Effect of intraoperative aberrometry on the rate of postoperative enhancement: retrospective study

To determine whether the use of intraoperative wavefront aberrometry reduces the frequency of postoperative laser enhancements over the rate in cases in which aberrometry was not used.

Private surgical center and private practice, Eugene, Oregon, USA.

This was a retrospective case-control chart review of patients who chose to have correction of preexisting corneal astigmatism by limbal relaxing incisions (LRIs) at the time of cataract surgery or refractive lens exchange. In the aberrometry group, an ORange wavefront aberrometer was used intraoperatively to measure total ocular refractive cylinder after intraocular lens implantation and to guide LRI enhancement. A group in which the aberrometer was not used served as the control.

The control group had 37 eyes and the aberrometry group, 30 eyes. The excimer laser enhancement rate was 3.3% in the aberrometry group and 16.2% in the control group. The mean postoperative cylinder was 0.48 diopter (D) in the control group and 0.37 D in the aberrometry group. Residual cylindrical refractive error, not sphere, determined the patients' decision to have enhancement.

The use of intraoperative wavefront aberrometry to measure and enhance the effect of LRIs produced a nonsignificant trend that led to a 5.7-fold reduction in the odds ratio of subsequent excimer laser enhancement.