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Intraoperative Aberrometry for IOL Selection

  • Cataract (CE Starr and A Brissette, Section Editors)
  • Published:
Current Ophthalmology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To review the clinical use, advantages, and potential limitations of intraoperative aberrometry (IA) and its application in cataract surgery in the normal, astigmatic, and atypical eye.

Recent Findings

The use of IA is similar to traditional preoperative biometry methods for intraocular lens (IOL) determination in short and normal eyes. The use of IA resulted in equivalent outcomes to modern formulas with optimized axial lengths in long eyes and exceeded traditional formulas. Improved outcomes compared to traditional methods were noted with the use of IA when used for both astigmatism correction and IOL determination in patients with a history of corneal refractive surgery.

Summary

The greatest value in using IA is with atypical eyes. There is a surgeon learning curve with this technology to allow for optimal, consistent, and reproducible results. Despite the increasing popularity of IA, the number of published studies on this technology is limited.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Hatch KH. Intraoperative aberrometry. In: Narang P, Trattler WB, editors. Optimizing suboptimal results following cataract surgery. New York: Thieme; 2019.

    Google Scholar 

  2. Donaldson K, Fernández-Vega-Cueto L, Davidson R, Dhaliwal D, Hamilton R, Jackson M, et al. Perioperative assessment for refractive cataract surgery. J Cataract Refract Surg. 2018;44(5):642–53. https://doi.org/10.1016/j.jcrs.2018.02.022.

    Article  PubMed  Google Scholar 

  3. Mackool RJ, Ko W, Mackool R. Intraocular lens power calculation after laser in situ keratomileusis: aphakic refraction technique. J Cataract Refract Surg. 2006;32(3):435–7. https://doi.org/10.1016/j.jcrs.2005.11.045.

    Article  PubMed  Google Scholar 

  4. Holladay JT, Prager TC, Chandler TY, Musgrove KH, Lewis JW, Ruiz RS. A three-part system for refining lens power calculations. J Cataract Refract Surg. 1988;14(1):17–24.

    Article  CAS  Google Scholar 

  5. Hoffer KJ. Clinical results using the Holladay 2 intraocular lens power formula. J Cataract Refract Surg. 2000;26(8):1233–7.

    Article  CAS  Google Scholar 

  6. Gavin EA, Hammond CJ. Intraocular lens power calculation in short eyes. Eye (Lond). 2008;22(7):935–8.

    Article  CAS  Google Scholar 

  7. Gokce SE, Zeiter JH, Weikert MP, Koch DD, Hill W, Wang L. Intraocular lens power calculations in short eyes using 7 formulas. J Cataract Refract Surg. 2017;43(7):892–7. https://doi.org/10.1016/j.jcrs.2017.07.004.

    Article  PubMed  Google Scholar 

  8. •• Sudhakar S, Hill DC, King TS, Scott IU, Mishra G, Ernst BB, et al. Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in short eyes. J Cataract Refract Surg. 2019;45(6):719–24. https://doi.org/10.1016/j.jcrs.2018.12.016. This retrospective consecutive case series highlights that IA was no better than conventional biometry for IOL power determination.

    Article  PubMed  Google Scholar 

  9. Zaldivar R, Shultz MC, Davidorf JM, Holladay JT. Intraocular lens power calculations in patients with extreme myopia. J Cataract Refract Surg. 2000;26(5):668–74.

    Article  CAS  Google Scholar 

  10. Bang S, Edell E, Yu Q, Pratzer K, Stark W. Accuracy of intraocular lens calculations using the IOLMaster in eyes with long axial length and a comparison of various formulas. Ophthalmology. 2011;118(3):503–6. https://doi.org/10.1016/j.ophtha.2010.07.008.

    Article  Google Scholar 

  11. Wang L, Shirayama M, Ma XJ, Kohnen T, Koch DD. Optimizing intraocular lens power calculations in eyes with axial lengths above 25.0 mm. J Cataract Refract Surg. 2011;37(11):2018–27. https://doi.org/10.1016/j.jcrs.2011.05.042.

    Article  PubMed  Google Scholar 

  12. •• Hill DC, Sudhakar S, Hill CS, King TS, Scott IU, Ernst BB, et al. Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in axial myopia. J Cataract Refract Surg. 2017;43(4):505–10. https://doi.org/10.1016/j.jcrs.2017.01.014. This retrospective consecutive case series suggests that cases with IA had better refractive outcomes than conventional biometry–based formulas in myopic patients.

    Article  PubMed  Google Scholar 

  13. Jin H, Limberger IJ, Ehmer A, Guo H, Auffarth GU. Impact of axis misalignment of toric intraocular lenses on refractive outcomes after cataract surgery. J Cataract Refract Surg. 2010;36(12):2061–72. https://doi.org/10.1016/j.jcrs.2010.06.066.

    Article  PubMed  Google Scholar 

  14. U.S. Food and Drug Administration (2005). Summary of safety and effectiveness data P930014/S15, AcrySof® Toric IOL.

  15. • Hatch KM, Woodcock EC, Talamo JH. Intraocular lens power selection and positioning with and without intraoperative aberrometry. J. Refract Surg. 2015;31(4):237–42. https://doi.org/10.3928/1081597X-20150319-03. This study discusses that patients with toric IOLs placed with IA were 2.4 times more likely to have less than 0.5 D of residual refractive astigmatism than conventional methods.

    Article  PubMed  Google Scholar 

  16. Waisbren E, Ritterband D, Wang L, Trief D, Koplin R, Seedor J. Intraoperative biometry versus conventional methods for predicting intraocular lens power: a closer look at patients undergoing toric lens implantation for astigmatism correction. J Eye Cataract Surg. 2017;3:27. https://doi.org/10.21767/2471-8300.100027.

