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Emerging Technology in Refractive Cataract Surgery.

Saraiva J, Neatrour K, Waring Iv GO - J Ophthalmol (2016)

Bottom Line: Technology in cataract surgery is constantly evolving to meet the goals of both surgeons and patients.Recent major advances in refractive cataract surgery include innovations in preoperative and intraoperative diagnostics, femtosecond laser-assisted cataract surgery (FLACS), and a new generation of intraocular lenses (IOLs).This paper presents the latest technologies in each of these major categories and discusses how these contributions serve to improve cataract surgery outcomes in a safe, effective, and predictable manner.

View Article: PubMed Central - PubMed

Affiliation: Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USA.

ABSTRACT
Technology in cataract surgery is constantly evolving to meet the goals of both surgeons and patients. Recent major advances in refractive cataract surgery include innovations in preoperative and intraoperative diagnostics, femtosecond laser-assisted cataract surgery (FLACS), and a new generation of intraocular lenses (IOLs). This paper presents the latest technologies in each of these major categories and discusses how these contributions serve to improve cataract surgery outcomes in a safe, effective, and predictable manner.

No MeSH data available.


Related in: MedlinePlus

The ORA device attached to the operating microscope.
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fig2: The ORA device attached to the operating microscope.

Mentions: Patients with a history of corneal refractive surgery expect reduced dependence on spectacles after cataract surgery. The use of intraoperative aberrometry can adjunctively guide the future of IOL power selection [18]. The Optiwave Refractive Analysis (ORA, Alcon, Fort Worth, TX) uses wavefront interferometry to produce a fringe pattern, and distortions in this pattern are translated into refractive values and aphakic and pseudophakic readings (Figure 2) [19]. Hatch et al. studied mean postoperative residual refractive astigmatism in patients receiving toric IOLs with power selection aided by intraoperative aberrometry. Surgeons altered cylindrical power 24% of the time and spherical power 35% of the time. Patients were 2.4 times more likely to have less than 0.50 D of residual refractive astigmatism when intraoperative aberrometry was used [20]. In contrast, Huelle et al. published a study where aphakic spherical equivalent- (SE-) based IOL formulas were generated from repeated intraoperative wavefront aphakic measurements of SE. The agreement of repeated aphakic SE readings ranged from −0.69 diopters to +0.66 diopters. The authors concluded that measurement precision is limiting reliability of intraoperative aberrometry and application to routine cataract surgery [21]. However, it may be useful in guiding limbal relaxing incision enhancements and has resulted in the need for fewer subsequent laser enhancements [22]. This technology is particularly useful in postrefractive patients and those with astigmatism uncertainty or other corneal pathology. However, barriers exist, such as financial, temporal, and workflow considerations. Other intraoperative inconsistencies include cyclotorsion, variable anterior chamber depth and intraocular pressure, variability in wound hydration, and use of viscoelastic device versus balanced salt solution [18]. Although limitations may exist in quality and measurement precision, the future of this technology is promising.


Emerging Technology in Refractive Cataract Surgery.

Saraiva J, Neatrour K, Waring Iv GO - J Ophthalmol (2016)

The ORA device attached to the operating microscope.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4940542&req=5

fig2: The ORA device attached to the operating microscope.
Mentions: Patients with a history of corneal refractive surgery expect reduced dependence on spectacles after cataract surgery. The use of intraoperative aberrometry can adjunctively guide the future of IOL power selection [18]. The Optiwave Refractive Analysis (ORA, Alcon, Fort Worth, TX) uses wavefront interferometry to produce a fringe pattern, and distortions in this pattern are translated into refractive values and aphakic and pseudophakic readings (Figure 2) [19]. Hatch et al. studied mean postoperative residual refractive astigmatism in patients receiving toric IOLs with power selection aided by intraoperative aberrometry. Surgeons altered cylindrical power 24% of the time and spherical power 35% of the time. Patients were 2.4 times more likely to have less than 0.50 D of residual refractive astigmatism when intraoperative aberrometry was used [20]. In contrast, Huelle et al. published a study where aphakic spherical equivalent- (SE-) based IOL formulas were generated from repeated intraoperative wavefront aphakic measurements of SE. The agreement of repeated aphakic SE readings ranged from −0.69 diopters to +0.66 diopters. The authors concluded that measurement precision is limiting reliability of intraoperative aberrometry and application to routine cataract surgery [21]. However, it may be useful in guiding limbal relaxing incision enhancements and has resulted in the need for fewer subsequent laser enhancements [22]. This technology is particularly useful in postrefractive patients and those with astigmatism uncertainty or other corneal pathology. However, barriers exist, such as financial, temporal, and workflow considerations. Other intraoperative inconsistencies include cyclotorsion, variable anterior chamber depth and intraocular pressure, variability in wound hydration, and use of viscoelastic device versus balanced salt solution [18]. Although limitations may exist in quality and measurement precision, the future of this technology is promising.

Bottom Line: Technology in cataract surgery is constantly evolving to meet the goals of both surgeons and patients.Recent major advances in refractive cataract surgery include innovations in preoperative and intraoperative diagnostics, femtosecond laser-assisted cataract surgery (FLACS), and a new generation of intraocular lenses (IOLs).This paper presents the latest technologies in each of these major categories and discusses how these contributions serve to improve cataract surgery outcomes in a safe, effective, and predictable manner.

View Article: PubMed Central - PubMed

Affiliation: Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USA.

ABSTRACT
Technology in cataract surgery is constantly evolving to meet the goals of both surgeons and patients. Recent major advances in refractive cataract surgery include innovations in preoperative and intraoperative diagnostics, femtosecond laser-assisted cataract surgery (FLACS), and a new generation of intraocular lenses (IOLs). This paper presents the latest technologies in each of these major categories and discusses how these contributions serve to improve cataract surgery outcomes in a safe, effective, and predictable manner.

No MeSH data available.


Related in: MedlinePlus