Reduction in Laser Vision Correction Enhancement Rate After Introduction of Intraoperative Aberrometry for Refractive Cataract Surgery
Narrative Responses:
Purpose
Laser vision correction (LVC) can enhance results of refractive cataract surgery in cases where the postoperative uncorrected vision is not as good as desired. This analysis was conducted to determine whether the introduction of wavefront aberrometry reduced the rate of LVC enhancement after premium IOL procedures.
Methods
A retrospective chart review was conducted to determine the actual rate of enhancement after premium IOL (multifocal, accommodating, or toric) surgery before and after introduction to the practice of wavefront aberrometry (ORA System, WaveTec Vision). Enhancements are typically performed at 6 weeks postop. Other outcomes include the percentage of time intraoperative aberrometry measurement led to a change in the IOL power implanted, and uncorrected visual acuity at 1 month.
Results
Of 463 eyes implanted with premium IOLs prior to ORA use, from January 2012-August 2012, 32 (7%) went on to require LVC enhancement. Postoperative records were available for 516 eyes implanted with premium IOLs after the introduction of ORA, from September 2012-August 2013. Of these, 9 (2%) went on to require LVC enhancement. This represents a 71% reduction in the rate of enhancements post-premium IOL surgery.
Conclusion
While effective, LVC enhancement after premium IOL surgery increases risk, expense, and time commitment for surgeon and patient and decreases patient satisfaction. In this private practice setting, the incorporation of intraoperative aberrometry significantly reduced the rate of LVC enhancement.