Pre-operative vs. Intra-operative Calculations

What will be your Aha moment?

Top surgeons discuss how the ORA SYSTEM® technology empowers decision making during cataract surgery with real-time guidance that is clinically proven1,2 – when it matters most.

    Pre-op vs. Intra-op Calculations Experts

    Neel R. Desai, MD

    Neel R. Desai, MD
    The Eye Institute of West Florida
    Largo, FL

    Kevin Everett, MD

    Kevin Everett, MD
    Henry Ford Health Systems
    Sterling Heights, MI

    Kamran Massoumi, MD

    Kamran Massoumi, MD
    Oklahoma Eye Institute
    Lawton, OK

    Henry Gelender, MD

    Henry Gelender, MD
    Cornea Associates of Texas
    Dallas, TX

    Bret L. Fisher, MD

    Bret L. Fisher, MD
    The Eye Center of North Florida
    Panama City, FL

    Michael G. Woodcock, MD

    Michael G. Woodcock, MD
    Carolina Vision Center
    Fayetteville, NC

    John Berdahl, MD

    John Berdahl, MD
    Vance Thompson Vision
    Sioux Falls, SD

    All of the above are paid Alcon consultants.


    1. Woodcock MG, Lehmann R, Cionni RJ, et al. Intraoperative aberrometry versus standard preoperative biometry and a toric IOL calculator for bilateral toric IOL implantation with a femtosecond laser: one month results. J Cataract Refract Surg. 2016;42:817-825.
    2. Ianchulev, Intraoperative Refractive Biometry for Predicting Intraocular Lens Power Calculation after Prior Myopic Refractive Surgery. Ophthalmology. June 2014


    Neel R. Desai, MD on Decision Making

    "Intraoperative aberrometry…captures the entire eye, the entire optical system together, [and] provides me a great level of accuracy and intraoperative decision-making power. I wouldn’t dream of doing a post-refractive case without [it], and that’s why we have [a unit] in every single one of our operating rooms."


    Kevin Everett, MD on Lens Selection

    "I had a very demanding patient who did not want to wear glasses for distance, so I was planning for a 9.5 monofocal lens. ...The ORA SYSTEM® told me I needed a moderately high 10.5 astigmatism lens. ...I gulped, placed the moderately high astigmatism lens in, and the next day, I was rewarded with a 20/20 uncorrected, ecstatic patient."


    Kamran Massoumi, MD on Experience

    "On a weekly basis, I have a case or two that give me a 'wow' factor...prior to the ORA SYSTEM®, I would not have dared to do [certain] patients."


    Henry Gelender, MD on Outcomes

    "I just recently had cataract surgery myself. One of my partners...used the ORA SYSTEM®... and I'm just thrilled with the outcome."


    Bret L. Fisher, MD on Surgical Guidance

    "The ORA SYSTEM® suggested something to me in terms of surgical guidance or lens choice, that was really different than what I had planned preoperatively, and the difference was significant."


    Michael G. Woodcock, MD on Accuracy

    "Patients now are becoming much more demanding of a refractive outcome...the only consistent way of doing that is to have a live wavefront device that is very accurate, and more accurate than any of the formulas that are out there at this point."


    John Berdahl, MD on Measurement

    "We placed [the lens] after doing multiple readings... it was the right power, and we saved that patient from having two lenses in her eye."





    CAUTION: Federal (USA) law restricts this device to the sale by or on the order of a physician.

    INTENDED USES: The ORA SYSTEM® uses wavefront aberrometry data in the measurement and analysis of the refractive power of the eye (i.e. sphere, cylinder, and axis measurements) to support cataract surgical procedures.

    CONTRAINDICATIONS: There are no known contraindications for this device.

    The following conditions may make it difficult to obtain accurate readings using the ORA SYSTEM®

    • Patients having progressive retinal pathology such as diabetic retinopathy, macular degeneration, or any other pathology that the physician deems would interfere with patient fixation;
    • Patients having corneal pathology such as Fuchs’, EBMD, keratoconus, advanced pterygium impairing the cornea, or any other pathology that the physician deems would interfere with the measurement process;
    • Patients for which the preoperative regimen includes residual viscous substances left on the corneal surface such as lidocaine gel or viscoelastics;
    • Visually significant media opacity, such as prominent floaters or asteroid hyalosis, will either limit or prohibit the measurement process; or
    • Patients having received retro or peribulbar block or any other treatment that impairs their ability to visualize the fixation light.
    • Use of iris hooks during an ORA SYSTEM® image capture will yield inaccurate measurements.

    In addition:

    • Significant central corneal irregularities resulting in higher order aberrations might yield inaccurate refractive measurements.
    • Post refractive keratectomy eyes might yield inaccurate refractive measurement.
    • The safety and effectiveness of using the data from the ORA SYSTEM® have not been established for determining treatments involving higher order aberrations of the eye such as coma and spherical aberrations.
    • The ORA SYSTEM® is intended for use by qualified health personnel only.
    • Improper use of this device may result in exposure to dangerous voltage or hazardous laser-like radiation exposure. Do not operate the ORA SYSTEM® in the presence of flammable anesthetics or volatile solvents such as alcohol or benzene, or in locations that present an explosion hazard.

    ATTENTION: Refer to the ORA SYSTEM® Operator’s Manual for a complete description of proper use and maintenance, as well as a complete list of contraindications, warnings and precautions.

    ® 2017 Novartis 9/17 US-ORA-17-E-0585(1)