Itrace posterior corneal aberrations11/14/2022 ![]() AUFFARTH, MD, PHD, FEBO AND MAXIMILIAN HAMMER, BSC, - We all have the same overarching goal as physicians, and that is to take optimal care of our patients using the most appropriate therapies and surgical methods. Pentacam AXL Wave: A Cost-Benefit Analysis - An all-in-one system that in our minds is worth every penny.īY GERD U. The Pentacam AXL Wave has become an indispensable tool for better and faster measurements in refractive cataract surgery. Having access to one device that performs five very important functions in one measurement routine is practical and economical. In my experience and clinical studies, I have been impressed with the Pentacam AXL Wave to provide this level of precision. The most important consideration in ensuring that we can achieve these results is to incorporate precise, repeatable, reliable measurements in the pre- and postoperative periods. Providing patients with refractive accuracy after cataract surgery is no longer a bonus to patients, it is expected every time. This translates to reliable measurements and high repeatability. We concluded that the correlation was better with the Pentacam AXL Wave and that both devices offer a good coefficient of variation (Pentacam AXL Wave, 0.11 vs iTrace, 0.14). We found high correlation with the objective measurements of both devices to the subjective refraction performed by a trained optician (Pentacam AXL Wave, 1.58 vs 1.61 D iTrace, 1.96 vs 1.56 D). In this retrospective, consecutive case series, we took three consecutive measurements with the Pentacam AXL Wave and the iTrace (Tracey Technologies). We also looked at the comparability of subjective and objective refraction in 21 pseudophakic and phakic eyes. #Itrace posterior corneal aberrations series#In a retrospective, consecutive case series of refractive cataract surgery performed in 20 phakic and pseudophakic eyes, we concluded that the device provided high repeatability of the total root mean square and third- and fourth-order HOAs (0.04 µm for a pupil diameter ≤ 4 mm 0.05 µm for a pupil diameter of 5 mm). We’ve also found the Pentacam AXL Wave to be reliable. I can repeat the objective refraction, recheck for HOAs including spherical aberration and coma, use retroillumination of the pseudophakic eye to depict the multifocal or toric IOL, perform wavefront aberrometry, and assess the postoperative visual performance. There are also clinical benefits in the postoperative period. Lastly, it can be used to perform optical biometry and IOL power calculation. I can also use the Pentacam AXL Wave to assess the visual disturbance and identify its cause (ie, the cornea or the lens). Further, the anterior segment tomography function can be used to screen for glaucoma, ectasia, and Fuchs endothelial dystrophy, to name a few. It uses two different pupil diameters (mesopic and scotopic), which is required when implanting a multifocal IOL or performing laser refractive surgery. I can perform an objective refraction on every patient, identify any higher-order aberrations (HOAs), and obtain one wavefront to achieve aberration measurements for all eye segments including the total cornea, total eye, and crystalline lens or IOL. The Pentacam AXL Wave has not only the practical benefits outlined above, but it also has clinical benefits that I have found especially valuable in preoperative assessments for refractive cataract surgery. CLINICAL BENEFITS IN PRE- AND POSTOPERATIVE ASSESSMENTS This is especially practical and helpful in this time of COVID-19 restrictions, as it means there are fewer devices for us to use and sterilize in between patients. In all, this one device performs five major functions in one measurement routine on the same measuring axis and using the same alignment navigation: objective refraction, total eye wavefront, retroillumination, optical biometry, and anterior segment tomography. The latest model, the Pentacam AXL Wave, includes a Hartmann-Shack wavefront sensor to measure total eye aberrations and objective refraction, as well as retroillumination for preoperative assessment of crystalline lens opacities in the nondilated pupil and postoperative control of IOL position and inclination. In my experience, one of the best technologies for all these functions is the Pentacam AXL (OCULUS). We now need a device that can also measure the posterior corneal surface, anterior chamber depth, and optical biometry. BY THOMAS KOHNEN, MD, PHD, FEBO, - Given the high expectations of today’s cataract surgery patients to achieve excellent vision at all distances, we are now tasked with providing refractive precision as the standard of care.īut achieving great results with refractive cataract surgery requires much more than simple biometry and collecting the basic measurements of axial length and anterior surface keratometry. ![]()
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