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Kern, C.; El Kaissi, L.; Kortuem, K.; Shajari, M.; Vounotrypidis, E.; Langenbucher, A.; Priglinger, S. und Mayer, W. J. (2019): Comparing refractive outcomes of a standard industry toric IOL calculator using anterior corneal astigmatism and total corneal refractive power. In: Graefes Archive for Clinical and Experimental Ophthalmology, Bd. 258, Nr. 2: S. 345-350

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Abstract

Purpose To evaluate refractive outcomes for a standard industry calculator using anterior corneal astigmatism or total corneal refractive power. Methods This prospective interventional study evaluated the refractive outcomes of 56 eyes using a standard industry calculator (Zeiss ZCalc) and a digital IOL alignment software. After A-constant optimisation the ZCalc was recalculated with two different keratometry values using appropriate refractive indices: anterior corneal astigmatism (ACA) by IOLMaster 700 and total corneal refractive power (TCRP) by Pentacam. The Barrett toric calculator was used as a reference. Results Undercorrection of 0.04 +/- 0.42 D after 1 week and 0.13 +/- 0.48 D after 3 months was achieved for the spherical equivalent by using a standard industry calculator. IOL misalignment was 2.8 degrees +/- 3.4 degrees using a digital alignment system. For the ZCalc, the mean absolute error could be reduced from 0.19 +/- 0.40 D using ACA to 0.04 +/- 0.48 D when considering total corneal refractive power (p = 0.06). The Barrett calculator delivered better refractive outcomes than using a standard industry calculator with ACA measurements only (- 0.06 +/- 0.43 D;p < 0.01). Conclusion Reliable and accurate refractive outcomes in toric IOL calculation were achieved by using the ZCalc calculator. The prediction error for a widely used standard industry toric IOL calculator could be reduced by using measured total corneal refractive power.

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