Effect of Surgeon Learning on Intraoperative Wavefront Aberrometry Over 1 Year
Narrative Responses:
Purpose
To evaluate the effects of surgeon experience and learning over time with intraoperative wavefront aberrometry.
Methods
A retrospective, case control study compared two methods for IOL power predction. The accuracy of a standard method for predicting IOL power, optical coherence biometry and topography, was compared to a new, unfamiliar method, intraoperative wavefront aberrotmetry. Both methods were available for each study patient. The surgeon made a determination of which method to use during surgery. There were three possible outcomes, optical coherence better, wavefront better, and no difference. The outcomes actually achieved by each eye vs the theoretical outcome that would have been achieved by the alternative method where compared. A trend analysis was completed.
Results
A total of 687 eyes had cataract surgery with intraoperative wavefront in 5 sequential time periods of approximately 3 months each. The time periods contained 144, 145, 146, 141 and 111 subjects, respectively. The achieved outcomes (mean SE +/- SD)were 0.42+/-0.50, 0.39+/-0.37, 0.44+/-0.36, 0.42+/-0.40, and 0.34+/-0.3. The spherical equivalent outcomes were significantly improved (p<0.05) by the intraoperative aberrometry in the final time period.
Conclusion
Intraoperative aberrometry demonstrated improved outcomes over time while the outcomes of optical biometry did not change over the same time period. This suggests a significant surgeon learning effect with this new method of IOL power calculation that requires a significant amount of time to reach its full clinical potential.