Eyeworld

EW CATARACT 82 January 2017 Eyeing continued from page 80 U N I T I N G O V E R 5 0 0 L E A D E RS IN THE DEVELOPMENT OF GROUND-BREAKING OPHTHALMIC TECHNOLOGIES O I S . N E T MAY 4, 2017 LOS ANGELES, CA " I see aberrometry as a valuable adjunct in trying to reach higher accuracy for IOL powers, given the need to match patient expectations with what we can deliver. " –Samuel Masket, MD The differences are a result of the index of refraction. "The higher index of refraction agents do two things. They cause light to slow down going through the aberrome- ter and change the interface differ- ence between index of refraction when going from air to the cornea," Dr. Masket explained. "For those rea- sons, we tend to get a higher axial length as the device would read it, and it suggests a lower IOL power by about 0.5 D." Practical applications Clinically, this can make a differ- ence. For those who prefer to use OVDs during aberrometry due to concerns about wound leakage with balanced salt solution, Dr. Masket recommends keeping this in mind. "If the surgeon is not consistent with his or her wound construc- tion and is concerned there will be fluid leakage from the incision and therefore cannot establish proper IOP to do aberrometry, he or she can use one of the low molecular weight agents such as Amvisc, Healon, or ProVisc," Dr. Masket said. "On the other hand, if a surgeon is com- fortable with incision construction and knows how to carefully hydrate without distorting the cornea, it's fine to just work under balanced salt solution." Dr. Masket hopes that practi- tioners come away from the study with an understanding of the impor- tance of accurate aberrometry. "I see aberrometry as a valuable adjunct in trying to reach higher accuracy for IOL powers, given the need to match patient expectations with what we can deliver," he said. "I be- lieve in the benefit of aberrometry. But I think, like everything else, it depends on how you use it, and one needs to develop a facility for using it, for establishing physiologic IOP, with proper wound construction." Going forward, investigators hope to tackle the idea of adjusting for OVD differences in index of refraction. "We're in the process of restudying DisCoVisc," Dr. Masket said. "[We're trying] to establish appropriate nomograms for each of the agents that surgeons may choose to use." EW Reference 1. Masket S, et al. Influence of ophthalmic vis- cosurgical devices on intraoperative aberrom- etry. J Cataract Refract Surg. 2016;42:990–4. Editors' note: Dr. Masket has financial interests with Alcon. Contact information Masket: sammasket@aol.com

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