Multicenter Evaluation of Intraoperative Aberrometry-Assisted IOL Power Selection Using Streaming Refractive Data

Tuesday, April 29, 2014: 11:01 AM
Room 151B (Boston Convention and Exhibition Center)
Robert J. Cionni, MD, The Eye Institute of Utah, Salt Lake City, UT, USA

Narrative Responses:

Purpose
To determine whether streaming refractive data during eye stabilization prior to intraoperative aberrometry measurements offers additional accuracy in IOL power calculation

Methods
Cataract surgery with IOL implantation was performed at 11 centers using the ORA System (WaveTec Vision), which allows for real-time monitoring of refractive information during eye stabilization. Eyes were implanted with a range of IOLs, including standard monofocals, presbyopia-correcting IOLs, and toric IOLs.  Post-refractive eyes were excluded from this analysis.   Final IOL power selection was based on the ORA aphakic refraction. The primary outcome measure is the mean absolute value of the prediction error (MAVPE) for the ORA-selected IOL power compared to the IOL power that would have been implanted based on preoperative biometry alone.

Results
262 eyes were enrolled and followed for 1 month.The MAVPE was 0.29 ± 0.20 D. The difference between this and the MAVPE for standard power calculations (0.33 ± 0.27 D) is statistically significant (p < 0.03). Nearly all eyes (99%) were within 1.00 D of the predicted spherical equivalent and 84% were within 0.50 D.  Had the IOL selection been based on preoperative information, 96% and 78%, respectively, would have been within 1.0 D and 0.5 D. In a single-center subset of 45 eyes, the MAVPE was 0.25 ± 0.20 D, with 89% of eyes within 0.5 D.

Conclusion
Intraoperative aberrometry-assisted power calculation with streaming refractive data closely predicts refractive outcome.