Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in axial myopia

Darren C. Hill, Shruti Sudhakar, Christopher S. Hill, Tonya King, Ingrid Scott, Brett B. Ernst, Seth Pantanelli

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose To compare the accuracy of intraoperative wavefront aberrometry (ORA) and the Hill-radial basis function (RBF) formula with other formulas based on preoperative biometry in predicting residual refractive error after cataract surgery in eyes with axial myopia. Setting Private practice, Harrisburg, Pennsylvania, USA. Design Retrospective consecutive case series. Methods Eyes with an axial length (AL) greater than 25.0 mm had cataract extraction with intraocular lens implantation. For each eye, the 1-center Wang-Koch AL-optimized Holladay 1 formula was used to select an IOL targeting emmetropia. Residual refractive error was predicted preoperatively using the SRK/T, Holladay 1 and 2, Barrett Universal II, and Hill-RBF formulas and intraoperatively using wavefront aberrometry. The postoperative refraction was compared with the preoperative and intraoperative predictions. Results The study comprised 37 patients (51 eyes). The mean numerical errors ± standard error associated with using the SRK/T, Holladay 1, AL-optimized Holladay 1, Holladay 2, Barrett Universal II, and Hill-RBF formulas and intraoperative wavefront aberrometry were 0.20 ± 0.06 diopters (D), 0.33 ± 0.06 D, −0.02 ± 0.06 D, 0.24 ± 0.06 D, 0.19 ± 0.06 D, 0.22 ± 0.06 D, and 0.056 ± 0.06 D, respectively (P <.001). The proportion of patients within ±0.5 D of the predicted error was 74.5%, 62.8%, 82.4%, 79.1%, 73.9%, 76.7%, and 80.4%, respectively (P =.090). Hyperopic outcomes occurred in 70.6%, 76.5%, 49.0%, 74.4%, 76.1%, 74.4%, and 45.1% of the eyes, respectively (P =.007). Conclusions Intraoperative wavefront aberrometry was better than all formulas based on preoperative biometry and as effective as the AL-optimized Holladay 1 formula in predicting residual refractive error and reducing hyperopic outcomes. The Hill-RBF formula's performance was similar to that of the fourth-generation formulas.

Original languageEnglish (US)
Pages (from-to)505-510
Number of pages6
JournalJournal of Cataract and Refractive Surgery
Volume43
Issue number4
DOIs
StatePublished - Apr 1 2017

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Aberrometry
Biometry
Intraocular Lenses
Myopia
Refractive Errors
Eye Axial Length
Emmetropia
Intraocular Lens Implantation
Cataract Extraction
Private Practice
Cataract
Power (Psychology)

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology
  • Sensory Systems

Cite this

@article{b3886b70bb214a2998f342a78df56b3f,
title = "Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in axial myopia",
abstract = "Purpose To compare the accuracy of intraoperative wavefront aberrometry (ORA) and the Hill-radial basis function (RBF) formula with other formulas based on preoperative biometry in predicting residual refractive error after cataract surgery in eyes with axial myopia. Setting Private practice, Harrisburg, Pennsylvania, USA. Design Retrospective consecutive case series. Methods Eyes with an axial length (AL) greater than 25.0 mm had cataract extraction with intraocular lens implantation. For each eye, the 1-center Wang-Koch AL-optimized Holladay 1 formula was used to select an IOL targeting emmetropia. Residual refractive error was predicted preoperatively using the SRK/T, Holladay 1 and 2, Barrett Universal II, and Hill-RBF formulas and intraoperatively using wavefront aberrometry. The postoperative refraction was compared with the preoperative and intraoperative predictions. Results The study comprised 37 patients (51 eyes). The mean numerical errors ± standard error associated with using the SRK/T, Holladay 1, AL-optimized Holladay 1, Holladay 2, Barrett Universal II, and Hill-RBF formulas and intraoperative wavefront aberrometry were 0.20 ± 0.06 diopters (D), 0.33 ± 0.06 D, −0.02 ± 0.06 D, 0.24 ± 0.06 D, 0.19 ± 0.06 D, 0.22 ± 0.06 D, and 0.056 ± 0.06 D, respectively (P <.001). The proportion of patients within ±0.5 D of the predicted error was 74.5{\%}, 62.8{\%}, 82.4{\%}, 79.1{\%}, 73.9{\%}, 76.7{\%}, and 80.4{\%}, respectively (P =.090). Hyperopic outcomes occurred in 70.6{\%}, 76.5{\%}, 49.0{\%}, 74.4{\%}, 76.1{\%}, 74.4{\%}, and 45.1{\%} of the eyes, respectively (P =.007). Conclusions Intraoperative wavefront aberrometry was better than all formulas based on preoperative biometry and as effective as the AL-optimized Holladay 1 formula in predicting residual refractive error and reducing hyperopic outcomes. The Hill-RBF formula's performance was similar to that of the fourth-generation formulas.",
author = "Hill, {Darren C.} and Shruti Sudhakar and Hill, {Christopher S.} and Tonya King and Ingrid Scott and Ernst, {Brett B.} and Seth Pantanelli",
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language = "English (US)",
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pages = "505--510",
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Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in axial myopia. / Hill, Darren C.; Sudhakar, Shruti; Hill, Christopher S.; King, Tonya; Scott, Ingrid; Ernst, Brett B.; Pantanelli, Seth.

