Time Utilization and Refractive Prediction Enhancement Associated with Intraoperative Aberrometry Use During Cataract Surgery

Karen L Christopher,1 Jennifer L Patnaik,1 Cristos Ifantides,1 D Claire Miller,1 Richard S Davidson,1 Michael J Taravella,1 Anne Lynch,1 Brandie Wagner2 1University of Colorado Anschutz Medical Campus, Department of Ophthalmology, Aurora, CO, USA; 2Colorado School of Public Health, Department of Bio...

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Main Authors: Christopher KL, Patnaik JL, Ifantides C, Miller DC, Davidson RS, Taravella MJ, Lynch A, Wagner B
Format: Article
Language:English
Published: Dove Medical Press 2021-02-01
Series:Clinical Ophthalmology
Subjects:
Online Access:https://www.dovepress.com/time-utilization-and-refractive-prediction-enhancement-associated-with-peer-reviewed-article-OPTH
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author Christopher KL
Patnaik JL
Ifantides C
Miller DC
Davidson RS
Taravella MJ
Lynch A
Wagner B
author_facet Christopher KL
Patnaik JL
Ifantides C
Miller DC
Davidson RS
Taravella MJ
Lynch A
Wagner B
author_sort Christopher KL
collection DOAJ
description Karen L Christopher,1 Jennifer L Patnaik,1 Cristos Ifantides,1 D Claire Miller,1 Richard S Davidson,1 Michael J Taravella,1 Anne Lynch,1 Brandie Wagner2 1University of Colorado Anschutz Medical Campus, Department of Ophthalmology, Aurora, CO, USA; 2Colorado School of Public Health, Department of Biostatistics and Informatics, Aurora, CO, USACorrespondence: Karen L Christopher 1675 Aurora Ct MS 731, Aurora, CO, 80045, USATel +1 720-848-2508Fax +1 720-848-5014Email karen.christopher@cuanschutz.eduPurpose: To evaluate the time cost of intraoperative aberrometry (IA), to compare IA prediction error to the prediction error associated with conventional formulas using preoperative calculations (PC) and evaluate when IA provides clinically relevant benefit.Methods: This is a retrospective study of eyes that underwent cataract phacoemulsification surgery with IA at an academic eye center. IA versus PC prediction error were compared amongst various preoperative and intraoperative characteristics. Additionally, a dichotomous variable indicating clinically relevant benefit of IA, where IA absolute prediction error was less than 0.5D and PC absolute prediction error greater than 0.5D, was associated with clinical factors.Results: Five hundred eyes of 341 patients were included in the analysis. The quantitative difference between mean absolute prediction errors for IA versus PC was between 0.0D and 0.03D in most subgroups. For the 11.0% of eyes that had clinically relevant benefit to IA, the multivariable model identified the following strongest predictors: prior myopic corneal refractive surgery (Odds ratio (OR) 3.9, p< 0.01 for myopic LASIK/PRK, OR 5.5, p=0.01 for radial keratotomy), toric or multifocal/EDOF lens implantation (OR 2.7, p=0.03 for toric monofocal lenses, OR 3.1, p=0.01 for EDOF/multifocal lenses), and short and long axial lengths (p< 0.01). On average, IA implementation added 3.0 minutes to surgery (p< 0.01).Conclusion: For greatest likelihood of a clinically meaningful improvement in outcomes despite increased surgical time, surgeons and patients should consider using IA for eyes with extremes in axial length, eyes with prior myopic corneal refractive surgery, or when implanting lenses with toric or extended-depth-of-focus/multifocal properties.Keywords: intraoperative aberrometry, IOL calculations, cataract refractive outcomes
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spelling doaj.art-4d2e2f30570047849361a0c700a0e49b2022-12-21T21:21:07ZengDove Medical PressClinical Ophthalmology1177-54832021-02-01Volume 1553153961980Time Utilization and Refractive Prediction Enhancement Associated with Intraoperative Aberrometry Use During Cataract SurgeryChristopher KLPatnaik JLIfantides CMiller DCDavidson RSTaravella MJLynch AWagner BKaren L Christopher,1 Jennifer L Patnaik,1 Cristos Ifantides,1 D Claire Miller,1 Richard S Davidson,1 Michael J Taravella,1 Anne Lynch,1 Brandie Wagner2 1University of Colorado Anschutz Medical Campus, Department of Ophthalmology, Aurora, CO, USA; 2Colorado School of Public Health, Department of Biostatistics and Informatics, Aurora, CO, USACorrespondence: Karen L Christopher 1675 Aurora Ct MS 731, Aurora, CO, 80045, USATel +1 720-848-2508Fax +1 720-848-5014Email karen.christopher@cuanschutz.eduPurpose: To evaluate the time cost of intraoperative aberrometry (IA), to compare IA prediction error to the prediction error associated with conventional formulas using preoperative calculations (PC) and evaluate when IA provides clinically relevant benefit.Methods: This is a retrospective study of eyes that underwent cataract phacoemulsification surgery with IA at an academic eye center. IA versus PC prediction error were compared amongst various preoperative and intraoperative characteristics. Additionally, a dichotomous variable indicating clinically relevant benefit of IA, where IA absolute prediction error was less than 0.5D and PC absolute prediction error greater than 0.5D, was associated with clinical factors.Results: Five hundred eyes of 341 patients were included in the analysis. The quantitative difference between mean absolute prediction errors for IA versus PC was between 0.0D and 0.03D in most subgroups. For the 11.0% of eyes that had clinically relevant benefit to IA, the multivariable model identified the following strongest predictors: prior myopic corneal refractive surgery (Odds ratio (OR) 3.9, p< 0.01 for myopic LASIK/PRK, OR 5.5, p=0.01 for radial keratotomy), toric or multifocal/EDOF lens implantation (OR 2.7, p=0.03 for toric monofocal lenses, OR 3.1, p=0.01 for EDOF/multifocal lenses), and short and long axial lengths (p< 0.01). On average, IA implementation added 3.0 minutes to surgery (p< 0.01).Conclusion: For greatest likelihood of a clinically meaningful improvement in outcomes despite increased surgical time, surgeons and patients should consider using IA for eyes with extremes in axial length, eyes with prior myopic corneal refractive surgery, or when implanting lenses with toric or extended-depth-of-focus/multifocal properties.Keywords: intraoperative aberrometry, IOL calculations, cataract refractive outcomeshttps://www.dovepress.com/time-utilization-and-refractive-prediction-enhancement-associated-with-peer-reviewed-article-OPTHintraoperative aberrometryiol calculationscataract refractive outcomes
spellingShingle Christopher KL
Patnaik JL
Ifantides C
Miller DC
Davidson RS
Taravella MJ
Lynch A
Wagner B
Time Utilization and Refractive Prediction Enhancement Associated with Intraoperative Aberrometry Use During Cataract Surgery
Clinical Ophthalmology
intraoperative aberrometry
iol calculations
cataract refractive outcomes
title Time Utilization and Refractive Prediction Enhancement Associated with Intraoperative Aberrometry Use During Cataract Surgery
title_full Time Utilization and Refractive Prediction Enhancement Associated with Intraoperative Aberrometry Use During Cataract Surgery
title_fullStr Time Utilization and Refractive Prediction Enhancement Associated with Intraoperative Aberrometry Use During Cataract Surgery
title_full_unstemmed Time Utilization and Refractive Prediction Enhancement Associated with Intraoperative Aberrometry Use During Cataract Surgery
title_short Time Utilization and Refractive Prediction Enhancement Associated with Intraoperative Aberrometry Use During Cataract Surgery
title_sort time utilization and refractive prediction enhancement associated with intraoperative aberrometry use during cataract surgery
topic intraoperative aberrometry
iol calculations
cataract refractive outcomes
url https://www.dovepress.com/time-utilization-and-refractive-prediction-enhancement-associated-with-peer-reviewed-article-OPTH
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