October 25, 2017
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Intraoperative aberrometry provides more data for better IOL outcomes

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NEW YORK — Using an intraoperative aberrometer for IOL procedures can provide additional data for the refractive vergence formula and lead to better outcomes in complex and normal eyes, according to a speaker here.

“I use ORA on every case. It has become a timeout for me. It’s become a way to use another formula. It’s very good for post-LASIK and PRK eyes, for toric IOL power and alignment, and for long eyes,” Nicole R. Fram, MD, said at OSN New York 2017.

The ORA system with VerifEye+ (Alcon) makes an IOL power recommendation and creates nomograms for normal and complex eyes. The ORA outperforms, according to some studies in the literature, the standard formula and achieves 0.5 D or less of residual astigmatism in 89% of patients compared with 76% of patients using the traditional formula, she said.

“We’re seeing evidence-based data to support that this technology, if used properly, can help improve outcomes,” Fram said.

To improve accuracy, information going into the ORA must be confirmed as accurate, such as axial length or white-to-white distance. The surgeon must check entries and the post-refractive boxes, avoid overhydration of the main incision and pressurize the eye to approximately 22 mm Hg for the inside ring, she said.

“This is a formula. Garbage in, garbage out,” she said.

In summary, Fram noted the ORA can increase reliability in toric or post-laser vision corrected eyes, but surgeons should be cautious about using the ORA in RK eyes or eyes with highly irregular corneas. – by Robert Linnehan

Reference:

Fram NR. What’s in the magic box? Intraoperative aberrometry. Presented at: OSN New York 2017; Oct. 20 to 22, 2017; New York.

Disclosure: Fram reports she receives consulting fees for Alcon (Novartis), Allergan, Bio-Tissue and SightLife; is on the speakers bureau for Abbott Medical Optics/Johnson & Johnson Vision, Alcon (Novartis), Bausch + Lomb/Valeant, Bio-Tissue, Shire and Sun Pharmaceutical; and receives nonfinancial grant support from Accutome.