Clinical Ophthalmology (Apr 2022)

Comparison of the Accuracy of Intraoperative Aberrometry in Intraocular Lens Implantation Between Myopic Eyes with Emmetropia and Myopia Targets

  • Sakai D,
  • Demoto S,
  • Iwai Y,
  • Hirami Y,
  • Nakamura M,
  • Kurimoto Y

Journal volume & issue
Vol. Volume 16
pp. 1165 – 1171

Abstract

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Daiki Sakai,1– 3 Sakiko Demoto,1,2 Yukako Iwai,1,2 Yasuhiko Hirami,1,2 Makoto Nakamura,3 Yasuo Kurimoto1,2 1Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan; 2Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Japan; 3Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, JapanCorrespondence: Daiki Sakai, Department of Ophthalmology, Kobe City Eye Hospital, 2-1-8 Minatojima Minamimachi, Chuo-ku, Kobe-shi, Hyogo, 650-0047, Japan, Tel +81-78-381-9876, Fax +81-78-381-9910, Email [email protected]: To compare the accuracy of intraoperative aberrometry (IA) for predicting postoperative refraction between eyes with emmetropia and myopia targets.Patients and Methods: This retrospective analysis included patients with axial myopia (axial length ≥ 25.0 mm) who underwent uncomplicated phacoemulsification cataract surgery with IA to achieve emmetropia (plano to − 0.5 D) or intentional myopia (− 2.5 D to − 5.0 D). Preoperative ocular biometry was performed in all eyes using an IOLMaster. Refractive prediction errors in IA were compared between eyes with emmetropia and myopia targets. Refractive prediction errors in IA for both groups were also compared with those predicted by intraocular lens power calculation formulas including the SRK/T, Holladay 1, Hoffer Q, Holladay 2, Haigis, and Barrett Universal II formulas.Results: Thirty-nine eyes of 39 patients with a target of emmetropia and 22 eyes of 22 patients with a target of intentional myopia were included in the final analysis. The mean numerical error was significantly different from zero (myopic trend) in myopia-targeted eyes (− 0.37 ± 0.54 D, one-sample t-test, P = 0.004, 95% confidence interval: − 0.61 to − 0.14), while it was close to zero in emmetropia-targeted eyes. The mean absolute error was significantly smaller in emmetropia-targeted eyes (0.28 ± 0.27 D) than in myopia-targeted eyes (0.51 ± 0.41 D, P = 0.01). IA was revealed as the most accurate method for predicting postoperative refraction in eyes with emmetropia target, whereas Barrett Universal II formula was found to be the most accurate for eyes with myopia target.Conclusion: In patients with axial myopia, the performance of IA was altered when targeting intentional myopia compared with emmetropia. Myopic shift in the refractive outcome should be considered when IA is used to target myopia.Keywords: cataract surgery, postoperative refraction, intentional myopia, axial myopia, intraocular lens calculation formula

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