Predictive accuracy of an intraoperative aberrometry device for a new monofocal intraocular lens

Lindsay S Spekreijse*, Noel J C Bauer, Frank J H M van den Biggelaar, Rob W P Simons, Claudette A Veldhuizen, Tos T J M Berendschot, Rudy M M A Nuijts

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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PURPOSE: To evaluate refractive outcomes for the Clareon® monofocal IOL in terms of achieved target refraction for the ORA® Intraoperative Wavefront Aberrometry device (Alcon Laboratories,Inc.) and preoperative noncontact biometry.

SETTING: University Eye Clinic Maastricht, Maastricht University Medical Center+, the Netherlands.

DESIGN: Prospective observational clinical trial.

METHODS: Patients with bilateral age-related cataracts undergoing phacoemulsification, either by delayed sequential surgery or on the same day, were included in the study. Exclusion criteria were an increased risk of refractive surprise or complicated surgery. Implanted IOL power was based on noncontact optical biometry data using the Barrett Universal II formula (BU-II), optimized for the Clareon®IOL. Postoperative subjective refraction was measured four to six weeks after surgery. Catquest-9SF questionnaires were completed preoperatively and three months after surgery.

RESULTS: One hundred eyes (51 patients) were included. The percentage of eyes within 1.0D, 0.75D, 0.50D and 0.25D of target for ORA vs. BU-II were 84% (84 eyes), 72% (72 eyes), 57% (57 eyes) and 21% (21 eyes) vs. 97% (97 eyes), 88% (88 eyes), 77% (77 eyes) and 53% (53 eyes), respectively. Mean absolute prediction error was significantly higher for ORA vs. preoperative biometry(P<0.001). After global optimization, the prediction accuracy of ORA improved significantly (P<0.001). Catquest-9SF questionnaires showed improved levels of ability at three months after surgery (P<0.001).

CONCLUSIONS: This study showed lower percentages of eyes within target refraction for ORA (prior to lens constant optimization) compared to the BU-II formula when implanting the Clareon®IOL. However, prediction accuracy of ORA improved significantly after global optimization. Therefore, further intraoperative measurements, postoperative measurements, and optimization are needed to improve the ORA prediction for this IOL.

Original languageEnglish
Pages (from-to)542-548
Number of pages7
JournalJournal of Cataract and Refractive Surgery
Issue number5
Early online date19 Aug 2021
Publication statusPublished - May 2022

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