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Reducing refractive error in cataract surgery using miLOOP: a micro-interventional lens fragmentation technique

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First Author: G.Roper USA

Co Author(s):    -. -                    

Abstract Details

Purpose:

To assess the effect of a new micro-interventional lens fragmentation technique on post-operative residual refractive error. Techniques to reduce manipulation of anterior segment structures (e.g., zonules) may improve effective lens position (ELP) prediction and the resulting intraocular lens (IOL) power calculation accuracy.

Setting:

Single surgoen experience in a private practice ambulatory surgical center

Methods:

Standard phaco chop nuclear disassembly was compared to a micro-interventional lens fragmentation technique in a retrospective, consecutive-case series performed by a single surgeon. Eyes in Group 1 were operated on with the standard phaco chop technique, and eyes in Group 2 used the micro-interventional technique (miLOOP device, Carl Zeiss Meditec Cataract Technology, Inc). Optimized lens constants and residual refractive error were calculated using Holladay II. Outcomes included median absolute error and the proportion of eyes within target diopter range. Refractions were measured at least 2 weeks postoperative.

Results:

A total of 118 eyes of 79 patients that qualified for refractive outcome measurement following cataract surgery were reviewed. For Group 1 (n=69 eyes of 45 patients) and Group 2 (n=49 eyes of 34 patients), the proportion of females was 53% and 59%, and the mean ± SD age was 69.9 ± 10.0 and 70.8 ± 8.5 years old, respectively. The mean absolute error ± SD was 0.24 ± 0.21 (group 1) and 0.14 ± 0.15 (group 2 and the median absolute error was 0.19 vs. 0.10 respectively, a 40% reduction (p=0.002). The proportion of patients within 0.25 D of target was 64% vs. 84% respectively, a 31% improvement (p=0.0172). Analysis of patients with bilateral eyes did not affect the outcome.

Conclusions:

Preliminary results show that micro-interventional lens fragmentation using the miLOOP device can significantly reduce residual refractive error following cataract surgery vs. standard phaco chop. By minimizing manipulation of the anterior segment structures, the novel technique preserves zonular and capsular integrity and improves estimation to effective lens position.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented