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Hwang S, Kim DS, Kim D, Hong EH, Shin YU, Kim YJ, Kang MH. Repeatability of Scheimpflug-Placido camera in mild dry eye versus normal eyes according to the topographical position of the cornea. Sci Rep 2024; 14:23271. [PMID: 39370437 PMCID: PMC11456577 DOI: 10.1038/s41598-024-73900-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 09/23/2024] [Indexed: 10/08/2024] Open
Abstract
We aimed to investigate the repeatability of various corneal measurements according to topographical location in the entire cornea measured by dual rotating Scheimpflug-Placido camera and to explore the differences in repeatability between patients with mild dry eye and those with normal eyes. In both the normal and dry eye groups, divided based on BUT or the height of the tear film, there were no statistically significant differences in the ratio of unacceptable variation (RUV) and ICC. The consistency of the examination of the anterior and posterior refractive values and corneal thickness according to the corneal location, measured three times repeatedly using the Galilei anterior segment camera, was high. There was no difference based on the height of the tear film or the tear film break-up time. However, caution is needed when interpreting the values of the anterior corneal refractive values, as there can be changes of more than 0.5D within 3 mm of the central area.
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Affiliation(s)
- Sunjin Hwang
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Korea
| | - Dae Sung Kim
- Department of Ophthalmology, Hanyang University Hospital, Seoul, Korea
- , Blue Eye Center, Paju, Korea
| | - Duroo Kim
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Korea
| | - Eun Hee Hong
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Korea
| | - Yong Un Shin
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Korea
| | - Yu Jeong Kim
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Hanyang University Hospital, Seoul, Korea
| | - Min Ho Kang
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea.
- Department of Ophthalmology, Hanyang University Guri Hospital, Guri, Korea.
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Wang L, Shao X, Fu JL, Hu JJ, Zhou KJ, Li R, Yu AY. Repeatability and Agreement of 4 Biometers Measuring Corneal Astigmatism in Eyes With Irregular Corneal Astigmatism Component. Am J Ophthalmol 2024; 265:200-212. [PMID: 38719132 DOI: 10.1016/j.ajo.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/01/2024] [Accepted: 05/01/2024] [Indexed: 06/04/2024]
Abstract
PURPOSE To investigate the repeatability and agreement of corneal astigmatism measurements in eyes with irregular corneal astigmatism component (ICAC) using four devices: IOLMaster 700 biometer, Lenstar 900 biometer, iTrace, and Pentacam. DESIGN Prospective cross-sectional reliability analysis. METHODS Sixty-four eyes (52 patients) with ICAC were examined three times using the four devices. The eye with ICAC in this study is defined as the cornea has a certain degree of irregular astigmatism (asymmetric and/or skewed bowtie pattern of corneal topography according to corneal topography classification), accompanied with total corneal higher-order aberrations in the 4 mm zone of 0.3 µm or greater. Corneal astigmatism was evaluated using three categories: anterior corneal astigmatism (ACA), posterior corneal astigmatism, and total corneal astigmatism (TCA). The repeatability was determined using the ∆Ast (arithmetic mean of vector differences among three repeated corneal astigmatism measurements). Bland-Altman plots and astigmatism vector analyses were employed to assess agreement. RESULTS The IOLMaster 700 (∆Ast = 0.27 ± 0.20 D) showcased higher repeatability in ACA measurements compared to iTrace (∆Ast = 0.37 ± 0.38 D, P = .040) and Pentacam (∆Ast = 0.50 ± 0.22 D, P < .001), and paralleled the performance of Lenstar 900 (∆Ast = 0.31 ± 0.26 D, P = .338). The Pentacam (∆Ast = 0.09 ± 0.07 D, P < .001) demonstrated superior repeatability in posterior corneal astigmatism, whereas the IOLMaster 700 (∆Ast = 0.33 ± 0.23 D, P < .001) excelled in TCA. The IOLMaster 700 exhibited good agreement with either Lenstar 900 or iTrace, characterized by narrow 95% limits of agreement and clinically acceptable vector differences. Conversely, vector differences between Pentacam and the other three devices in ACA and TCA measurements were clinically significant, exceeding 0.50 D (all P < .05). CONCLUSIONS In terms of repeatability of corneal astigmatism measurements in eyes with ICAC, the IOLMaster 700 and Lenstar 900 outperformed iTrace and Pentacam. While the IOLMaster 700 can be used interchangeably with either Lenstar 900 or iTrace, the Pentacam is not interchangeable with the other three devices.
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Affiliation(s)
- Lan Wang
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - Xu Shao
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - Jin-Ling Fu
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - Jing-Jing Hu
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - Kai-Jing Zhou
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - Ran Li
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China
| | - A-Yong Yu
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital (L.W., X.S., J.L.F., J.J.H., K.J.Z., R.L., A.Y.Y.), Wenzhou Medical University, Wenzhou, China; National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital (A.Y.Y.), Wenzhou Medical University, Wenzhou, China.
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Abicca I, Schiano-Lomoriello D, Gilardi M, Giannini D, Dinu V, Coutinho C, Savini G. Repeatability of Automatic Measurements by an Anterior Segment Swept-Source OCT Biometer in Patients With Keratoconus. J Refract Surg 2024; 40:e445-e452. [PMID: 39007818 DOI: 10.3928/1081597x-20240514-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
PURPOSE To evaluate the repeatability of automatic measurements of a new anterior segment optical coherence tomographer (ANTERION; Heidelberg Engineering) and their agreement with an anterior segment optical coherence tomography device combined with Placido disc corneal topography (MS-39; CSO) in patients affected by keratoconus. METHODS Fifty-four consecutive patients were included. Three measurements were performed with the ANTERION and one with the MS-39. Repeatability was assessed by means of within-subject standard deviation, coefficient of variation (CoV), and intraclass correlation coefficient (ICC). Agreement was investigated with the 95% limits of agreement. The paired t-test and Wilcoxon matched-pairs test were performed to compare the measurements of the different devices. RESULTS Repeatability of ANTERION measurements was high, with an ICC greater than 0.98 for all parameters. Many parameters revealed a CoV of less than 1% and a CoV within 5% was obtained for astigmatism measurements. The ANTERION measured a significantly higher corneal power and the MS-39 more negative posterior keratometric values. These differences were mirrored by a moderate agreement for mean simulated keratometry and poor agreement for total corneal power and posterior keratometry. CONCLUSIONS The ANTERION revealed high repeatability of automatic measurements and good agreement with the MS-39 for many parameters in patients affected by keratoconus, but for most parameters the two instruments cannot be considered interchangeable. [J Refract Surg. 2024;40(7):e445-e452.].
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Lei CS, Lin X, Ning R, Yu J, Huang X, Li K, Wang Y, Savini G, Schiano-Lomoriello D, Zhou X, Huang J. Repeatability and Interobserver Reproducibility of a Swept-Source Optical Coherence Tomography for Measurements of Anterior, Posterior, and Total Corneal Power. Ophthalmol Ther 2023; 12:3263-3279. [PMID: 37787889 PMCID: PMC10640522 DOI: 10.1007/s40123-023-00815-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/05/2023] [Indexed: 10/04/2023] Open
Abstract
INTRODUCTION The aim of this work is to evaluate the intraobserver repeatability and interobserver reproducibility of corneal power measurements obtained with a swept-source optical coherence tomographer (CASIA 2, Tomey, Japan) in healthy subjects. METHODS A total of 67 right eyes from 67 healthy subjects were enrolled. Two experienced observers measured each eye three times consecutively with the CASIA 2. Corneal power values were recorded as simulated keratometry, anterior, posterior, and total corneal power. Parameters were flattest keratometry (Kf), steepest keratometry (Ks), mean keratometry (Km), astigmatism magnitude, astigmatism power vectors J0 and J45. Intraobserver repeatability and interobserver reproducibility of the CASIA 2 were assessed by the within-subject standard deviation (Sw), test-retest repeatability (TRT), coefficients of variation (CoV), and intraclass correlation coefficients (ICCs). Double-angle plots were used for astigmatism vector analysis. RESULTS The CASIA 2 had high repeatability for all corneal power values, with Sw values ≤ 0.17 diopters (D), TRT ≤ 0.46 D, and ICCs ranging from 0.866 to 0.998. Interobserver reproducibility was also high, showing all Sw values ≤ 0.10 D, TRT ≤ 0.27 D, and ICCs ≥ 0.944. The reproducibility of the average of three consecutive measurements (Sw 0.01-0.10 D, TRT 0.03-0.27 D, ICC 0.944-0.998) was higher than the reproducibility of single measurements (Sw 0.01-0.17 D, TRT 0.03-0.47 D, ICC 0.867-0.996). CONCLUSIONS The CASIA 2 showed high intraobserver repeatability and interobserver reproducibility for anterior, posterior, and total corneal power measurements in 6.0-mm diameter area. In addition, we suggest that using the average of three consecutive measurements can improve reproducibility between observers, compared to single measurements only.
