Comparison of Ophthalmic Viscosurgical Device and Balanced Salt Solution to Achieve Pressurization for Intraoperative Aberrometry

Sunday, April 19, 2015: 4:06 PM
Room 4 (San Diego Convention Center)
Sumit (Sam) Garg, MD
Roger F. Steinert, MD
Marjan Farid, MD
Matthew Wade, MD
Jacqueline Ka-Wan Ng, MD
Elizabeth Pinney, MD

To determine whether an ophthalmic viscosurgical device (OVD) could serve as an effective and practical alternative to balanced salt solution (BSS) in pressurizing the eye for intraoperative aberrometry.

To avoid artifactual astigmatism, eyes must be pressurized prior to intraoperative aberrometry. Pressurization and stromal hydration with BSS helps to create a water-tight incision but can induce astigmatism.  During cataract surgery in normal eyes, aphakic intraoperative aberrometry with the ORA System with VerifEye (WaveTec) was performed 1) utilizing BSS and an anterior chamber maintainer; 2)  by pressurization with a cohesive OVD (Healon, Abbot Medical Optics); and then 3) after stromal hydration of the incision. Primary outcome was the consistency of intraoperative reading without evidence of artifact on the VerifEye image and in comparison to the preoperative astigmatism..

Adequate pressurization was achieved and accurate readings obtained with a cohesive OVD in eyes undergoing cataract surgery with intraoperative aberrometry.  Infusion with an anterior chamber maintainer did not uniformly obtain adequate pressurization due to wound leakage. A small amount of stromal hydration can be performed without inducing astigmatism but the surgeon must observe the aberrometry image to detect artifact encroaching on the optical zone.

Use of a cohesive OVD is a practical method of pressurizing the eye to obtain accurate and repeatable intraoperative aberrometry readings.