Eyeworld Daily News

EW SHOW DAILY 48 Meeting Reporter Sunday, April 15, 2018 by Vanessa Caceres EyeWorld Contributing Writer outcomes improved compared with results from the first version of the formula. There is research underway in Asia to make the formula stronger for use with ethnic Chinese eyes, Dr. Hill said. Adi Abulafia, MD, Jerusalem, Israel, presented information on the addition of the Abulafia-Koch formula for toric IOLs. Although the formula is helpful, he cautioned that it should not be used with unusual corneas. Poor corneal astigmatism measurements, inaccurate calcula- tion methods, surgically induced astigmatism, and toric IOL mis- calculations can lead to errors, he explained. As surgeons aim for better postop outcomes, Helga Sando- val, MD, Mount Pleasant, South Carolina, shared results she and Kerry Solomon, MD, have had with version 2 of the Hill-RBF formula. Ninety-eight percent of patients are within a half diopter of their intend- ed target; this is happening both for extended depth of focus and monofocal IOL patients. All patients are within 0.75 D of their intended target. To help improve postop out- comes, Dr. Sandoval advised attend- ees to: 1) track specific numerical outcomes, and set goal numbers for intended targets; 2) optimize the ocular surface before taking preop measurements; and 3) use the current IOL calculation formulas to help. EW Editors' note: This event was sponsored by Haag-Streit USA. If not, you won't get good informa- tion," Dr. Price said. When his practice started to use the LENSTAR, the difference was like going from camera film to digital, Dr. Price said. The system has helped to empower technicians so they feel more confident about their work, he said. "We can now more accurately predict IOLs preoperatively," he said. He contrasted this with earlier days of cataract surgery when 20/40 was considered a great endpoint. Michael Snyder, MD, Cincinna- ti, also shared pearls to help improve information obtained with the LENSTAR. He said to make sure to ask patients to remove their contact lenses and ask about previous refrac- tive surgery. This may seem basic, but these questions can be forgotten occasionally. Dr. Snyder also dis- cussed use of the LENSTAR system in the OR. Dr. Hill addressed the rapid rise of the Hill-RBF IOL calculation for- mula that uses artificial intelligence. When first released, he and fellow investigators thought it would take 4–5 years to catch on. How- ever, within the first year, 180,000 calculations with the formula were done online, and more were made with the Hill-RBF formula on the LENSTAR. A second version of the Hill-RBF formula will be released in about 2 weeks, Dr. Hill said. The formula has been in use by beta testers in 19 countries. In a study last year with 288 eyes, the formula had 94.7% accuracy overall, 98.7% accuracy for axial myopia, and 88.5% accuracy for axial hypero- pia. Overall and axial hyperopia Francis Price Jr., MD, Indianap- olis, shared how to improve pre- operative measurements using the LENSTAR system (Haag-Streit, Ma- son, Ohio), noting that 57% of the eyes he treats are potentially more difficult cases. These include eyes with previous refractive surgery or surgeries such as Descemet's mem- brane endothelial keratoplasty. One pearl with all eyes is to improve the ocular surface. "We make sure the ocular surface is in good condition. U se of state-of-the-art tech- nology can help improve cataract surgery refractive outcomes, said panelists during Saturday's "Pearls for Improved Refractive Outcomes with Cataract Surgery." In fact, with all of the technology available nowadays, if fewer than 90% of your patients are not getting within a half diopter of your target, you may be doing something wrong, said War- ren Hill, MD, Mesa, Arizona. Surgeons share tips for more accurate cataract outcomes Dr. Snyder shares how to better manage preop measurements with LENSTAR. ASCRS.org/Center-for-Learning

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