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Affiliation(s)
- Chak Seng Lei
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, No. 19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xuanqiao Lin
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Rui Ning
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, No. 19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jinjin Yu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, No. 19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaomin Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, No. 19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Kexin Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, No. 19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yiran Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, No. 19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | | | | | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, No. 19 Baoqing Road, Xuhui District, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
| | - Jinhai Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, No. 19 Baoqing Road, Xuhui District, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
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Wendelstein J, Casazza M, Riaz KM, Fischinger I, Fuchs B, Bolz M, Seiler TG, Kohnen T, Langenbucher A. Characteristics of surgically induced astigmatism after standardized microincisional cataract surgery with a superior limbal incision. J Cataract Refract Surg 2023; 49:1025-1035. [PMID: 37532255 DOI: 10.1097/j.jcrs.0000000000001271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/21/2023] [Indexed: 08/04/2023]
Abstract
PURPOSE To determine (1) if measurements of surgically induced astigmatism (SIA) as measured by keratometry (K) and total keratometry (TK) differ (2) if SIA affects the magnitude and/or meridian of keratometric astigmatism (3) if SIA evolves over time. SETTING Tertiary care center. DESIGN Retrospective data analysis. METHODS A swept-source optical coherence tomography biometry dataset (IOLMaster700) consisting of 498 eyes (327 patients) from a tertiary care center was analyzed. For all eyes preoperative and postoperative biometric measurements at 1-month, 3-month, and 6-months postoperative visits were considered for vector analysis of SIA K and SIA TK . RESULTS Centroids in right and left eyes were 0.26 diopters (D) @5 degrees/0.31 D @1 degree for SIA K and 0.27 D @4 degrees/0.34 D @1 degree for SIA TK . Centroids for difference vectors K-TK in right and left eyes were 0.02 D @ 176 degrees/0.03 D @6 degrees. The mean SIA magnitudes in right and left eyes were 0.48 ± 0.41 D and 0.50 ± 0.37 D for SIA K and 0.53 ± 0.42 D and 0.54 ± 0.40 D for SIA TK . In eyes with ATR astigmatism, an increase in postoperative astigmatism magnitude was more common than a decrease. More than 30% of eyes showed changes in the meridian of more than 15 degrees. CONCLUSIONS Overall, we observed differences in K- and TK-derived SIA, and changes in SIA magnitude over time. For postsurgical interventions, postoperative astigmatism meridian values should be measured to base treatments. Astigmatism magnitude showed a tendency to decrease for steep-meridian incisions and to increase in flat-meridian incisions.
