Evaluation of variables affecting intraoperative aberrometry

PurposeTo understand some of the variable refractive changes that occur during routine cataract surgery that could affect the accuracy and effectiveness of intraoperative aberrometry as it relates to the postoperative refractive state.SettingJohn A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.DesignComparative case series.MethodsPhase 1 of this study assessed the cylinder induced by 2 eyelid speculums (open wire and closed wire) with corneal topographic images from participants without cataract. Phase 2 assessed the refractive change in cylinder, its axis, and the spherical equivalent (SE) in cataract patients within 1 hour of cataract surgery compared with 1 week after surgery. These measurements were taken using wavefront aberrometry, manual refraction, and corneal topography.ResultsPhase 1 evaluated 99 corneal topographic images from 5 participants. The presence of a speculum induced erratic changes in cylinder and a statistically significant difference in axis when comparing the open-wire speculum and the closed-wire speculum (both P<.0001). In phase 2, which evaluated 10 patients, there was a significant change in the SE within 1 hour of cataract surgery compared with 1 week after surgery (P=.039).ConclusionCataract surgery induced changes in cylinder, its axis, and the SE. This suggests that decisions based on intraoperative aberrometry may be inaccurate.Financial DisclosureDr. Olson has been a consultant to Abbott Medical Optics, Inc., Becton, Dickinson and Co., and Allergan, Inc., and has received grant support from Abbott Medical Optics, Inc. and Allergan, Inc. No author has a financial or proprietary interest in any material or method mentioned.