Retrospective comparison of new accommodating toric IOL outcomes with intraoperative aberrometry vs the standard toric IOL calculator

Session Details

Session Title: Interactive Free Paper Session: Pseudophakic IOLs/ Toric

Session Date/Time: Monday 15/09/2014 | 16:30-18:30

Paper Time: 18:10

Venue: Capital Hall B

First Author: : D.Stephenson USA

Co Author(s): :                  

Abstract Details

Purpose:

Expectations of refractive cataract surgery are very high and can be difficult to satisfy, particularly among patients with astigmatism who desire good uncorrected vision at near intermediate and distance. This retrospective evaluation of a new toric IOL was conducted to determine whether toric IOL power selection guided by intraoperative aberrometry with streaming refractive data produces better refractive outcomes than use of the standard astigmatism calculator, for virgin and post-refractive surgery eyes.

Setting:

Single site private practice clinic in Venice, Florida, USA

Methods:

Fifty eyes were implanted with a new toric IOL (Trulign, Bausch + Lomb) through 2.7-mm superior incisions. Subjects were limited to those with good visual potential, no significant surgical or postoperative complications, and no significant ocular comorbidities or ocular trauma. All procedures were performed by a single surgeon. The cylinder power and axis were measured preoperatively with topography and IOL Master, and intraoperatively with an aberrometer (ORA with VerifEye, WaveTec Vision). The IOL power and axis were calculated using the IOL manufacturer’s standard calculator. Final IOL selection was guided by the postoperative refraction predicted by aphakic intraoperative aberrometry measurement. Postoperative manifest refractive cylinder was compared to the ORA predicted cylinder error and to the error predicted by the toric IOL calculator.

Results:

Postoperative analysis is currently available for 44 eyes; results for all 50 will be presented. Mean preoperative keratometric astigmatism was 1.18 ± 0.77 D. Postoperatively, the mean manifest refractive cylinder was 0.09 ± 0.26 D. In 58% of cases a different IOL cylinder power than the one selected by using the toric IOL calculator was implanted based on the intraoperative aberrometry. With ORA, all eyes had postop refractive astigmatism ≤1.00 D, 95% were ≤ 0.50 D, and 91% were ≤0.25 D. Had the toric calculator power been used instead, 98% would have been ≤1.00 D, 74% ≤0.50 D, and 39% ≤0.25 D.

Conclusions:

Particularly with the addition of streaming refractive data, intraoperative aberrometry allows for very accurate cylinder power selection and toric IOL positioning. Incorporating ORA measurements during cataract surgery with a new toric IOL improved refractive outcomes compared to what would have been obtained with the toric IOL calculator alone.

Financial Interest:

One or more of the authors... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented