Analysis of real-world refractive outcomes in patients with long eyes comparing intraoperative aberrometry to preoperative calculations

Session Details

Session Title: IOL Power Calculations, Post-LASIK & Extreme Eyes

Session Date/Time: Tuesday 25/09/2018 | 14:00-16:00

Paper Time: 15:28

Venue: Room A2

First Author: : M.Breen USA

Co Author(s): :    R. Dimalanta   C. Hamilton   R. Cionni              

Abstract Details

Purpose:

The objective of this study was to retrospectively test for differences between the absolute prediction error (PE) using an intraoperative aberrometer (aberrometry prediction error) and the surgeon preoperative formula-estimated absolute prediction error (preoperative prediction error) in cases involving eyes with axial lengths 26.5mm or greater.

Setting:

Over 700 practices, both private and academic centers in the USA, inputted data into the intraoperative aberrometry system’s secure web based data system.

Methods:

The study involved a retrospective analysis of data collected using an intraoperative aberrometry device’s data base capable of storing preoperative intraoperative, and postoperative data from multiple centers across the USA. With a total database size of over ½ million entries to date, the entire database was limited according to predetermined inclusion/exclusion criteria. Primary endpoints included comparing the percentage of cases where the aberrometry PE was ≤ 0.50D with the percentage of cases where the preoperative absolute PE was ≤ 0.50D and comparing the difference between the mean and median absolute aberrometry PE to the mean and median preoperative PE.

Results:

1786 eyes were included. A greater percentage of eyes had an aberrometry absolute PE ≤ 0.50D than eyes with a preoperative absolute PE ≤ 0.50D (82.4% and 68.3% respectively, p< 0.0001). Aberrometry calculations differed from the preoperative calculations 51.1 % of the time. In those cases, the difference in the percentages was greater (82.7% vs 59.6% respectively, p<0.0001).The aberrometry mean absolute PE was 0.31 D (SD, 0.30) and the preoperative mean absolute PE was 0.43 D (SD, 0.38). The aberrometry median absolute PE was 0.23 D (0.0 – 2.7) and the preoperative median absolute PE was 0.35D (0.0 – 4.4).

Conclusions:

In a data set of 1786 long eyes, intraoperative aberrometry provided more accurate spherical equivalent outcomes than the preoperative calculations would have in terms of percentage of cases with ≤ 0.50D prediction error, mean absolute PE and median absolute PE. In those cases where the aberrometry recommendation was different from the preoperative plan, the differences were more pronounced.

Financial Disclosure:

... is employed by a for-profit company with an interest in the subject of the presentation, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented