Study shows superior accuracy of intraoperative aberrometry in IOL power selection
ATHENS, Greece — Intraoperative aberrometry increases the accuracy of IOL power selection and has a lower mean prediction error than the formulas based on preoperative biometry, according to a study carried out at the University of Toronto.
“The inability to accurately predict postoperative effective lens position is a major limitation in achieving emmetropia. Despite recent advances, only 60% to 78% of all eyes achieve a spherical equivalent within 0.5 D of the predicted refraction. Intraoperative aberrometry addresses these limitations,” Jingyi Ma, MD, said at the European Society of Cataract and Refractive Surgeons Winter Meeting.
In the study, the prediction error of intraoperative aberrometry was compared with the prediction error of seven common formulas based on preoperative biometry measurements. Seventy patients implanted with monofocal or trifocal IOLs were enrolled, and 34 eyes were included in the final analysis.
IOL power was selected based on preoperative biometry with the IOLMaster 500 (Carl Zeiss Meditec). The spherical equivalent (SE) was predicted preoperatively with the Barrett Universal II, SRK/T, Holladay I, Holladay II, Haigis, Hoffer Q and Hill-RBF formulas and intraoperatively with aberrometry. For each formula, the 1-month postoperative SE was compared with the predicted SE to determine the prediction error. The proportion of eyes with a postoperative SE within 0.5 D of the refractive target was calculated.
“Intraoperative aberrometry showed a lower mean prediction error than all the formulas based on preoperative biometry. All patients had a SE within 1 D of the refractive target, 85% were within 0.5 D, and 59% were within 0.25 D,” Ma said.
The study also investigated how intraoperative aberrometry influenced the surgeon’s best preoperative choice.
“We found that in 52% of eyes, intraoperative aberrometry recommended a different IOL power than the surgeon’s previous choice, and in 35% of eyes, the surgeon implanted a different IOL, choosing either the power suggested by aberrometry or an intermediate power between the preoperative choice and intraoperative aberrometry,” Ma said. – by Michela Cimberle
Ma J, et al. Prediction accuracy of intraoperative aberrometry compared to pre-operative biometry formulas for intraocular lens power selection. Presented at: ESCRS Winter Meeting; Feb. 15-17, 2019; Athens, Greece.
Disclosure: Ma reports no relevant financial disclosures.