EyeWorld India March 2015 Issue

IOL Calculations March 2015 30 EWAP SECONDARY FEATURE Intraoperative aberrometry helps steer surgical outcomes by Vanessa Caceres EyeWorld Contributing Writer While the technology has a learning curve, pearls can assist in overcoming those challenges M ore cataract surgeons are turning to intraoperative aberrometry to help identify a precise IOL power for patients. Yet how does the technology work, and what variables can affect outcomes? EyeWorld asked some experts in the field for answers. “The devices are made from the idea of measuring the eye while we are operating to gather refractive information to help make decisions,” said Robert Weinstock, MD , The Eye Institute of West Florida, Largo, Fla. “The raw data translates into AT A GLANCE • Intraoperative aberrometry is helping to improve cataract surgery outcomes, particularly in patients with previous laser refractive surgery or those receiving a toric IOL. • The technology has a learning curve; surgeons should monitor IOP, the tear film, and patient positioning during its use. • Surgeons should always have a back-up plan in place and check intraoperative aberrometry’s results against their preop readings. The technology evolution Intraop aberrometry equipment Source (all): Sean Ianchulev, MD, MPH a prescription after it’s taken through different formulas,” said Jonathan Solomon, MD , Solomon Eye Physicians & Surgeons, Bowie, Md. “It guides refinement in hopes of achieving a better outcome refractively.” “Intraoperative aberrometry works by using a Talbot-Moire waveform aberrometer to measure the optical powers of the eye at the time of surgery, such as aphakic and pseudophakic, as well as astigmatic residuals,” said Sean Ianchulev, MD, MPH, clinical associate professor, University of California, San Francisco, and chief medical officer, Transcend Medical, Menlo Park, Calif. “This is then used to derive precise IOL power.” Dr. Ianchulev holds 4 patents for intraoperative aberrometry related to the ORA system (Alcon, Fort Worth, Texas). In the United States currently, the ORA system, and the HOLOS IntraOp (Clarity Medical Systems, Pleasanton, Calif.) are approved for use. There are other systems available outside the U.S. This article will focus on pearls for using these devices. Specific information about each system will be featured in future issues of EyeWorld . The devices continue to evolve and become more accurate, said Shamik Bafna, MD , Cleveland Eye Clinic, Cleveland. The technology across platforms works particularly well for patients with previous laser surgery and for patients who require a toric IOL, he said. It also is especially useful in eyes that are longer or shorter than usual, Dr. Ianchulev said. In a study of 246 eyes published last year in