Intraoperative aberrometry: an update on applications and outcomes

Abstract

Purpose of reviewThere is now a large body of experience with intraoperative aberrometry. This review aims to synthesize available data regarding intraoperative aberrometry applications and outcomes. Recent findingsThe Optiwave Refractive Analysis (ORA) System utilizes Talbot-moir e interferometry and is the only commercially available intraoperative aberrometry device. There are few studies that include all-comers undergoing intraoperative aberrometry-assisted cataract surgery, as most studies examine routine patients only or atypical eyes only. In non-post-refractive cases, studies have consistently shown a small but statistically significant benefit in spherical equivalent refractive outcome for intraoperative aberrometry versus preoperative calculations. In studies examining axial length extremes, most studies have shown intraoperative aberrometry to perform similarly to preoperative calculations. Amongst post-refractive cases, post-myopic ablation cases appear to benefit the most from intraoperative aberrometry. For toric intraocular lenses (IOLs), intraoperative aberrometry may be used for refining IOL power (toricity and spherical equivalent) and alignment, and most studies show intraoperative aberrometry to achieve low postoperative residual astigmatism.

Refractive cataract surgery

“…Intraoperative aberrometry is a technology designed to provide intraoperative refractive measurements to define, analyse and assist in choosing the correct IOL power for the patient. It also allows to understand the amount of astigmatic correction needed for the case that may include the rotation of a toric IOL to offset the misalignment or to induce corneal relaxing incisions for correction of astigmatism [11,12]. Intraoperative aberrometry may be especially beneficial for nonpost-refractive cases, postmyopic ablation eyes and eyes that need toric IOL implantation, although other cases can also be benefitted with this technology.…”

A Comparison of Operating Room Toric Placement Tools: CALLISTO Eye vs. Wavetec AnalyzOR (CORTCO)

“…There remains a need to determine both the time it takes to perform the surgery and whether the additional time needed to use the ORA intraoperatively results in better visual outcomes postoperatively. Some have argued that toric IOL implantation surgeries may benefit the most from intraoperative aberrometry, 16 but others have suggested little clinical benefit from the use of the technology. [16][17][18] The purpose of this study was to evaluate the amount of procedure time needed with each of these cataract planning tools for phakic power calculation and toric positioning to predict the residual astigmatism (prediction error) and other visual outcomes in patients with corneal astigmatism (up to 3.0D).…”