Optimising refractive outcomes before cataract surgery

A comprehensive overview of key issues in fine-tuning refractive results

Dermot McGrath

Posted: Saturday, February 20, 2021

Nino Hirnschall MD, PhD

Delegates picked up a wealth of useful advice and tips to improve their refractive results at the symposium “Optimizing Your Refractive Outcomes Before Cataract Surgery” held during the 25th ESCRS Winter Meeting Virtual 2021.
Chaired by Nino Hirnschall MD, PhD , Adi Abulafia MD, and Wojciech Lubinski MD, the session presented a comprehensive overview of key issues in fine-tuning refractive results, including optics and ray tracing, biometry, IOL power calculations, toric IOLs and extended depth of focus (EDOF) lenses.
While the technology and calculation methods have evolved over time, the fundamentals of hitting the target refraction remains the same, delegates were told.
Dr Gerd Auffarth explained some of the fundamental concepts of optics and inherent compromises involved in modern IOL designs, while Dr Jaime Aramberri examined the current state of play in biometry devices and advances in IOL power calculations. All participants agreed that the accuracy of IOL power calculations continues to improve with the use of modern instruments for biometry, updated formulas, and constant optimization.
Dr Thomas Olsen discussed techniques to improve the accuracy of power calculation in complex and irregular eyes, while Dr Giacomo Savini focused on post-refractive eyes and methods to reduce residual refractive error. The ideal conditions for toric IOL implantation were described by Dr Peter Hoffmann, with Dr Damien Gatinel concluding the session with a round-up of the range of extended depth of focus and multifocal IOLs on the market.
Although a lot of progress has been made in recent years in terms of improved biometry and better calculation formulae, the panel agreed that there is always scope for further improvement.

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