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Refractive outcomes in post-refractive eyes undergoing cataract surgery with toric IOL implantation guided by intraoperative aberrometry

Poster Details

First Author: D.Stephenson USA

Co Author(s):                  

Abstract Details


Patients who have enjoyed good uncorrected vision after corneal refractive surgery are highly motivated to seek refractive cataract surgery with advanced IOLs. However, IOL power calculation and accurate determination of the axis and magnitude of astigmatism in post-refractive eyes is particularly challenging. The purpose of this study was to evaluate refractive outcomes in post-refractive eyes undergoing cataract surgery with toric IOL implantation guided by intraoperative aberrometry.


Single site private practice clinic in Venice, Florida, USA.


Results were retrospectively evaluated for 20 post-refractive eyes of 14 patients implanted with either the B+L Trulign (n=16) or Staar Toric (n=4) IOLs. All procedures were performed by a single surgeon and all involved the use of intraoperative aberrometry (ORA with VerifEye, WaveTec Vision) to refine the IOL spherical power, cylinder power, and cylinder axis. The prediction error with ORA was compared to the preop lens choice prediction error. The distribution of postop manifest cylinder is also reported.


Mean preop keratometric astigmatism was 1.19 ± 0.67 D (range 0.56 to 2.43 D). Mean postop manifest astigmatism was 0.25 ± 0.39 D (range 0.00 to 1.25 D). Fifty percent of the eyes had ≤ 0.25 D of astigmatism postoperatively, 85% had ≤ 0.50 D, 90% had ≤ 0.75 D and 95% had ≤ 1.00 D. The ORA prediction error (MAVPE) was 0.30 ± 0.23 D, compared to a MAVPE of 0.64 ± 0.48 for the calculated preop lens choice (p < 0.05). The prediction error was ≤ 0.50 D in 80% of eyes with ORA, compared to 60% of eyes with the preop lens choice. The IOL power was changed from the preop plan based on intraoperative aberrometry in 70% of the cases (14 eyes), with a 1.0-D change or greater in 8 of the eyes.


Intraoperative aberrometry can improve the accuracy of the lens power selected for challenging post-refractive eyes undergoing toric IOL implantation. This series demonstrates that ORA intraoperative aberrometry improves the prediction error and postop refractive results in post-refractive eyes implanted with toric IOLs. FINANCIAL INTEREST: One of more of the authors... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented

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