Clinical Ophthalmology (Jul 2023)

The Current Burden and Future Solutions for Preoperative Cataract-Refractive Evaluation Diagnostic Devices: A Modified Delphi Study

  • Henderson BA,
  • Aramberri J,
  • Vann R,
  • Abulafia A,
  • Ainslie-Garcia M,
  • Berdahl J,
  • Ferko N,
  • Gundersen KG,
  • Goto S,
  • Gupta P,
  • Multack S,
  • Persaud E,
  • Raoof D,
  • Savini G,
  • Shammas HJ,
  • Wang L,
  • Wang WZ

Journal volume & issue
Vol. Volume 17
pp. 2109 – 2124

Abstract

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Bonnie An Henderson,1 Jaime Aramberri,2 Robin Vann,3 Adi Abulafia,4 Margaret Ainslie-Garcia,5 John Berdahl,6 Nicole Ferko,5 Kjell Gunnar Gundersen,7 So Goto,8,9 Preeya Gupta,10,11 Samuel Multack,12– 14 Elizabeth Persaud,5 Duna Raoof,15 Giacomo Savini,16 H John Shammas,17 Li Wang,18 Wendy Zhi Wang5 1Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA; 2Ophthalmology Clinic Miranza Begitek, San Sebastian, Spain; 3Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA; 4Department of Ophthalmology, Shaare Zedek Medical Center, Hadassah Faculty of Medicine, the Hebrew University, Jerusalem, Israel; 5EVERSANA, Burlington, ON, Canada; 6Vance Thompson Vision, Sioux Falls, SD, USA; 7IFocus Øyeklinikk AS, Haugesund, Norway; 8Herbert Wertheim School Optometry and Vision Science, University of California, Berkeley, CA, USA; 9Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, Tokyo, Japan; 10Triangle Eye Consultants, Raleigh, NC, USA; 11Department of Ophthalmology, Tulane University, New Orleans, LA, USA; 12Laser and Cataract Institute, Frankfort, IL, USA; 13Advocate South Suburban Hospital, Hazel Crest, IL, USA; 14Advocate Trinity Hospital, Chicago, IL, USA; 15NVISION Eye Center, Newport Beach, CA, USA; 16IRCCS - G.B. Bietti Foundation, Rome, Italy; 17Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA; 18Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USACorrespondence: Bonnie An Henderson, Tufts University School of Medicine, Boston, MA, USA, Tel +1 617 957 9279, Email [email protected]: To obtain consensus on the key areas of burden associated with existing devices and to understand the requirements for a comprehensive next-generation diagnostic device to be able to solve current challenges and provide more accurate prediction of intraocular lens (IOL) power and presbyopia correction IOL success.Patients and Methods: Thirteen expert refractive cataract surgeons including three steering committee (SC) members constituted the voting panel. Three rounds of voting included a Round 1 structured electronic questionnaire, Round 2 virtual face-to-face meeting, and Round 3 electronic questionnaire to obtain consensus on topics related to current limitations and future solutions for preoperative cataract-refractive diagnostic devices.Results: Forty statements reached consensus including current limitations (n = 17) and potential solutions (n = 23) associated with preoperative diagnostic devices. Consistent with existing evidence, the panel reported unmet needs in measurement accuracy and validation, IOL power prediction, workflow, training, and surgical planning. A device that facilitates more accurate corneal measurement, effective IOL power prediction formulas for atypical eyes, simplified staff training, and improved decision-making process for surgeons regarding IOL selection is expected to help alleviate current burdens.Conclusion: Using a modified Delphi process, consensus was achieved on key unmet needs of existing preoperative diagnostic devices and requirements for a comprehensive next-generation device to provide better objective and subjective outcomes for surgeons, technicians, and patients.Keywords: next-generation diagnostic device, measurement accuracy and validation, IOL power prediction, surgical planning, cataract surgery

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