Official ESCRS | European Society of Cataract & Refractive Surgeons


Clinical outcomes after aphakic vs aphakic/pseudophakic intraoperative aberrometry in cataract surgery with toric IOL implantation

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Session Details

Session Title: Toric IOLs & Lens Power Calculations

Session Date/Time: Sunday 15/09/2019 | 08:00-10:00

Paper Time: 08:24

Venue: Free Paper Forum: Podium 3

First Author: : D.Lubeck USA

Co Author(s): :                                 

Abstract Details


To determine if there was a clinically significant difference in results obtained for Toric IOL implantation when using intraoperative aberrometry(IA) to measure the eye in the aphakic state, or measure twice, both when aphakic,and again when pseudophakic.


This was a prospective, randomized, contralateral eye study, at one site: Seeta Eye Centers, at 23 Davis Avenue, Poughkeepsie, New York, USA.


Subjects included patients presenting for uncomplicated bilateral cataract surgery who were eligible for toric lens implantation with regular corneal astigmatism in both eyes. One eye was measured with aphakic IA only (IA_1), and the other was measured both when aphakic and pseudophakic (IA_2). The Primary Outcome Measure was the magnitude of residual refractive astigmatism. Secondary measures included the percentage of eyes within 0.50D or less of residual refractive astigmatism and spherical equivalent refraction at one month. The time required for IA measurement was also noted in each case.


Mean residual refractive astigmatism was not statistically different between groups (0.32D+/- 0.46D IA_1 versus 0.23D +/- 0.35D IA_2, p= 0.25), nor was the percentage of eyes with a residual refractive cylinder of 0.50D or less (94% in both groups, p=1.0). The average time to measure the pseudophakic eye was 3 minutes, 46 seconds. Aphakic IA measurements on the other hand averaged about 50 seconds. Aphakic IA measurements appeared to produce better spherical equivalent refractive results relative to preoperative calculations with the SRK/T formula.


Pseudophakic IA measurements took nearly four minutes more per case. Residual refractive astigmatism was not appreciably lower when pseudophakic IA measurements were made after aphakic IA measurements , which suggests aphakic IA measurements alone are sufficient to produce excellent clinical results with Toric IOLs.

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