    Article  Google Scholar 

  17. Woodcock MG, Lehmann R, Cionni RJ, Breen M, Scott MC. 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(6):817–25. https://doi.org/10.1016/j.jcrs.2016.02.048.

    Article  PubMed  Google Scholar 

  18. Solomon JD, Ladas J. Toric outcomes: computer-assisted registration versus intraoperative aberrometry. J Cataract Refract Surg. 2017;43(4):498–504. https://doi.org/10.1016/j.jcrs.2017.01.012.

    Article  PubMed  Google Scholar 

  19. Solomon KD, Sandoval HP, Potvin R. Correcting astigmatism at the time of cataract surgery: toric IOLs and corneal relaxing incisions planned with an image-guidance system and intraoperative aberrometer versus manual planning and surgery. J Cataract Refract Surg. 2019;45(5):569–75. https://doi.org/10.1016/j.jcrs.2018.12.002.

    Article  PubMed  Google Scholar 

  20. Kessel L, Andresen J, Tendal B, Erngaard D, Flesner P, Hjortdal J. Toric intraocular lenses in the correction of astigmatism during cataract surgery: a systematic review and meta-analysis. Ophthalmology. 2016;123(2):275–86. https://doi.org/10.1016/j.ophtha.2015.10.002.

    Article  PubMed  Google Scholar 

  21. • Packer M. Effect of intraoperative aberrometry on the rate of postoperative enhancement: retrospective study. J Cataract Refract Surg. 2010;36(5):747–55. https://doi.org/10.1016/j.jcrs.2009.11.029. This is a retrospective case-control chart review that shows that when IA was used for LRIs, there was a significant reduction in the odds ratio of subsequent laser vision enhancement.

    Article  PubMed  Google Scholar 

  22. • Canto AP, Chhadva P, Cabot F, Galor A, Yoo SH, Vaddavalli PK, et al. Comparison of IOL power calculation methods and intraoperative wavefront aberrometer in eyes after refractive surgery. J Refract Surg. 2013;29(7):484–9. https://doi.org/10.3928/1081597X-20130617-07. This retrospective study indicates that IA was the most accurate method to predict IOL power in patients with history of keratorefractive surgery. It compares refractive outcomes for RK, PRK, and LASIK.

    Article  PubMed  Google Scholar 

  23. Demill DL, Moshirfar M, Neuffer MC, Hsu M, Sikder S. A comparison of the American Society of Cataract and Refractive Surgery post-myopic LASIK/PRK intraocular lens (IOL) calculator and the ocular MD IOL calculator. Clin Ophthalmol. 2011;5:1409–14. https://doi.org/10.2147/OPTH.S24131.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Yesilirmak N, Palioura S, Culbertson W, Yoo SH, Donaldson K. Intraoperative wavefront aberrometry for toric intraocular lens placement in eyes with a history of refractive surgery. J Refract Surg. 2016;32(1):69–70. https://doi.org/10.3928/1081597X-20151210-02.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Fram NR, Masket S, Wang L. Comparison of intraoperative aberrometry, OCT-based IOL formula, Haigis-L, and Masket formulae for IOL power calculation after laser vision correction. Ophthalmology. 2015;122(6):1096–101. https://doi.org/10.1016/j.ophtha.2015.01.027.

    Article  PubMed  Google Scholar 

  26. Cionni RJ, Dimalanta R, Breen M, Hamilton C. A large retrospective database analysis comparing outcomes of intraoperative aberrometry with conventional preoperative planning. J Cataract Refract Surg. 2018;44(10):1230–5. https://doi.org/10.1016/j.jcrs.2018.07.016.

    Article  PubMed  Google Scholar 

  27. Runde MR. Modern preoperative intraocular lens calculation is better than intraoperative aberrometry for normal eyes. J Cataract Refract Surg. 2019;45(2):253–4. https://doi.org/10.1016/j.jcrs.2018.10.036.

    Article  PubMed  Google Scholar 

  28. Zhang Z, Thomas LW, Leu SY, Carter S, Garg S. Refractive outcomes of intraoperative wavefront aberrometry versus optical biometry alone for intraocular lens power calculation. Indian J Ophthalmol. 2017;65(9):813–7. https://doi.org/10.4103/ijo.IJO_163_17.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Davison JA, Potvin R. Preoperative measurement vs intraoperative aberrometry for the selection of intraocular lens sphere power in normal eyes. Clin Ophthalmol. 2017;11:923–9. https://doi.org/10.2147/OPTH.S135659.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Stringham J, Pettey J, Olson RJ. Evaluation of variables affecting intraoperative aberrometry. J Cataract Refract Surg. 2012;38(3):470–4. https://doi.org/10.1016/j.jcrs.2011.09.039.

    Article  PubMed  Google Scholar 

  31. Masket S, Fram NR, Holladay JT. Influence of ophthalmic viscosurgical devices on intraoperative aberrometry. J Cataract Refract Surg. 2016;42(7):990–4. https://doi.org/10.1016/j.jcrs.2016.04.022.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cornea and Refractive Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA

    Jennifer J. Yong & Kathryn M. Hatch

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  1. Jennifer J. Yong
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  2. Kathryn M. Hatch
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Correspondence to Kathryn M. Hatch.

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Yong, J.J., Hatch, K.M. Intraoperative Aberrometry for IOL Selection. Curr Ophthalmol Rep 7, 213–218 (2019). https://doi.org/10.1007/s40135-019-00222-z

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  • DOI: https://doi.org/10.1007/s40135-019-00222-z

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