• Is ORA Analysis Necessary for Cataract Surgery After LASIK?


    Question:

    I had LASIK surgery (a procedure that corrects refractive errors to reduce dependence on glasses) done 12 years ago. My vision at that time was somewhere around 9.25 in each eye. It is my understanding that a machine called a Optiwave Refractive Analysis (ORA) is needed at the time of the cataract removal and lens placement for "spot on" accuracy or at least as close as possible. Can you tell me if this ORA procedure is necessary?


    Answer:

    It is true that it is more difficult to calculate the proper intraocular lens implant correctly in someone who has had laser vision correction on the cornea. However, there are many formulas available to do this. In my experience, with the appropriate pre-operative testing that includes corneal topography and other measures of the eye, I can almost always get a very accurate result. The ORA machine uses a wavefront analysis of the eye during the operation at the point after the cataract is removed and before the intraocular lens is inserted. The information obtained is then plugged into a mathematical formula that can then calculate the proper intraocular lens. As with all methods of predicting post-operative refraction when doing cataract surgery, the ORA system is also not perfect. I have seen no data that verify that the ORA is better than existing techniques. It may prove to be in the long run but we don't know that. I think it is more important to have a surgeon that understands the issues and has access to and uses the various calculators available.


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