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Prediction accuracy of intraoperative aberrometry compared with preoperative biometry formulae for intraocular lens power selection

      Abstract

      Objective

      To compare the accuracy of intraoperative wavefront aberrometry to preoperative biometry formulae for predicting intraocular lens power.

      Design

      Retrospective, consecutive case series.

      Participants

      Eyes undergoing cataract extraction with at least 1 month of follow-up after surgery at an ambulatory surgical centre in Toronto.

      Methods

      Consecutive sample of 228 cataract extractions with monofocal, trifocal, or toric intraocular lens implantation from November 1, 2017, to December 31, 2019. The spherical equivalent was predicted preoperatively with Barrett Universal II, Hill-Radial Basis Function (RBF), SRK/T, Holladay I, Holladay II, Haigis, and HofferQ using biometry measurements and intraoperatively with wavefront aberrometry. The primary outcomes were mean prediction error and proportion of eyes with a spherical equivalent within 0.5 D of the refractive target at postoperative month 1.

      Results

      The analysis included 159 eyes with 52% females and a mean age of 69.4 years. Formulae with the lowest mean prediction error were Hill-RBF (0.32 D ± 0.02 D), Barrett Universal II (0.32 D ± 0.02 D), intraoperative aberrometry (0.32 D ± 0.02 D), SRK/T (0.33 D ± 0.02 D), Holladay II (0.34 D ± 0.03 D), Holladay I (0.35 D ± 0.02 D), Haigis (0.37 D ± 0.02 D), and HofferQ (0.42 D ± 0.02 D). There were no statistically significant differences between intraoperative aberrometry and the preoperative formulae. Formulae with the highest proportion of eyes within 0.5 D of the refractive target were intraoperative aberrometry (82%), Barrett Universal II (81%), Hill-RBF (80%), SRK/T (77%), Holladay II (76%), Holladay I (75%), Haigis (71%), and HofferQ (70%).

      Conclusions

      Intraoperative aberrometry and modern preoperative biometry formulae are equally effective at reaching the refractive target. In normal eyes, intraoperative aberrometry does not appear to provide any additional benefit to modern prediction formulae.
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      References

