Impact of Streaming Refractive Information Via an in-Scope Dynamic Reticle on Toric IOL Results With Intraoperative Aberrometry

Sunday, April 19, 2015: 3:11 PM
Room 4 (San Diego Convention Center)
Michael G. Woodcock, MD

Recent improvements to an intraoperative aberrometry system allow surgeons to view streaming refractive data through the oculars of the surgical microscope to correctly align toric IOLs and LRIs intraoperatively.  This study was conducted to evaluate the impact of this dynamic reticle on postoperative refractive astigmatism correction.

This was a prospective, multicenter study in 54 eyes undergoing cataract surgery with toric IOL implantation.  In all cases, cylinder power and axis were determined using ORA with VerifEye+ (WaveTec Vision). Uncorrected and best-corrected visual acuity and manifest refraction were recorded at one month by an evaluator masked to IOL type and intraoperative aberrometry use. Primary outcomes include mean postoperative astigmatism and the percentage of eyes with postoperative refractive astigmatism ≤ 0.50 D. Results were compared to previously published results obtained with ORA and with the Acrysof toric calculator.

Mean postoperative astigmatism was 0.24 ± 0.26 D, and 93% of eyes had postoperative refractive astigmatism ≤ 0.50 D.  Recent reports have shown that postoperative refractive astigmatism ≤ 0.50 D was achieved in 89.2% of eyes with ORA without the dynamic reticle and in 76.6 % of eyes treated using a toric calculator without intraoperative aberrometry.

Results in this series of eyes implanted with toric IOLs guided by ORA with VerifEye+ were excellent, with more than 90% of eyes with ≤ 0.50 D of postoperative refractive astigmatism. A larger, randomized, prospective, contralateral eye study should be undertaken to confirm the advantages of a dynamic reticle with streaming refractive data.