J Refract Surg. 2022 May;38(5):304-309. doi: 10.3928/1081597X-20220331-01. Epub 2022 May 1.
To compare prediction error outcomes between the Optiwave Refractive Analysis System (ORA) (Alcon Laboratories, Inc) and two modern intraocular lens (IOL) formulas (Hill-RBF2.0 [HRBF] and Barrett Universal II [BUII]), and further analyze IOL selection in scenarios of disagreement between methods.
Patients with no previous history of corneal refractive surgery who underwent cataract extraction and had intraoperative aberrometry measurements between October 2016 and December 2019 were analyzed. The prediction error for the ORA, HRBF, and BUII were calculated based on the postoperative manifest refraction. Further analysis was performed evaluating prediction error for scenarios of disagreement between the three methods.
After exclusions, 281 eyes were included. The mean absolute prediction errors were 0.28 diopters (D) (ORA), 0.31 D (HRBF), and 0.33 D (BUII) ( < .05). In instances when the IOL recommended by the ORA was in disagreement with what was selected preoperatively, there was no benefit when the lens recommended by the ORA was selected based on anecdotal experience. When further analyzing these instances of disagreement, selecting the ORA-recommended lens when it is higher in power results in improved refractive outcomes: the ORA resulted in more eyes within ±0.25 diopters (D) of predicted spherical error (65% ORA, 37% HRBF, 32% BUII; = .004) and fewer hyperopic surprises (5% ORA, 15% HRBF, 24% BUII; = .009).
In normal eyes without previous corneal refractive surgery, intraoperative aberrometry is not different from to two modern preoperative IOL formulas. Placing the ORA-recommended lens when it is higher in power than that selected preoperatively results in better refractive outcomes. .
比较 Optiwave 屈光分析系统（ORA）（爱尔康实验室公司）与两种现代人工晶状体（IOL）公式（Hill-RBF2.0[HRBF]和 Barrett 通用 II[BUII]）之间的预测误差结果，并进一步分析方法之间存在差异的情况下 IOL 的选择。
分析了 2016 年 10 月至 2019 年 12 月期间接受白内障摘除术且术中存在像差测量的无先前角膜屈光手术史的患者。根据术后主观折射计算 ORA、HRBF 和 BUII 的预测误差。进一步分析了三种方法之间存在差异的情况下预测误差的情况。
排除后，共纳入 281 只眼。ORA 的平均绝对预测误差为 0.28 屈光度（D），HRBF 为 0.31 D，BUII 为 0.33 D（均<0.05）。在 ORA 推荐的 IOL 与术前选择的 IOL 存在差异的情况下，如果根据经验选择 ORA 推荐的镜片，则没有好处。当进一步分析这些存在差异的情况时，当 ORA 推荐的镜片的功率较高时，选择该镜片可以改善屈光结果：ORA 使更多的眼在预测的球镜误差的±0.25 屈光度（D）范围内（65%的 ORA，37%的 HRBF，32%的 BUII；=0.004），并且更少的远视惊喜（5%的 ORA，15%的 HRBF，24%的 BUII；=0.009）。
在没有先前角膜屈光手术史的正常眼中，术中像差与两种现代术前 IOL 公式没有差异。当 ORA 推荐的镜片的功率高于术前选择的镜片时，放置 ORA 推荐的镜片可以获得更好的屈光结果。
