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Jackson lecturer seeks ways to reduce corneal measurement inaccuracies
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CHICAGO — A healthy cornea, optimal tear function, accurate devices capable of taking both anterior and posterior measurements, and ways to noninvasively adjust postoperative refraction can help a surgeon accurately record cornea measurements and IOL calculations, Douglas D. Koch, MD, said in his delivery of the Jackson Memorial Lecture here.
“The requirement that we have for reducing and managing corneal measurement errors, is, of course, [that] our patient’s corneas need to be optimized. They need to be as healthy as possible with optimal tear function,” Koch said at the American Academy of Ophthalmology meeting. “We need well trained technicians, and we need to be skeptical surgeons to critically evaluate the data provided to us. And, presumably, we’ll get data from more than one device in order to cross check.”
Douglas D. Koch
The Hill-RBF calculator, which accounts for both posterior and anterior measurements, is 91% accurate in calculating IOL power within 0.5 D of predicted value, Koch said, noting also that this results in one in every 11 cases being inaccurate.
“Our measuring devices need to be capable of measuring not only the anterior, but [also] the posterior cornea so that we’re hopefully able to measure almost all of our corneas preoperatively, [allowing] us to get it right the first time,” Koch said.
Intraoperative aberrometry “clearly plays a role,” Koch said, adding that he was “very intrigued” by methods to avoid the need to adjust postoperative refraction. – by Robert Linnehan
Reference:
Koch DD. Hiding in plain sight: The enigmatic cornea and IOL calculations. Presented at: American Academy of Ophthalmology annual meeting; Oct. 14-18, 2016; Chicago.
Disclosure: Koch reports he is a consultant for Abbott Medical Optics, Alcon, Bausch + Lomb, Clarity, PerfectLens, PowerVision, Revision Optics and TrueVision. Koch reports he has financial interest in i-Optics, Ivantis and Ziemer.