Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in short eyes

Purpose To compare prediction errors of the Barrett True K No History (Barrett TKNH) formula and intraoperative aberrometry (IA) in eyes with prior radial keratotomy (RK). Methods A retrospective, non‐randomized study of all patients with RK who underwent cataract surgery using IA at the UCHealth Sue Anschutz‐Rodgers Eye Center from 2014 to 2019 was conducted. Refraction prediction error (RPE) for IA and Barrett TKNH was compared. General linear modelling accounting for the correlation between eyes was used to determine whether absolute RPE differed significantly between Barrett TKNH and IA. Outcome by number of RK cuts was also compared between the two methods. Results Forty‐seven eyes (31 patients) were included. The mean RPEs for Barrett TKNH and IA were 0.04 ± 0.92D and 0.01 ± 0.92D, respectively, neither was significantly different than zero (p = 0.77, p = 0.91). The median absolute RPEs were 0.50D and 0.48D, respectively (p = 0.70). The refractive outcome fell within ± 0.50D of prediction for 51.1% of eyes with Barrett TKNH and 55.3% with IA, and 80.8% were within ± 1.00D for both techniques. Mean absolute RPE increased with a higher number of RK cuts (grouped into < 8 cuts and ≥ 8 cuts) for both Barrett TKNH (0.35D and 0.74D, p = 0.008) and IA (0.30D and 0.80D, p = 0.0001). Conclusions There is no statistically significant difference between Barrett TKNH and IA in predicting postoperative refractive error in eyes with prior RK. Both are reasonable methods for choosing intraocular lens power. Eyes with more RK cuts have higher prediction errors.

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“…showed that in short eyes IA was equivalent to the best preoperative biometry measurements (Sudhakar et al. 2019). Hill et al.…”

Section: Discussionmentioning

confidence: 99%

Comparison of refractive prediction for intraoperative aberrometry and Barrett True K no history formula in cataract surgery patients with prior radial keratotomy

Dawson

Patnaik

Ifantides

et al. 2020

Acta Ophthalmologica

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“…According to a recent paper, the Hill-RBF (v. 1.0) and the Barrett Universal II methods performed in similar manner after optimization of the constants in short eyes; moreover, both methods give better prediction error results, that is, smaller than 0.5 D, compared with the intraoperative aberrometry technique. 29…”

Section: Discussionmentioning

confidence: 99%

Accuracy of the Hill–radial basis function method and the Barrett Universal II formula

Németh

Módis

2020

European Journal of Ophthalmology

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Purpose: The aim was to assess the postoperative results of a biometric method using artificial intelligence (Hill–radial basis function 2.0), and data from a modern formula (Barrett Universal II) and the Sanders–Retzlaff–Kraft/Theoretical formula. Methods: Phacoemulsification and biconvex intraocular lens implantation were performed in 186 cataractous eyes. The diopters of intraocular lens were established with the Hill–radial basis function method, based on biometric data obtained using the Aladdin device. The required diopters of the intraocular lens were also calculated by the Barrett Universal II formula and with the Sanders–Retzlaff–Kraft/Theoretical formula. The differences between the manifest postoperative refractive errors and the planned refractive errors were calculated, as well as the percentage of eyes within ±0.5 D of the prediction error. The mean- and the median absolute refractive errors were also determined. Results: The mean age of the patients was 70.13 years (SD = 10.67 years), and the mean axial length was 23.47 mm (range = 20.72–28.78 mm). The percentage of eyes within a prediction error of ±0.5 D was 83.62% using the Hill–radial basis function method, 79.66% with the Barrett Universal II formula, and 74.01% in the case of the Sanders–Retzlaff–Kraft/Theoretical formula. The mean- and the median absolute refractive errors were not statistically different. Conclusion: Clinical success was the highest when using the biometric method, based on pattern recognition. The results obtained using Barrett Universal II came a close second. Both methods performed better compared to a traditionally used formula.

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“…Published studies comparing preoperative measurement and IA for selection of intraocular lens sphere power have reported conflicting results 4–8. However, these studies were comparatively small, which may have played a role when lack of a statistical significance was reported 4–8.…”

Section: Discussionmentioning

confidence: 99%

“…In another study of 124 eyes, IA was associated with reduced refractive astigmatism 5. Other studies have reported no significant difference between preoperative measurement and IA for selection of intraocular lens sphere power; however, sample sizes in these studies were comparatively small (51 to 160 eyes) 6–8…”

Section: Introductionmentioning

confidence: 95%

<p>Retrospective analysis of an intraoperative aberrometry database: a study investigating absolute prediction in eyes implanted with low cylinder power toric intraocular lenses</p>

Cionni¹,

Breen²,

Hamilton³

et al. 2019

OPTH

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Purpose To evaluate the spherical equivalent outcomes of intraoperative aberrometry (IA) power calculations compared with the surgeons’ preoperative power calculations in eyes implanted with AcrySof ® IQ T3 intraocular lenses (IOLs). Patients and methods We assessed data collected by an IA system from multiple centers in the United States. Data was from patients who had undergone cataract extraction by phacoemulsification with the use of the Optiwave Refractive Analysis System and whose eyes had been implanted with model SN6AT3 (1.5 diopter [D] at IOL plane) aspheric lenses. The analysis was performed in 2 stages: hypothesis generation and confirmatory testing. Confirmatory endpoints were a comparison of absolute prediction errors for IA for the implanted IOL versus preoperative formula power calculations. Design Retrospective analysis of preoperative, intraoperative, and postoperative data concerning eyes implanted with model SN6AT3 (1.5 D) aspheric lenses from the AnalyzOR™ database. Results Mean absolute IA prediction error was significantly lower than preoperative prediction error (paired difference: −0.06 D; p <0.0001); this was mirrored by the median paired difference of −0.04 D ( p <0.0001). For eyes where the power of the implanted IOL differed from the power of the preoperatively planned lens, mean and median paired differences in prediction errors were greater: −0.13 D ( p <0.0001) and −0.15 D ( p <0.0001), respectively. The percentage of eyes with prediction error ≤0.50 D was significantly higher with IA (83.4%, n=5388/6460) than with the preoperative formula (76.5%, n=4942/6460, p <0.0001). When the powers of the implanted IOL and the preoperatively planned lens were different, the percentage of eyes with prediction error ≤0.50 D was 83.3% (2155/2587) for IA and 68.8% (1781/2587, p <0.0001) for the preoperative formula. Conclusion IA produces more accurate spherical equivalent outcomes for eyes implanted with a low toric IOL than the preoperative formulas.

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Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in short eyes

Cited by 27 publications

References 28 publications

Comparison of refractive prediction for intraoperative aberrometry and Barrett True K no history formula in cataract surgery patients with prior radial keratotomy

Comparison of refractive prediction for intraoperative aberrometry and Barrett True K no history formula in cataract surgery patients with prior radial keratotomy

Accuracy of the Hill–radial basis function method and the Barrett Universal II formula

<p>Retrospective analysis of an intraoperative aberrometry database: a study investigating absolute prediction in eyes implanted with low cylinder power toric intraocular lenses</p>

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