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Affiliation(s)
- Jascha Wendelstein
- From the Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Linz, Austria (Wendelstein, Casazza, Fischinger, Fuchs, Bolz); Johannes Kepler University Linz, Medical Faculty, Linz, Austria (Wendelstein, Casazza, Fischinger, Fuchs, Bolz); Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany (Wendelstein, Langenbucher); Dean McGee Eye Institute, University of Oklahoma, Oklahoma City, Oklahoma (Riaz); Department of Ophthalmology, Augentagesklinik Spreebogen Berlin, Berlin, Germany (Fischinger); Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zurich, Switzerland (Wendelstein, Seiler); Klinik für Augenheilkunde, Universitätsklinikum Düsseldorf, Duesseldorf, Germany (Seiler); Universitätsklinik für Augenheilkunde, Inselspital Bern, Bern, Switzerland (Seiler); Department of Ophthalmology, Goethe University, Frankfurt, Germany (Kohnen)
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Repeatability of new optical biometer and agreement with 2 validated optical biometers, all based on SS-OCT. J Cataract Refract Surg 2023; 49:5-10. [PMID: 36026703 DOI: 10.1097/j.jcrs.0000000000001023] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/19/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE To evaluate the repeatability of the measurements provided by a new optical biometer (EyeStar 900) based on swept-source optical coherence tomography (SS-OCT) and their agreement with the measurements given by 2 validated biometers based on the same technology, the IOLMaster 700 and Argos. SETTING IRCCS G.B. Bietti Foundation, Rome, Italy. DESIGN Prospective evaluation of diagnostic test. METHODS In a series of unoperated eyes, 3 consecutive scans were acquired with the EyeStar 900, and 1 with the IOLMaster 700 and the Argos. The following biometry parameters were analyzed: axial length (AL), keratometry (K), corneal astigmatism, central corneal thickness, corneal diameter (CD), anterior chamber depth (ACD), lens thickness (LT), and lens tilting. Repeatability was assessed using test-retest variability, the coefficient of variation (CoV), and the intraclass correlation coefficient (ICC); agreement was based on the 95% limits of agreement. RESULTS 56 eyes of 56 patients were analyzed. High repeatability was achieved for all measured parameters, as the CoV was <1% in most cases and ICC was >0.95 for all parameters. Good to high agreement was found among the measurements of the 3 optical biometers, although some statistically significant differences were detected between the EyeStar 900 and Argos (mean K, ACD, LT, and CD were higher with the Argos). The Argos measured a shorter AL in eyes >25 mm. CONCLUSIONS The new generation SS-OCT EyeStar 900 optical biometer produces highly repeatable measurements that are in good agreement with those provided by 2 previously validated instruments.
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Comparison of keratometry using SS-OCT and dual Scheimpflug-Placido imaging in postmyopic corneal refractive surgery eyes. J Cataract Refract Surg 2023; 49:16-20. [PMID: 36026694 DOI: 10.1097/j.jcrs.0000000000001045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/15/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE To compare simulated (SimK) and total (True-K) keratometry and corneal astigmatism values between the IOLMaster 700 (IOLM) and Galilei G4 (G4) devices in postmyopic laser refractive surgery eyes. SETTING Methodist Eye Associates, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas. DESIGN Retrospective cohort study. METHODS A chart review was conducted on patients with prior myopic laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK), undergoing phacoemulsification at a single institution from May 2019 through January 2022, who underwent imaging with both the IOLM and G4. Exclusion criteria were prior radial keratotomy, keratoectatic diseases, and inability to obtain a reliable image. Mean, flat, and steep SimK and True-K (TK from the IOLM and TCP IOL from the G4) values and astigmatism magnitude were compared. RESULTS 50 eyes of 50 patients were included. The mean difference in SimK and True-K between devices (IOLM - G4) was -0.04 (95% CI -0.13 to 0.06; P > .05) diopters (D) and 1.14 (95% CI 1.02 to 1.25; P < .05) D, respectively. The IOLM measured steeper True-K values than the G4. There were no statistically significant differences between devices for all other SimK values, whereas for True-K there were significant differences in flat K and steep K ( P < .05), but not astigmatism magnitude. CONCLUSIONS Despite an overall good correlation in postmyopic laser refractive surgery eyes in keratometry and astigmatism measurements, there is a significant difference in True-K, with the IOLM measuring steeper values by about 1.0 D compared with the G4, similar to prior studies on nonrefractive surgery eyes.
