Expert: ORA system significantly changed cataract surgery
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Alcon’s ORA system provides real-time measurements during cataract surgery, including total ocular astigmatism.
The device uses intraoperative aberrometry, as well as inputs on postoperative outcomes, to help select customized IOLs for each eye.
Healio/OSN spoke with Lawrence Woodard, MD, medical director of Omni Eye Services in Atlanta, about his experiences with the ORA system, which he has been using since 2015.
Healio/OSN: What made you interested in using the ORA system as a cataract surgeon?
Woodard: What intrigued me the most was the ability to more accurately manage astigmatism due to the aphakic capability of the ORA system. When we learned about the role that the posterior cornea plays in total corneal astigmatism, that is when I started paying more attention to ORA.
I was also interested in its ability to fine-tune the spherical power through aphakic refraction. I do a lot of premium lenses, and achieving refractive targets is important in my practice. I wanted to do everything I could to accomplish that. The ORA, in addition to our A-scans, was a valuable tool to help accomplish that.
Healio/OSN: How has your management of patients undergoing cataract surgery changed since adopting the ORA system?
Woodard: It has changed significantly. Before ORA, I would only use A-scan and a toric calculator to predict how much total corneal astigmatism a patient had. That means only using preoperative measurements and population averages to select an IOL power for a specific patient.
After getting ORA, I now have the ability to perform an aphakic refraction that is specific for each eye. I feel that I am much more accurate with obtaining the refractive outcome I am trying to accomplish because I am using more specific information for the eye and not going only on averages.
It is also good in post-refractive eyes. Traditionally, we were using formulas to predict the right spherical power for patients after they have undergone LASIK or any other refractive surgery. Incorporating the aphakic refraction into the A-scan measurement gives us an added level of accuracy beyond just simply using preoperative measurements.
Healio/OSN: Do you have any advice for other surgeons who might be looking to adopt the ORA system?
Woodard: One of the things I have heard from other surgeons that might be preventing them from acquiring new technologies is that they feel the learning curve is too prolonged. That was not my experience with ORA. I do not think it takes too many cases to become comfortable with it.
It is also important for surgeons to input their postoperative data into the system so that the technology can customize each IOL and make them specific for each surgeon. If you are not entering that postoperative data, you are not gaining all of the benefits that the analyzer offers. The data also give you the ability to communicate with the other technologies in the cataract refractive suite and to prevent manual transcription errors.
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