Intraoperative wavefront aberrometry shows low success rate

This prospective study found a very low success rate and high variation in measurements for wavefront aberrometry performed during cataract surgery.

This is the first report addressing quality and reproducibility of wavefront aberrometry in a large sample. This appears to be a tool that shows promise but is not yet ready for reliance as the sole method of IOL determination.

The authors used Wavefront Supported Custom Ablation (Zeiss Meditec, Germany) to record intraoperative wavefront aberrometry at seven defined measurement points during standard cataract surgery in 74 eyes of 74 consecutive patients (mean age 69 ± 11.3 years).

Of 814 wavefront aberrometry attempts, only 462 actual measurements (56.8%) were obtained. The most successful readings were obtained in the aphakic state with viscoelastic in the anterior chamber. There was good reliability in the repeatability of measurements, but the limits of agreement with regards to spherical equivalence (>1.5 D) was large.

The authors conclude that although intraoperative wavefront aberrometry seems feasible without interrupting the surgical workflow, more efforts are required to improve the precision and quality of measurements before it can be used to guide the surgical refractive plan in cataract surgery.