Improvement in Predictive Power of Intraoperative Aberrometry With Optimized Multifocal IOL Constants
Narrative Responses:
Purpose
Determine whether the addition of a surgeon-optimized ORA constant for multifocal and other IOLs improves the predictive power of intraoperative aberrometry.
Methods
Regression coefficients and the surgeon factor used by the ORA intraoperative aberrometer to calculate effective lens position and IOL power for the Tecnis Multifocal were optimized based on prior cases at a single surgery center. Eyes implanted with multifocal IOLs post-optimization (n=32) are compared to 70 eyes implanted pre-optimization. Optimization results for multiple IOLs in a larger multicenter analysis (211 eyes with optimized IOL constants, 906 non-optimized) are also presented. Mean absolute value of the prediction error (MAVPE) and distribution of predicted spherical equivalent (SE) are reported.
Results
The single center MAVPE for eyes with IOL power selected by preoperative biometry was 0.35 ± 0.27D. With IOL power selection guided by intraoperative aberrometry, MAVPE was 0.32 ± 0.24D, compared to 0.27 ± 0.20D following optimization for the Tecnis Multifocal IOL (p=0.04). The percentage of eyes within 0.5D of predicted SE increased from 79% pre-optimization to 91% post-optimization. In the global analysis, MAVPE with non-optimized intraoperative aberrometry was 0.28 ± 0.25D, with 84% of eyes within 0.50D of predicted SE. In the optimized group, MAVPE was 0.27 ± 0.21D, and 89% were within 0.50D of predicted SE.
Conclusion
The prediction error decreased and the percentage of eyes with ≤ 0.50 D of astigmatism postoperatively increased following optimization of the ORA constant for Tecnis Multifocal and other IOLs. IOL-specific optimization further improves the accuracy of intraoperative aberrometry-guided refractive cataract surgery.