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Wendelstein JA, Reifeltshammer SA, Cooke DL, Hirnschall N, Hoffmann PC, Langenbucher A, Bolz M, Riaz KM. The 10,000 Eyes Study: Analysis of Keratometry, Abulafia-Koch regression transformation, and Biometric Eye Parameters Obtained With Swept-Source Optical Coherence Tomography. Am J Ophthalmol 2023; 245:44-60. [PMID: 36084683 DOI: 10.1016/j.ajo.2022.08.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To analyze Abulafia-Koch regression (AKRT), anterior and posterior astigmatism (K and TK), and evaluate biometry data in a large population. DESIGN Retrospective cross-sectional study. METHODS This multicenter (2 tertiary care centers) study analyzed datasets acquired between 2017 and 2020. Axial length (AL), corneal front and back radii (including meridians for K and TK conversion), horizontal corneal diameter, anterior chamber depth, lens thickness, and central corneal thickness were measured using telecentric keratometry and swept-source optical coherence tomography-based biometry (IOLMaster 700; Carl Zeiss Meditec AG). Cooke-modified axial length (CMAL) and AKRT were calculated. Difference vectors between K and TK astigmatism and between AKRT and TK astigmatism were compared. RESULTS A total of 10,300 eyes from 6388 patients were assessed. Difference vectors for K and TK were significantly smaller than for AKRT and TK. K measurement showed a configuration of 51.49% of with-the-rule astigmatism and 30.51% against-the-rule astigmatism, TK measurement showed a configuration of 41.60% of with-the-rule astigmatism and 40.21% against-the-rule astigmatism. Mean total astigmatism was -0.94 ± 0.74 dpt. Mean values for AL and CMAL were 23.70 ± 1.39 mm and 23.70 ± 1.34 mm, respectively. Anterior chamber depth, lens thickness, horizontal corneal diameter, AL, and age were all correlated with each other. CONCLUSION Astigmatism analysis showed less difference between K and TK than between AKRT and TK. There were significantly fewer eyes with with-the-rule astigmatism and more eyes with against-the-rule astigmatism configuration in TK-derived than in K-derived keratometry. The study provides data on gender and generational differences in biometry. Significant intersexual differences in AL and CMAL were observed, with CMAL providing lower standard deviation compared with AL.
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Affiliation(s)
- Jascha A Wendelstein
- Department for Ophthalmology and Optometry (J.A.W., S.A.R., N.H., M.B.), Kepler University Hospital GmbH, Linz, Austria; Johannes Kepler University Linz Medical Faculty (J.A.W., S.A.R., N.H., M.B.), Linz, Austria; Institute of Experimental Ophthalmology (J.A.W., A.L.), Saarland University, Homburg, Germany
| | - Sophia A Reifeltshammer
- Department for Ophthalmology and Optometry (J.A.W., S.A.R., N.H., M.B.), Kepler University Hospital GmbH, Linz, Austria; Johannes Kepler University Linz Medical Faculty (J.A.W., S.A.R., N.H., M.B.), Linz, Austria.
| | - David L Cooke
- Great Lakes Eye Care (D.L.C.), Saint Joseph, Michigan State University, College of Osteopathic Medicine, East Lansing, Michigan, USA; Department of Neurology and Ophthalmology (D.L.C.), Michigan State University, College of Osteopathic Medicine, East Lansing, Michigan, USA
| | - Nino Hirnschall
- Department for Ophthalmology and Optometry (J.A.W., S.A.R., N.H., M.B.), Kepler University Hospital GmbH, Linz, Austria; Johannes Kepler University Linz Medical Faculty (J.A.W., S.A.R., N.H., M.B.), Linz, Austria
| | | | - Achim Langenbucher
- Institute of Experimental Ophthalmology (J.A.W., A.L.), Saarland University, Homburg, Germany
| | - Matthias Bolz
- Department for Ophthalmology and Optometry (J.A.W., S.A.R., N.H., M.B.), Kepler University Hospital GmbH, Linz, Austria; Johannes Kepler University Linz Medical Faculty (J.A.W., S.A.R., N.H., M.B.), Linz, Austria
| | - Kamran M Riaz
- Dean A. McGee Eye Institute (K.M.R.), University of Oklahoma, Oklahoma City, Oklahoma, USA
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Intraobserver Repeatability of Tomographic, Pachymetric, and Anatomical Measurements in Healthy Eyes Using a New Swept-Source Optical Coherence Topographer. Cornea 2022; 41:598-603. [DOI: 10.1097/ico.0000000000002799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/06/2021] [Indexed: 11/26/2022]