In: Journal of Cataract and Refractive Surgery, Vol. 43, No. 4, 01.04.2017, p. 505-510.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in axial myopia

AU - Hill, Darren C.

AU - Sudhakar, Shruti

AU - Hill, Christopher S.

AU - King, Tonya

AU - Scott, Ingrid

AU - Ernst, Brett B.

AU - Pantanelli, Seth

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Purpose To compare the accuracy of intraoperative wavefront aberrometry (ORA) and the Hill-radial basis function (RBF) formula with other formulas based on preoperative biometry in predicting residual refractive error after cataract surgery in eyes with axial myopia. Setting Private practice, Harrisburg, Pennsylvania, USA. Design Retrospective consecutive case series. Methods Eyes with an axial length (AL) greater than 25.0 mm had cataract extraction with intraocular lens implantation. For each eye, the 1-center Wang-Koch AL-optimized Holladay 1 formula was used to select an IOL targeting emmetropia. Residual refractive error was predicted preoperatively using the SRK/T, Holladay 1 and 2, Barrett Universal II, and Hill-RBF formulas and intraoperatively using wavefront aberrometry. The postoperative refraction was compared with the preoperative and intraoperative predictions. Results The study comprised 37 patients (51 eyes). The mean numerical errors ± standard error associated with using the SRK/T, Holladay 1, AL-optimized Holladay 1, Holladay 2, Barrett Universal II, and Hill-RBF formulas and intraoperative wavefront aberrometry were 0.20 ± 0.06 diopters (D), 0.33 ± 0.06 D, −0.02 ± 0.06 D, 0.24 ± 0.06 D, 0.19 ± 0.06 D, 0.22 ± 0.06 D, and 0.056 ± 0.06 D, respectively (P <.001). The proportion of patients within ±0.5 D of the predicted error was 74.5%, 62.8%, 82.4%, 79.1%, 73.9%, 76.7%, and 80.4%, respectively (P =.090). Hyperopic outcomes occurred in 70.6%, 76.5%, 49.0%, 74.4%, 76.1%, 74.4%, and 45.1% of the eyes, respectively (P =.007). Conclusions Intraoperative wavefront aberrometry was better than all formulas based on preoperative biometry and as effective as the AL-optimized Holladay 1 formula in predicting residual refractive error and reducing hyperopic outcomes. The Hill-RBF formula's performance was similar to that of the fourth-generation formulas.

AB - Purpose To compare the accuracy of intraoperative wavefront aberrometry (ORA) and the Hill-radial basis function (RBF) formula with other formulas based on preoperative biometry in predicting residual refractive error after cataract surgery in eyes with axial myopia. Setting Private practice, Harrisburg, Pennsylvania, USA. Design Retrospective consecutive case series. Methods Eyes with an axial length (AL) greater than 25.0 mm had cataract extraction with intraocular lens implantation. For each eye, the 1-center Wang-Koch AL-optimized Holladay 1 formula was used to select an IOL targeting emmetropia. Residual refractive error was predicted preoperatively using the SRK/T, Holladay 1 and 2, Barrett Universal II, and Hill-RBF formulas and intraoperatively using wavefront aberrometry. The postoperative refraction was compared with the preoperative and intraoperative predictions. Results The study comprised 37 patients (51 eyes). The mean numerical errors ± standard error associated with using the SRK/T, Holladay 1, AL-optimized Holladay 1, Holladay 2, Barrett Universal II, and Hill-RBF formulas and intraoperative wavefront aberrometry were 0.20 ± 0.06 diopters (D), 0.33 ± 0.06 D, −0.02 ± 0.06 D, 0.24 ± 0.06 D, 0.19 ± 0.06 D, 0.22 ± 0.06 D, and 0.056 ± 0.06 D, respectively (P <.001). The proportion of patients within ±0.5 D of the predicted error was 74.5%, 62.8%, 82.4%, 79.1%, 73.9%, 76.7%, and 80.4%, respectively (P =.090). Hyperopic outcomes occurred in 70.6%, 76.5%, 49.0%, 74.4%, 76.1%, 74.4%, and 45.1% of the eyes, respectively (P =.007). Conclusions Intraoperative wavefront aberrometry was better than all formulas based on preoperative biometry and as effective as the AL-optimized Holladay 1 formula in predicting residual refractive error and reducing hyperopic outcomes. The Hill-RBF formula's performance was similar to that of the fourth-generation formulas.

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