        • Busbee BG
        • Brown MM
        • Brown GC
        • Sharma S.
        Incremental cost-effectiveness of initial cataract surgery.
        Ophthalmology. 2002; 109: 606-612
        • Gale R
        • Saldana M
        • Johnston R
        • Zuberbuhler B
        • McKibbin M.
        Benchmark standards for refractive outcomes after NHS cataract surgery.
        Eye. 2007; 23: 149-152
        • Aristodemou P
        • Knox Cartwright N
        • Sparrow J
        • Johnston R
        Formula choice: Hoffer Q, Holladay I, or SRK/T and refractive outcomes in 8108 eyes after cataract surgery with biometry by partial coherence interferometry.
        J Cataract Refract Surg. 2011; 37: 63-71
        • Behndig A
        • Montan P
        • Stenevi U
        • Kugelberg M
        • Zetterström C
        • Lundström M.
        Aiming for emmetropia after cataract surgery: Swedish National Cataract Register study.
        J Cataract Refract Surg. 2012; 38: 1181-1186
        • Hemmati H
        • Gologorsky D
        • Pineda R.
        Intraoperative wavefront aberrometry in cataract surgery.
        Semin Ophthalmol. 2012; 27: 100-106
        • Donaldson K
        • Fernández-Vega-Cueto L
        • Davidson R
        • et al.
        Perioperative assessment for refractive cataract surgery.
        J Cataract Refract Surg. 2018; 44: 642-653
        • Curado SX
        • Hida WT
        • Vilar CMC
        • et al.
        Intraoperative aberrometry versus preoperative biometry for IOL power selection after radial keratotomy: a prospective study.
        J Refract Surg. 2019; 35: 656-661
        • Lafetá Queiroz RF
        • Kniggendorf DV
        • de Medeiros AL
        • et al.
        Clinical comparison of speculum's influence on intraoperative aberrometry reading.
        Clin Ophthalmol. 2019; 13: 953-958
        • Khokhar S
        • Gupta Y
        • Dhull C
        • Singh V.
        Intraoperative aberrometry in cataract surgery with topical versus peribulbar anaesthesia.
        Indian J Ophthalmol. 2020; 68: 776-779
        • Hill DC
        • Sudhakar S
        • Hill CS
        • et al.
        Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in axial myopia.
        J Cataract Refract Surg. 2017; 43: 505-510
        • Davison J
        • Potvin R.
        Preoperative measurement vs intraoperative aberrometry for the selection of intraocular lens sphere power in normal eyes.
        Clin Ophthalmol. 2017; 11: 923-929
        • Zhang Z
        • Thomas LW
        • Leu S-Y
        • Carter S
        • Garg S.
        Refractive outcomes of intraoperative wavefront aberrometry versus optical biometry alone for intraocular lens power calculation.
        Indian J Ophthalmol. 2017; 65: 813-817
        • Cionni R
        • 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: 1230-1235
        • Sudhakar S
        • Hill DC
        • King TS
        • et al.
        Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in short eyes.
        J Cataract Refract Surg. 2019; 45: 719-724
        • Hatch K
        • Woodcock E
        • Talamo J.
        Intraocular lens power selection and positioning with and without intraoperative aberrometry.
        J Refract Surg. 2015; 31: 237-242
        • Woodcock M
        • Lehmann R
        • Cionni R
        • Breen M
        • Scott M.
        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
        • Solomon K
        • Sandoval H
        • Potvin R.
        Evaluating the relative value of intraoperative aberrometry versus current formulas for toric IOL sphere, cylinder, and orientation planning.
        J Cataract Refract Surg. 2019; 45: 1430-1435
        • Davison JA
        • Makari S
        • Potvin R.
        Clinically relevant differences in the selection of toric intraocular lens power in normal eyes: preoperative measurement vs intraoperative aberrometry.
        Clin Ophthalmol. 2019; 13: 913-920
        • Cionni RJ
        • Breen M
        • Hamilton C
        • Williams R.
        Retrospective analysis of an intraoperative aberrometry database: a study investigating absolute prediction in eyes implanted with low cylinder power toric intraocular lenses.
        Clin Ophthalmol. 2019; 13: 1485-1492
        • Raufi N
        • James C
        • Kuo A
        • Vann R.
        Intraoperative aberrometry vs modern preoperative formulas in predicting intraocular lens power.
        J Cataract Refract Surg. 2020; 46: 857-861
        • Waisbren E
        • Ritterband D
        • Wang L
        • et al.
        Intraoperative biometry versus conventional methods for predicting intraocular lens power: a closer look at patients undergoing toric lens implantation for astigmatic correction.
        J Eye Cataract Surg. 2017; 3: 27
        • Solomon JD
        • Ladas J.
        Toric outcomes: computer-assisted registration versus intraoperative aberrometry.
        J Cataract Refract Surg. 2017; 43: 498-504
        • Canto A
        • Chhadva P
        • Cabot F
        • et al.
        Comparison of IOL power calculation methods and intraoperative wavefront aberrometer in eyes after refractive surgery.
        J Refract Surg. 2013; 29: 484-489
        • Ianchulev T
        • Hoffer K
        • Yoo SH
        • et al.
        Intraoperative refractive biometry for predicting intraocular lens power calculation after prior myopic refractive surgery.
        Ophthalmology. 2014; 121: 56-60
        • Fram N
        • 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: 1096-1101
        • Yesilirmak N
        • Palioura S
        • Culbertson W
        • Yoo S
        • Donaldson K.
        Intraoperative wavefront aberrometry for toric intraocular lens placement in eyes with a history of refractive surgery.
        J Refract Surg. 2016; 32: 69-70
        • Fisher B
        • Potvin R.
        Clinical outcomes with distance-dominant multifocal and monofocal intraocular lenses in post-LASIK cataract surgery planned using an intraoperative aberrometer.
        Clin Exp Ophthalmol. 2018; 46: 630-636
        • Melles R
        • Holladay J
        • Chang W.
        Accuracy of intraocular lens calculation formulas.
        Ophthalmology. 2018; 125: 169-178
        • Runde M.
        Modern preoperative intraocular lens calculation is better than intraoperative aberrometry for normal eyes.
        J Cataract Refract Surg. 2019; 45: 253-254
        • Huelle J
        • Katz T
        • Druchkiv V
        • et al.
        First clinical results on the feasibility, quality and reproducibility of aberrometry-based intraoperative refraction during cataract surgery.
        Br J Ophthalmol. 2014; 98: 1484-1491
        • Huelle JO
        • Druchkiv V
        • Habib NE
        • et al.
        Intraoperative aberrometry-based aphakia refraction in patients with cataract: status and options.
        Br J Ophthalmol. 2017; 101: 97-102
        • Stringham J
        • Pettey J
        • Olson R.
        Evaluation of variables affecting intraoperative aberrometry.
        J Cataract Refract Surg. 2012; 38: 470-474
        • Masket S
        • Fram N
        • Holladay J.
        Influence of ophthalmic viscosurgical devices on intraoperative aberrometry.
        J Cataract Refract Surg. 2016; 42: 990-994