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Kose B. Agreement between swept-source optical biometry and Scheimpflug-based topography measurements of posterior corneal curvature. J Cataract Refract Surg 2022; 48:185-189. [PMID: 34174042 DOI: 10.1097/j.jcrs.0000000000000731] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 06/14/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate agreement of posterior corneal curvature parameters between a swept-source optical coherence tomography-based biometer (IOLMaster 700) and Scheimpflug topography (Pentacam HR) in healthy, myopic eyes. SETTING Department of Ophthalmology, Osmangazi Aritmi Hospital, Bursa, Turkey. DESIGN Retrospective study. METHODS In this study, 59 eyes of 59 patients who applied as candidates for refractive surgery were included. Measurements of the posterior corneal curvature were performed using IOLMaster 700 and Pentacam HR. J0 and J45 vector components were calculated using astigmatic values. Posterior corneal keratometry (K) measurements at flat (K flat) and steep (K steep) axes and J0 and J45 values were compared between the 2 devices. The agreement between the devices was analyzed using the Bland-Altman method. Intraclass correlation coefficients and within-subject SD were calculated to assess the repeatability. RESULTS 59 eyes of 59 patients were included in this study. The IOLMaster 700 provided significantly flatter K flat and K steep values (P < .001, for both). Significant differences were found in J0 and J45 values (P = 0.13 and P < .001, respectively). The mean differences between K flat, K steep, and J0 and J45 values were 0.49 diopter (D), 0.53 D, 0.04 D, and -0.05 D, respectively. CONCLUSIONS The IOLMaster 700 and the Pentacam HR could not be used interchangeably to measure K flat, K steep, and J0 and J45 values of the posterior corneal curvature in healthy, myopic eyes. Both devices showed high repeatability for posterior corneal curvature measurement.
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Affiliation(s)
- Bulent Kose
- From the Department of Ophthalmology, Osmangazi Aritmi Hospital, Bursa, Turkey
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Comparison of Simulated and True Keratometry Measurements Using Swept-Source Optical Coherence Tomography and Dual Scheimpflug-Placido Imaging. J Ophthalmol 2021; 2021:5860846. [PMID: 34567799 PMCID: PMC8460384 DOI: 10.1155/2021/5860846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/16/2021] [Accepted: 09/03/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To compare simulated and total keratometry and corneal astigmatism values between the IOLMaster 700 and Galilei G4 devices. Methods A retrospective chart review was conducted for all patients undergoing phacoemulsification by a single surgeon (RTP) from March through September 2020 and who underwent imaging with both the IOLMaster 700 and Galilei G4. Exclusion criteria were prior corneal surgery, keratectatic diseases and inability to obtain a reliable image during image acquisition. Mean, flat, and steep keratometry values as well as astigmatism magnitude were compared. Results A total of 200 eyes of 100 patients were included. Intraclass correlation coefficients (ICC) were moderate or high for all variables. Mean difference ± SD in SimK and TrueK between devices (G4-IOLM) was 0.05 ± 0.318 diopters and −1.1156 ± 0.438 diopters, respectively (p < 0.05 for both). The IOLM measured steeper TrueK value than the G4. For SimK, there was a statistically significant difference between devices only for mean keratometry (K), whereas for TrueK, there were significant differences in flat K, steep K, and mean K. Astigmatism analysis revealed a difference in mean (±SD) SimK of 0.07 (±0.57) D at 94 degrees and in mean TrueK of 0.04 (±0.85) D at 108 degrees. Conclusion Though there is overall good correlation between the IOLMaster 700 and Galilei G4 in SimK and astigmatism measurements, there is a significant difference in TrueK measurements, with the IOLM measuring steeper values by about 1.0 diopter as compared to the G4.
