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Session Title: Intraoperative Biometry and Correction of Astigmatism
Session Date/Time: Monday 07/10/2013 | 08:00-10:00
Paper Time: 08:12
Venue: Main Lecture Hall (Ground Floor)
First Author: : P.Stephenson, MD,FACS USA
Co Author(s): :
Intraoperative Aberrometry for Rapid Optimization of Power Calculations to Improve Refractive Outcomes with a New IOL To evaluate refractive outcomes following the first cases of a new-to-market IOL when the selection of IOL power is guided by intraoperative aberrometry.
Single site, private clinical practice
Patients undergoing routine cataract surgery were implanted with a new 1-piece, aspheric, hydrophobic acrylic IOL (enVista, Bausch + Lomb). IOL power was calculated using an IOL Master (Carl Zeiss Meditec) with several different formulas. All procedures were performed by a single surgeon through1.8-mm incisions. Multiple intraoperative aberrometry measurements were obtained using the ORA System (WaveTec Vision). Two aphakic measurements were used to confirm or alter the IOL power selection; following implantation of the selected lens, 2 pseudophakic measurements were taken. Uncorrected (UCVA) and best-corrected visual acuity (BCVA) and absolute prediction error were evaluated at 1 day, 1week, and 1 and 3 months.
The mean age of subjects undergoing surgery was 72 (range: 49-82). In the first 50 eyes of 34 patients implanted (16 bilaterally) with the new lens, final IOL power selection was determined by IOL Master alone in 12% of cases, IOL Master with ORA confirmation in 34%, and ORA in 54% of cases. At 1-3 month postop, UCVA was 20/20 or better in 36% of eyes, 20/25 or better in 76% of eyes, and 20/40 or better in 98% of eyes. All eyes had 20/20 or better BCVA. The mean absolute prediction error was 0.17 ± 0.12 D, with 72% of the eyes within 0.25 D and all eyes within 0.5 D of predicted refraction at 1 month. No IOLs have been explanted. One-month results for the first 100 eyes will be presented.
Refractive outcomes in this consecutive case series were improved compared to previous experience with new IOLs prior to optimization of A-constants. The high degree of refractive accuracy increased patient satisfaction and reduced the need for postoperative enhancement. These results demonstrate that intraoperative aberrometry can reliably be used as a basis for confirming or altering IOL power selection.
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