Aberrometry optimizes outcomes after clinical surgery

The addition of intraoperative aberrometry to proper preoperative measurements and available clinical history improves refractive and functional outcomes after cataract surgery with accomudating IOL implantation in postLASIK patients.

Dr. Tran highlighted results from a series of 31 eyes that had a history of either myopic (22 eyes) or hyperopic (nine eyes) LASIK. The surgeries were performed between February 2010 and February 2011 using software version Gen 2.1 of the intraoperative aberrometer. All eyes had the single-optic aspheric accommodating IOL (Crystalens AO, Bausch + Lomb) implanted.

Analyses based on 1- to 3-month postoperative MRSE data showed about 71% of eyes were within ±0.5 D of target refraction and 90% were ±1 D. Outcomes were better in eyes with a history of myopic LASIK than in those that were posthyperopic LASIK, but the 1- to 3-month MRSE was within ±1 D of intended in almost 80% of the hyperopic eyes. For the entire group, the mean predicted refractive error of the suggested IOL was –0.30 D and the mean postoperative error to target was –0.38 D.

"The refractive predictability in this cohort compares very favorably with results for eyes with no history of refractive surgery, considering both published results by Narvaez et al. who analyzed data for 643 eyes [J Cataract Refract Surg. 2006;32:2050-2053] and outcomes presented earlier at this meeting by Uday Devgan, MD, whose online registry-based analysis included data from almost 4,000 eyes with the single-optic aspheric accommodating IOL implanted," Dr. Tran said.

"In addition to showing a benefit of intraoperative aberrometry for guiding IOL power selection in the challenging population of postLASIK patients, my personal outcomes demonstrate that the aspheric accommodating IOL provides excellent visual outcomes in postrefractive surgery eyes with a high degree of refractive predictability and without visual disturbances," he said.

Dr. Tran added that he has been using a newer software version (Gen 2.5) for the intraoperative aberrometer since August 2010 and seems to be achieving even better results. The software upgrade features a new regression analysis with optimization for axial length up to 26 mm (a newer upgrade has optimization for longer axial lengths). In a series of 15 eyes, including 11 that were postmyopic LASIK and four that were posthyperopic LASIK, 100% of eyes were within 1 D of the refractive target, he said.

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