Refractive Accuracy of Intraoperative Aberrometry for a New-Material Trifocal Intraocular Lens: A Multicenter,...

We evaluated the refractive accuracy of the Optiwave Refractive Analysis (ORA) system in eyes implanted with a new-material trifocal intraocular lens (IOL), CNWT (Clareon PanOptix), and compared it to preoperative IOL power calculation formulas.

In this multicenter, prospective, observational study, CNWTT0 was implanted based on intraoperative ORA measurements. The absolute refractive prediction error (RPE) and the percentage of eyes with the absolute RPE were compared between ORA and three formulas: Sanders-Retzlaff-Kraff/Theoretical (SRK/T), Barrett Universal II (Barrett U II), and Haigis. Monocular uncorrected distance (UCVA), intermediate (UIVA), and near visual acuity (UNVA) were evaluated.

Seventy-eight eyes (78 patients) were included. Mean absolute RPE for ORA, SRK/T, Barrett U II, and Haigis were 0.24 ± 0.20, 0.28 ± 0.20, 0.23 ± 0.19, and 0.35 ± 0.24 diopters (D), respectively. ORA showed significantly lower absolute RPE than Haigis (p<0.001), but no significant difference from SRK/T and Barrett U II. Significant differences were also found between Barrett U II and SRK/T (p<0.004) and between Barrett U II and Haigis formulas (p<0.0001). The percentage of eyes with an absolute RPE ≤ 0.25 D was significantly higher with ORA (61.5%) and Barrett U II (65.4%) than those with SRK/T and Haigis (p<0.05 for both comparisons). No significant differences were observed for the absolute RPE ≤ 0.5 D among the groups. The mean ± standard deviation UCVA, UIVA, and UNVA were -0.01 ± 0.07, 0.08 ± 0.12, and 0.06 ± 0.10 logMAR, respectively.

The ORA system provides accurate refractive prediction and favorable clinical outcomes for the new trifocal IOL. Whereas its accuracy was comparable to that of the Barrett Universal II formula, the ORA system achieved more favorable outcomes than conventional formulas. Integrating intraoperative validation with preoperative calculations offers a robust strategy to minimize refractive surprises and optimize clinical results.