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Repeatability and comparability of the Galilei-G4 and Cassini in measuring corneal power and astigmatism in normal and post-refractive surgery eyes. Sci Rep 2021; 11:16141. [PMID: 34373485 PMCID: PMC8352897 DOI: 10.1038/s41598-021-94319-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/08/2021] [Indexed: 11/08/2022] Open
Abstract
To assess the repeatability and comparability of the Galilei G4 versus the Cassini topographer in post-refractive eyes and in normal eyes, including older patients representative of an initial cataract evaluation. Simulated keratometric (simK), total corneal and posterior corneal power and astigmatism were evaluated in both post-refractive and normal eyes. Repeatability was measured by calculating within-subject standard deviation (Sw), coefficient of variation (CoV), and intraclass correlation coefficient (ICC). Vector analyses and Bland-Altman plots were employed to assess agreement between devices. We studied 32 subjects with a history of refractive surgery and 32 subjects without a history of refractive surgery undergoing cataract surgery. The mean age was 55 ± 18.5 years and the age range was 21.5-91.5 years. In non-refractive and post-refractive eyes, the ICC was > 0.9 (P < 0.001) for all corneal powers and for simK and total corneal astigmatism for both analyzers. The ICC for posterior corneal astigmatism magnitude using the Galilei was 0.62 and 0.67 and for the Cassini 0.55 and 0.38 in normal and post-refractive eyes, respectively. In both post-refractive and normal eyes, the Galilei G4 and Cassini analyzers have high repeatability in simK, total, and posterior corneal power and low repeatability for posterior corneal astigmatism.
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Repeatability and comparability of keratometry measurements obtained with swept-source optical coherence and combined dual Scheimpflug-Placido disk-based tomography. J Cataract Refract Surg 2021; 46:1637-1643. [PMID: 32818349 DOI: 10.1097/j.jcrs.0000000000000346] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the repeatability of keratometric measurements obtained using a reflectance and swept-source optical coherence tomography (SS-OCT) based biometer and to compare these values with those obtained with a dual Scheimpflug-Placido (S-P) disk-based tomographer/topographer. SETTING Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania, USA. DESIGN Prospective consecutive case series. METHODS Patients undergoing cataract evaluation were prospectively enrolled. Surgery-naive eyes without corneal pathology were measured 3 times with the reflectance/SS-OCT biometer and once with the dual S-P disk tomographer/topographer. Intradevice repeatability for anterior (K), posterior (PK), and total corneal keratometry (TK) readings were evaluated using within-eye SDs, test-retest repeatability (TRT), coefficients of variance, and intraclass correlation coefficients (ICCs). Bland-Altman analysis was used to assess agreement between devices. RESULTS Eighty-two eyes from 48 patients met inclusion criteria. The TRT for the anterior, posterior, and total corneal powers were 0.33, 0.08, and 0.36 diopter (D), respectively. TRT for the anterior, posterior, and total keratometric astigmatism were 0.58, 0.14, and 0.64 D, respectively. Anterior keratometric indices had higher ICCs than posterior indices. Bland-Altman analysis revealed that the SS-OCT consistently reported flatter posterior corneal curvatures than the S-P. CONCLUSIONS The SS-OCT posterior keratometric measurements contain more noise (lower ICCs), but still have lower within-eye SDs and TRTs than that of anterior measurements. This may be due to the small index of refraction change at the cornea-aqueous interface. Although keratometric indices from the 2 devices are highly correlated, measurements taken using SS-OCT and S-P devices were not interchangeable.
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Agreement and repeatability of corneal tomography in healthy eyes using a novel Swept-Source optical coherence tomographer, a rotating Scheimpflug camera and a dual Scheimpflug-Placido system. J Cataract Refract Surg 2021; 48:190-198. [PMID: 34224476 DOI: 10.1097/j.jcrs.0000000000000734] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the accordance and repeatability of tomographic parameters measured by a novel Swept-Source optical coherence tomographer (SS-OCT, ANTERION), a rotating Scheimpflug camera (RSC, Pentacam) and a dual Scheimpflug-Placido system (DSP, Galilei G6). SETTING Department of Ophthalmology of Univ. Hospital Carl Gustav Carus, Dresden, Germany. DESIGN Prospective reliability analysis. METHODS Thirty randomly selected eyes of 30 healthy participants were enrolled in this study. Normal tomography were ensured by bilaterally evaluating appropriated parameters using RSC. All subjects received three consecutive measurements on each device by the same operator and in the uniform order RSC, SS-OCT and DSP. Anterior (ACP) and posterior (PCP) corneal parameters such as flat and steep keratometry and corneal thickness were analyzed. Repeatability was assessed by using a coefficient of repeatability (CR) and a coefficient of variation (CV). Agreement between RSC and SS-OCT as well as RSC and DSP were shown by Bland-Altman plots (BA). RESULTS CR of ACP did not exceed 0.5 D. There were no statistical differences in repeatability of ACP obtained from the three devices (P>0.05). For PCP and corneal thickness there was statistically significant higher repeatability mostly found for SS-OCT as opposed to RSC and DSP (P<0.05). For a wide range of analyzed parameters there were large limits of agreement (95%-LoA) found between the devices. CONCLUSION The SS-OCT showed highly repeatable measurements in healthy subjects regarding anterior, posterior and corneal thickness parameters. Repeatability of ACP did not differ between the devices. A mostly wide range of 95%-LoA prevents interchangeability between the devices.
