Regional EuroTimes
Date Posted 13/09/2009
ORange cataract study shows improving outcomes
Initial clinical studies are generating positive results about the value of intraoperative wavefront aberrometry using a proprietary device (ORange Intraoperative Wavefront Aberrometer, Wavetec Vision) for improving the refractive and visual outcomes of patients undergoing cataract surgery, said Edward J Holland MD, at the XXVII Congress of the ESCRS.
ORange provides real-time analysis of cylinder, allowing surgeons to make and enhance limbal relaxing incisions (LRIs) as needed. Results from comparative studies indicate use of this technology reduces the amount of residual cylinder and the rate of refractive surprises while improving vision outcomes.
“A study by Warren Hill MD, including 6,000 patients undergoing cataract surgery showed that more than half of these subjects had more than 0.75 D of pre-existing astigmatism. Relaxing incisions have been the most common method for managing this astigmatism to improve visual outcomes, but the results for this technique can be unpredictable, in part because surgeons cannot be absolutely certain about the length and depth of their incisions,” said Dr Holland, professor of ophthalmology, University of Cincinnati, and director, cornea service, Cincinnati Eye Institute, Cincinnati, Ohio, US.
“Findings from clinical studies show that by providing real-time refractive assessment, this intraoperative wavefront aberrometer is a great tool for surgeons striving to provide patients with the best visual outcomes.”
Dr Holland reported data from a manufacturer-sponsored trial conducted at the first 10 sites in the US where the device was commercially available. The study cohort consisted of 94 patients who underwent LRIs with intraoperative ORange evaluation and 189 historical controls operated on by the same surgeons without use of this technology.
Mean cylinder preoperatively was the same in the ORange group and controls, 1.45 D and 1.47 D, respectively, but was 35 per cent lower postoperatively. in the eyes evaluated with ORange versus the controls, 0.47 D vs. 0.7 D.
“Thirty-nine per cent of ORange patients underwent an intraoperative enhancement because of identified undercorrection. Surgical surprises, defined as >1.5 D of residual cylinder at 30 days, occurred at a rate of eight per cent in the control group, but were absent in the ORange group,” reported Dr Holland.
Preliminary data from an ongoing prospective randomised clinical study currently under way at the Cincinnati Eye Institute are corroborating the multicentre trial results.
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