Intraoperative refractive biometry for predicting intraocular lens power calculation after prior myopic refractive surgery

To evaluate a new method of intraoperative refractive biometry (IRB) for intraocular lens (IOL) power calculation in eyes undergoing cataract surgery after prior myopic LASIK or photorefractive keratectomy. Retrospective consecutive cases series. We included 215 patients undergoing cataract surgery...

Full description

Saved in:
Bibliographic Details
Published in:Ophthalmology (Rochester, Minn.) Vol. 121; no. 1; p. 56
Main Authors: Ianchulev, Tsontcho, Hoffer, Kenneth J, Yoo, Sonia H, Chang, David F, Breen, Michael, Padrick, Thomas, Tran, Dan B
Format: Journal Article
Language:English
Published: United States 01.01.2014
Subjects:
Aberrometry - methods
Biometry
Corneal Surgery, Laser
Humans
Intraoperative Period
Lens Implantation, Intraocular
Lenses, Intraocular
Myopia - surgery
Optics and Photonics
Phacoemulsification
Reproducibility of Results
Visual Acuity - physiology
ISSN:1549-4713, 1549-4713
Online Access:Get more information
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To evaluate a new method of intraoperative refractive biometry (IRB) for intraocular lens (IOL) power calculation in eyes undergoing cataract surgery after prior myopic LASIK or photorefractive keratectomy. Retrospective consecutive cases series. We included 215 patients undergoing cataract surgery with a history of myopic LASIK or photorefractive keratectomy. Patients underwent IRB for IOL power estimation. The Optiwave Refractive Analysis (ORA) System wavefront aberrometer was used to obtain aphakic refractive measurements intraoperatively and then calculate the IOL power with a modified vergence formula obtained before refractive surgery. Comparative effectiveness analysis was done for IRB predictive accuracy of IOL power determination against 3 conventional clinical practice methods: surgeon best preoperative choice (determined by the surgeon using all available clinical data), the Haigis L, and the Shammas IOL formulas. Median absolute error of prediction and percentage of eyes within ±0.50 diopters (D) and ±1.00 D of refractive prediction error. In 246 eyes (215 first eyes and 31 second eyes) IRB using ORA achieved the greatest predictive accuracy (P < 0.0001), with a median absolute error of 0.35 D and mean absolute error of 0.42 D. Sixty-seven percent of eyes were within ±0.5 D and 94% were within ±1.0 D of the IRB's predicted outcome. This was significantly more accurate than the other preoperative methods: Median absolute error was 0.6, 0.53, and 0.51 D for surgeon best choice, Haigis L method, and Shammas method, respectively. The IOL power estimation in challenging eyes with prior LASIK/photorefractive keratectomy was most accurately predicted by IRB/ORA.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ObjectType-Undefined-3
ISSN:1549-4713
1549-4713
DOI:10.1016/j.ophtha.2013.08.041