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ORA helps prevent postop surprise in high myopes, hyperopes

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SAN DIEGO — Intraoperative aberrometry calculations more accurately determined IOL power than did two standard IOL formulas in certain patients, according to a study presented here.

Samuel F. Passi , MD, and colleagues at Duke University evaluated whether calculations made with the ORA (Alcon) could improve upon calculations made with either the Barrett Universal formula or the Holladay 1 formula in highly myopic and highly hyperopic eyes. In post-refractive eyes, calculations made with ORA were compared with those of the Barrett True K formula.

“Overall ORA had a lower mean absolute error and a higher percentage of patients within 0.5 D, 0.75 D and 1 D of the refractive predicted error compared to Holladay 1 and Barrett Universal 2; however, in post-refractive eyes there was no significant difference between the performance of ORA and the Barrett True K,” Passi said at the American Society of Cataract and Refractive Surgery annual meeting.

The study included 198 eyes of 138 patients, including 107 high myopes, 23 high hyperopes, 41 post-myopic LASIK/PRK, 15 post hyperopic LASIK/PRK, and 12 post RK. Preoperatively, the standard formulas were used to choose an IOL in each case based on a selected refractive target. The ORA calculations were made intraoperatively based on the same target.

“The final lens always was based on the ORA suggested IOL,” Passi said.

When a lens change was made based on the intraoperative calculations, hyperopic surprise was prevented with a higher power lens change in 15 of 55 eyes (27%), and excess myopia was mitigated with a lower power lens change in 19 of 41 eyes (46%). – by Patricia Nale, ELS

Reference: Passi SF. Refractive outcomes using intraoperative aberrometry for highly myopic, highly hyperopic and post-refractive eyes. Presented at: American Society of Cataract and Refractive Surgery annual meeting; May 3-7, 2019; San Diego.

Disclosure: Passi reports no relevant financial disclosures. The study was supported in part by an Alcon Investigator-initiated Trial research grant.