Accuracy of Intraoperative Aberrometry-Based Prediction of Postoperative Refraction and Astigmatism After Novel Toric...

This study prospectively assessed the refractive and astigmatism prediction accuracy of intraoperative aberrometry, Optiwave Refractive Analysis (ORA), in eyes implanted with Clareon toric intraocular lenses (IOLs).

Patients with age-related cataracts who underwent phacoemulsification and toric IOL implantation using ORA were prospectively included in this single-center study. The absolute refractive prediction error (RPE) and rate of RPE for ORA, Sanders-Retzlaff-Kraft/Theoretical (SRK/T), and Barrett Universal II were evaluated 3 months after surgery. Uncorrected visual acuity (UCVA), residual astigmatism, refractive astigmatism prediction error, and the difference between the preoperatively planned axis and actual inserted axis recommended by ORA were assessed.

Eighty eyes (80 patients, mean age: 75.0 ± 8.8 years) were included in this study. Mean ± standard deviation (SD) of preoperative corneal astigmatism was 1.91 ± 1.03 D. The median absolute RPE values for ORA, SRK/T, and Barrett Universal II were 0.17, 0.14, and 0.14 D, respectively. At the 3-month follow-up after surgery, the mean ± SD of UCVA and residual astigmatism were 0.06 ± 0.16 logarithm of the minimum angle of resolution and 0.43 ± 0.48 D, respectively. The refractive astigmatism prediction errors were 0.11 D in the centroid for both ORA and the Barrett toric formula, at 67° and 63°, respectively. The mean absolute values were 0.38 D for ORA and 0.41 D for the Barrett toric formula. The median absolute value of the axis difference between the planned and actual inserted axes based on ORA was 4.00°.

The accuracy of ORA in the prediction of spherical refraction and astigmatism was comparable to that of the preoperative IOL calculation formula in eyes with Clareon toric IOLs. ORA is a useful tool for determining IOL power and improving preoperative corneal astigmatism.