Cataract Surgery With Toric Lens. Assessment Through Tomography And Intraoperative Aberrometry Ora.

Published 2022 - 40th Congress of the ESCRS

Reference: PP13.06 | Type: ESCRS 2022 - Posters | DOI: 10.82333/wsa1-zt50

Authors: MARÍA ÁNGELES DEL BUEY SAYAS* ¹ , SOFÍA BIELSA ALONSO ² , PAULA CASAS PASCUAL ³ , NURIA LOPEZ RODRIGUEZ ³ , CONSTANZA CARAMELLO ALVAREZ ³ , ENRIQUE MINGUEZ MURO ³

¹Ophthalmology,HCU LOZANO BLESA,zaragoza,Spain, ²Grado en óptica y optometría,Universidad de Zaragoza,Zaragoza,Spain, ³Ophthalmology,HCU LOZANO BLESA,Zaragoza,Spain

Purpose

To analyze the refractive results obtained in a group of patients undergoing femtosecond laser assisted cataract surgery (FLACS) with intraoperative aberrometry (ORA)-guided toric lens implant.

Setting

A prospective single-center cross-sectional study was performed at the Ophthalmology Department of the Lozano Blesa University Hospital of Zaragoza, which was conducted from July 2021 to February 2022

Methods

Including a total of 42 eyes of 34 patients (38% male, 62% female), with astigmatism greater than 2.00 keratometric diopters undergo cataract surgery. The surgical procedure is carried out using FLACS femtosecond laser-assisted surgery, altogether with implantation of toric intraocular lenses (Alcon SN6AT2-9). Inclusion criteria pursued uncomplicated interventions, performed by a single surgeon and with a NRR (No Rotation Recommended) outcome.

Results were analized using vector analysis, mean (standard deviation) and median (interquartile range) from a vector of astigmatism were included.

Results

The mean ages were 69.5 ± 11.89 years (39-90), the mean axial length was 23.61 ± 2.38 mm. The corneal dioptric power was 3.10 ± 1.22 D anterior surface contribution, and 0.58 ± 0.40 D posterior surface contribution. It is worth highlighting that the contribution or the posterior surface in ATR eyes (against the rule) was only 0.21 ± 0.15 D.

ORA's IOL recommendation and the preoperative prediction coincided in 50% of the cases (final astigmatism mean 0.76D ± 0.47 D). In the 50% remaining cases where they did not match, the biometer-recommended IOL was inserted (final astigmatism mean 0.84 D ± 0.77 D).

ORA predicted 1.18 D ± 0.85 D. Postoperatively, the mean of the final refractions was 0.89 D ± 0.72 D. ORA overestimates refraction.

Conclusions

Compared with standard methods, we show that the use of ORA intraoperative aberrometry system increases predictability and safety during the intervention, improving efficacy and giving better outcomes. The use of FLACS femtosecond laser-assisted surgery and intraoperative guidance systems make phacoemulsification surgery a simpler and more reproducible technique. Each case must be studied singely, however, these technologies together with the new biometric calculation formulas are highly reliable.