Intraoperative wavefront aberrometry: a comparison between IOL power calculation methods

Session Details

Session Title: Cataract Surgery Outcomes: IOL Power Calculations

Session Date/Time: Sunday 08/10/2017 | 14:30-16:00

Paper Time: 15:30

Venue: Meeting Center Room I

First Author: : M.Raimundo PORTUGAL

Co Author(s): :    C. Azenha   A. Martins   P. Gil   A. Rosa   M. Quadrado   J. Murta     

Abstract Details

Purpose:

To comparatively evaluate the accuracy of intraoperative wavefront aberrometry (IWA) and conventional intraocular lens (IOL) formulas.

Setting:

Private practice - Unidade de Oftalmologia de Coimbra (UOC), IDEALMED, Coimbra, Portugal.

Methods:

Prospective study evaluating eyes not previously submitted to refractive surgery undergoing uncomplicated cataract surgery with a posterior chamber IOL, aided by IWA (ORATM, Alcon), which allowed intraoperative calculation of IOLs. The IOL power was also estimated preoperatively using optical biometry (IOLMaster 500, Carl Zeiss) to calculate the SRK-T, Holladay, Hoffer Q and Haigis formulae. Outcomes were the median absolute prediction errors (MedAE) for each formula and the proportion of eyes within 0.50 and 1.00 diopters (D) of this prediction. A subgroup analysis in eyes implanted with premium IOLs and different axial lengths was conducted.

Results:

We included 241 eyes in this study. IWA yielded the lowest MedAE (0.24D) of all included formulae and outperformed all formulae (all p<0.05), including the Haigis formula (p=0.013). IWA had the highest proportion of eyes within 0.5D (80%) and 1.0D (95%). In premium IOLs (n=103 eyes), IWA had an even lower MedAE (0.20D) and still significantly outperformed all formulae (all p<0.05). In eyes with axial length <22 mm (n=15 eyes) and > 26 mm (n=37 eyes), IWA was at least as good as the Haigis (p=0.280) and the SRK-T formulae (p=0.301).

Conclusions:

IWA significantly outperformed third and fourth generation IOL power calculation formulae, while analysis by axial length suggested that IWA offered excellent full-range prediction. In the era of premium IOLs, this technology has the potential to improve IOL selection and, ultimately, patient satisfaction.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented