Presenting clinical experience and case sharing of Vivinex Gemetric IOL

張正忠 Cheng-Jong Chang Moderator

Prin RojanapongpunThailand Speaker Intraoperative Aberrometry: Benefits or Distractions?Intraoperative Aberrometry (IA) is a microscope-mounted aberrometer that uses a laser wavefront analyzer to provide an intraoperative refractometer with live measurement. IA utilizes real-time wavefront analysis to measure IOL power in the aphakic state (after I&A but before IOL implantation), guiding Toric IOL axis alignment, and confirming final refraction in the pseudophakic stage (after IOL implantation). IA serves as an IOL power verification process by providing aphakic measurements. IA has demonstrated improved accuracy compared to preoperative biometry and is most beneficial in complex cases, including post-refractive surgery eyes, eyes with uncertainty in preoperative biometry, and cases involving premium and toric IOL implantation, which results in less postoperative residual astigmatism. IA accuracy is highly dependent on meeting specific intraoperative conditions. Erroneous measurements can occur due to factors like eyelid squeezing, speculum pressure, eye position/fixation, abnormal eye pressure, media conditions (OVD type and refractive index), corneal status, small pupil size, and IOL specifics. Caution is recommended when IA readings disagree significantly with preoperative measurements (e.g., a vector difference of 0.5 D in cases of low astigmatism). Conclusion: Intraoperative Aberrometry is beneficial, especially for eyes with abnormal axial length, prior refractive surgery, toric IOLs, multifocal lenses, or uncertain biometry. IA functions as an additional measurement and verification tool. While IA can be beneficial when the surgeon masters the technique and all variables are optimized, it could be a distraction if optimization is not met.