Evaluation of variables affecting intraoperative aberrometry

Area of Science:

• Ophthalmology
• Refractive Surgery
• Ophthalmic Technology

Background:

• Intraoperative aberrometry aims to provide real-time refractive data during cataract surgery.
• Accurate postoperative refractive outcomes depend on precise intraoperative measurements.
• Variable refractive changes during surgery can challenge the reliability of intraoperative aberrometry.

Purpose of the Study:

• To investigate refractive changes occurring during cataract surgery.
• To assess the impact of these changes on intraoperative aberrometry.
• To understand implications for postoperative refractive accuracy.

Main Methods:

• Phase 1: Assessed speculum-induced corneal cylinder and axis changes using topography.
• Phase 2: Measured refractive changes (cylinder, axis, spherical equivalent) within 1 hour and 1 week post-cataract surgery.
• Utilized wavefront aberrometry, manual refraction, and corneal topography for measurements.

Main Results:

• Eyelid speculums induced significant, erratic changes in corneal cylinder and axis (P<.0001).
• Cataract surgery led to statistically significant changes in spherical equivalent (SE) within 1 hour post-op (P=.039).
• Refractive state, including cylinder and SE, varied between immediate post-op and 1 week later.

Conclusions:

• Cataract surgery induces significant alterations in corneal cylinder, axis, and spherical equivalent.
• These refractive shifts may compromise the accuracy of intraoperative aberrometry.
• Reliance on intraoperative aberrometry alone for refractive decisions may lead to inaccuracies.