Eyeworld

111 February 2015 EW MEETING REPORTER of the review was to find the inci- dence of preoperative abnormal cor- neal topography that could impact the final visual results in patients undergoing cataract surgery. "We found that 30% had an abnormal topography," Dr. Trattler said. The study included 337 eyes total, after excluding eyes with previous corneal surgery. In these cases, it is important to identify and treat dry eye and bleph- aritis preoperatively, Dr. Trattler said. "If we try to take topography and keratometry, it could impact our findings," he said. This could impact IOL calculations and/or limbal relaxing incisions or toric IOL axis and/or magnitude. Preoperative topographic evaluation is critical for optimizing the success of patients scheduled for cataract surgery, Dr. Trattler concluded. Sumit "Sam" Garg, MD, Irvine, Calif., discussed his experience with intraoperative aberrometry and how it has helped to improve his results. He focused on the ORA system with VerifEye, now from Alcon. The ORA system provides on- demand, real-time intraoperative aberrometry, Dr. Garg said. The system has an algorithm to help determine the power of the eye, as well as toric power and aphakic power. Dr. Garg offered a number of tips for using the system. "You want to start on normal cases and get used to the system because there is a learning curve," he said. Mak- ing sure the cornea is clear, filling the eye with viscoelastic, and using a Barraquer tonometer are other helpful tips. "Take multiple measurements," Dr. Garg said. "And have a backup plan." He relies on aphakic readings for toric alignment because there is less dependence on pseudophakic readings. He also uses VerifEye in a phakic setting without actually taking a measurement to verify steep axis prior to incision. "Make sure your surface is dry prior to capturing," Dr. Garg said. Additionally, if the biometry is off, this can cause inaccuracy. There may be limited utility for intraoperative aberrometry in cases that it's needed most, such as in children or those with developmental delays. Kevin Miller, MD, Los Ange- les, gave an update on the Light Adjustable Lens study (Calhoun Vision, Pasadena, Calif.). Today's technology is less than ideal, he said. Preoperative biometry may be inaccurate, IOL power formulas are not perfect, wound healing is not fully predictable, and effective lens position calculations are imprecise. The question is whether there is a way to adjust the power of the IOL 3 rd World Congress of Paediatric Ophthalmology and Strabismus www.wspos.org Fira Gran Via, Barcelona, Spain 4–6 September 2015 World Society of Paediatric Ophthalmology and Strabismus Expertise Does Not Reside in Only One Part of the World /WSPOS @WSPOS continued on page 112 View it now: Hawaiian Eye 2015 ... EWrePlay.org Jennifer Loh, MD, shares pearls for preop and intraop management of corneal conditions such as dry eye, keratoconus, and anterior basement membrane disease.

• Cover