Search

Nicole R Fram,1,2 John Davidson,2 Xiaolin Gu,3 Raiju J Babu,3 Michael Breen3 1Advanced Vision Care, Los Angeles, CA, USA; 2Stein Eye Institute, UCLA, Los Angeles, CA, USA; 3Alcon Vision LLC, Fort Worth, TX, USACorrespondence: Nicole R Fram, Advanced Vision Care, 2080 Century Park East, Suite 911, Los Angeles, CA, 90067, USA, Email nicfram@yahoo.comPurpose: To compare the refractive prediction accuracy of the Optiwave Refractive Analysis (ORA) SYSTEM with the Barrett True-K (BTK) formula in calculating intraocular lens (IOL) power in eyes that underwent cataract surgery after previous myopic photorefractive keratectomy (PRK) or laser-assisted in situ keratomileusis (LASIK).Methods: This retrospective study evaluated patients aged ≥ 22 years with prior myopic PRK or LASIK who underwent unilateral or bilateral cataract removal and monofocal IOL implantation using the ORA SYSTEM at 177 sites in the United States. Two datasets were analyzed: All Eyes (ie, all eligible eyes) and First Surgery Eyes (ie, each patient’s first implanted eye). All Eyes were subgrouped by axial length (AL) and further analyzed. The main outcomes included paired differences in absolute prediction errors (APEs) between the ORA SYSTEM and BTK and differences in the proportion of eyes with APEs of ≤ 0.25 diopter (D) and ≤ 0.50 D.Results: 1067 eyes were analyzed, including 897 First Surgery Eyes. Significantly higher proportions of All Eyes had APEs of ≤ 0.25 D (P = 0.0128) and ≤ 0.50 D (P

John Davidson,1 Xiaolin Gu,2 Michael Breen,2 Raiju J Babu2 1Stein Eye Institute, UCLA School of Medicine, Los Angeles, CA, USA; 2Alcon Vision LLC, Fort Worth, TX, USACorrespondence: John Davidson, Stein Eye Institute, UCLA School of Medicine, Los Angeles, CA, USA, Email doctorjohn@johndavidsonmd.comPurpose: To evaluate absolute prediction errors following phacoemulsification with implantation of a multifocal toric intraocular lens (IOL) using intraoperative aberrometry for IOL power selection and to compare findings with the globally optimized and manufacturer’s recommended lens constants and regression coefficients.Methods: Data from the Optiwave Refractive Analysis (ORA SYSTEM) were analyzed retrospectively. Absolute prediction errors from surgeries performed before and after the first optimization of the manufacturer’s recommended lens constant and non-optimized regression coefficients for the multifocal toric IOL (SND1T3-6) were compared. Optimization was based on outcomes of procedures performed using the ORA SYSTEM and archived in its database (AnalyzOR). Outcome measures included the proportion of eyes with absolute ORA SYSTEM prediction errors ≤ 0.25 D and ≤ 0.5 D and the mean and median absolute prediction errors.Results: The pre-optimization group included 1027 eyes operated on by 184 surgeons, and the optimized group included 419 eyes operated on by 143 surgeons. The proportions of eyes achieving absolute ORA SYSTEM prediction errors ≤ 0.25 D (52.5% vs 35.0%, p < 0.0001) and ≤ 0.50 D (83.1% vs 66.2%, p < 0.0001) were significantly higher in the optimized than in the pre-optimization group. The mean ± standard deviation (0.30 ± 0.25 D vs 0.43 ± 0.32 D, p < 0.0001) and median (0.24 D vs 0.36 D, p < 0.0001) absolute ORA SYSTEM prediction errors were significantly lower after than before optimization. Prediction errors following optimization were reduced more in eyes of average than of long and short axial lengths.Conclusion: Global optimization of the manufacturer’s IOL lens constants and regression coefficients resulted in lower absolute prediction errors when compared with the initial manufacturer labeled lens constants and non-optimized regression coefficients. Reductions in absolute prediction error can result in lower postoperative residual refractive error, which can improve post-operative uncorrected visual acuity and provide the potential for greater patient satisfaction following cataract surgery.Keywords: intraoperative aberrometry, intraocular lens implantation, prediction error, lens constant optimization, refractive error, visual acuity

Robert J Cionni,1 Michael Breen,2 Cody Hamilton,3 Ravaughn Williams41The Eye Institute of Utah, Salt Lake City, UT, USA; 2North America Clinical Development and Medical Affairs, Alcon Laboratories, Inc., Fort Worth, TX, USA; 3Biostatistics, Alcon Laboratories, Inc., Fort Worth, TX, USA; 4Global Clinical Development and Medical Affairs, Alcon Laboratories, Fort Worth, TX, USAPurpose: To evaluate the spherical equivalent outcomes of intraoperative aberrometry (IA) power calculations compared with the surgeons’ preoperative power calculations in eyes implanted with AcrySof® IQ T3 intraocular lenses (IOLs).Patients and methods: We assessed data collected by an IA system from multiple centers in the United States. Data was from patients who had undergone cataract extraction by phacoemulsification with the use of the Optiwave Refractive Analysis System and whose eyes had been implanted with model SN6AT3 (1.5 diopter [D] at IOL plane) aspheric lenses. The analysis was performed in 2 stages: hypothesis generation and confirmatory testing. Confirmatory endpoints were a comparison of absolute prediction errors for IA for the implanted IOL versus preoperative formula power calculations.Design: Retrospective analysis of preoperative, intraoperative, and postoperative data concerning eyes implanted with model SN6AT3 (1.5 D) aspheric lenses from the AnalyzOR™ database.Results: Mean absolute IA prediction error was significantly lower than preoperative prediction error (paired difference: −0.06 D; p