidates of Arab and South Asian Origin

Prakash¹,

Srivastava²,

Choudhuri³

et al. 2016

Middle East Afr J Ophthalmol

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Purpose:To compare the ocular monochromatic higher-order aberration. (HOA) profile in normal refractive surgery candidates of Arab and South Asian origin.Methods:This cross-sectional, observational, comparative study was performed in the cornea department of a specialty hospital. Normal refractive surgery candidates with no ocular morbidity except refractive error were recruited. Refractive surgery candidates underwent a preoperative evaluation, including wavefront aberrometry with the iDesign aberrometer (AMO, Inc., Santa Ana, California, United States). The HOA from right eyes were analyzed for HOA signed, absolute, and polar Zernike coefficients.Results:Two hundred Arab participants (group 1) and 200 participants of South-Asian origin (group 2) comprised the study sample. The age and refractive status were comparable between groups. The mean of the HOA root mean square (RMS) was 0.36 ± 17 μ and 0.38 ± 18 μ for Arab and South-Asian eyes, respectively (P < 0.05, rank sum test [RST]). Of the 22 higher order signed Zernike modes, only Z3−3, Z3−1,31, Z4−4, Z4−2, Z40, Z44, and Z5−5 were significantly different from zero (one sample t-test, P < 0.002, with a Bonferroni correction of 0.05/22). All the signed and absolute Zernike terms were comparable between groups (RST, P > 0.002 [0.05/22]). The polar coefficients for coma, trefoil, spherical aberration, and tetrafoil were comparable between groups (P > 0.05, RST). Combined RMS values of third, fourth, fifth, and sixth order also were comparable between groups (P > 0.05, RST).Conclusions:Preoperative whole eye HOA were similar for refractive surgery candidates of Arab and South-Asian origin. The values were comparable to historical data for Caucasian eyes and were lower than Asian (Chinese) eyes. These findings may aid in refining refractive nomograms for wavefront ablations.

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First clinical results on the feasibility, quality and reproducibility of aberrometry-based intraoperative refraction during cataract surgery

Cited by 23 publications

References 22 publications

Intraoperative aberrometry-based aphakia refraction in patients with cataract: status and options

Intraoperative aberrometry-based aphakia refraction in patients with cataract: status and options

Refractive outcomes of intraoperative wavefront aberrometry versus optical biometry alone for intraocular lens power calculation

Comparison of ocular monochromatic Higher-order aberrations in normal refractive surgery candidates of Arab and South Asian Origin

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