Intraoperative Aberrometry Best Determines IOL Power After Refractive Surgery

Patient undergoing LASIK surgery
A study suggests intraoperative aberrometry has advantages over BTK to determine IOL power in postmyopic LASIK/PRK eyes.

This article is part of Ophthalmology Advisor’s Focus on Retina coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the retinal experts at the AAO. Check back for more from the AAO 2021 Meeting.


In determining power for intraocular lenses following refractive surgery, intraoperative aberrometry is superior to an advanced preoperative IOL formula, according to a study presented at the American Academy of Ophthalmology 2021 meeting, held in New Orleans, November 12-15.  

The research team evaluated the cases of 1067 eyes implanted with AcrySof® (Alcon) monofocal IOLs. The eyes included were managed at several different locations across the US. They compared the refractive accuracy of using IA with that of the Barrett True K formula (BTK).

The investigation found that the mean paired difference in absolute prediction error (APE) between IA and BTK was 0.06 D, “with IA being significantly superior,” the presenter explained.

“A significantly greater percentage of eyes using IA than BTK were shown when APE was ≤0.50 D (IA 76.2% vs BTK 69.3%, P <.0001) and ≤0.25 D (IA 47.2% vs BTK 42.5%, P =.013),” according to the findings.

Differences that support the use of IA were numerically larger in eyes at least 26 mm (IA 6.7% vs BTK 3.8%), and especially in the case of eyes with an APE of 0.25 D or lower.

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Fram NR, Davidson JL, Gu X, Babu RJ, Breen M. Refractive prediction accuracy using intraoperative aberrometry vs. barrett true k in post-corneal refractive surgery eyes. Paper presented at: The American Academy of Ophthalmology 2021 Annual Meeting; November 12-15; New Orleans. Abstract PA024.