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Lwowski C, Van Keer K, Adas M, Schwarz L, Hinzelmann L, Pawlowicz K, Kohnen T. Ray-tracing Calculation Using Scheimpflug Tomography of Diffractive Extended Depth of Focus IOLs Following Myopic LASIK. J Refract Surg 2021; 37:231-239. [PMID: 34038658 DOI: 10.3928/1081597x-20210114-02] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate a ray-tracing formula for intraocular lens (IOL) calculation of diffractive extended depth of focus IOLs after myopic laser in situ keratomileusis (LASIK) compared to formulas from an established online calculator. METHODS This retrospective, consecutive case series included patients after cataract surgery with implantation of an extended depth of focus (EDOF) IOL (AT LARA, Carl Zeiss Meditec; Symfony, Johnson & Johnson) and a history of myopic LASIK. Preoperative assessments included biometry (IOLMaster; Carl Zeiss Meditec) and corneal tomography, including true net power (TNP) (Pentacam; Oculus Optikgeräte GmbH). To evaluate the measurements, the simulated keratometry values (SimK) were compared to the TNP. Regarding IOL calculation, the mean prediction error, mean and median absolute prediction error (MAE and MedAE), and number of eyes within ±0.50, ±1.00, and ±2.00 diopters (D) from the Haigis-L, Shammas, and Barrett True K No History formulas to the Potvin-Hill and Haigis with TNP (Pentacam) formulas were compared. RESULTS Thirty-six eyes matched the inclusion criteria with a mean spherical equivalent of -6.26 ± 3.25 diopters (D) preoperatively and -0.79 ± 0.75 D postoperatively. The mean difference from SimK and TNP was significantly different from zero (P < .001; -1.24 ± 0.81 D). The best performing formulas by MedAE were the Potvin-Hill and Barrett True K No History (0.39 ± 0.78 and 0.64 ± 1.00 D). The formula with the most eyes within ±0.50 D was the Potvin-Hill (64%), followed by the Barrett True K No History (44%). For MAE and percentage of eyes within ±0.50 D, the Potvin-Hill formula was significantly better than the Haigis-L, Shammas, and Haigis-TNP formulas (P < .05). CONCLUSIONS Calculation of IOLs in patients who had LASIK remains less predicable than calculations for virgin eyes. Using ray-tracing to calculate diffractive EDOF IOLs after myopic LASIK, the Potvin-Hill formula outperformed established formulas in terms of the percentage within target refraction and the MAE. [J Refract Surg. 2021;37(4):231-239.].
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Schiano-Lomoriello D, Hoffer KJ, Abicca I, Savini G. Repeatability of automated measurements by a new anterior segment optical coherence tomographer and biometer and agreement with standard devices. Sci Rep 2021; 11:983. [PMID: 33441703 PMCID: PMC7806838 DOI: 10.1038/s41598-020-79674-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022] Open
Abstract
We assess repeatability of automatic measurements of a new anterior segment optical coherence tomographer and biometer (ANTERION) and their agreement with those provided by an anterior segment-optical coherence tomography device combined with Placido-disk corneal topography (MS-39) and a validated optical biometer (IOLMaster 500). A consecutive series of patients underwent three measurements with ANTERION and one with MS-39. A subgroup of patients underwent biometry also with IOLMaster 500. Repeatability was assessed by means of within-subject standard deviation, coefficient of variation (COV), and intraclass correlation coefficient (ICC). Agreement was investigated with the 95% limits of agreement. Paired t-test and Wilcoxon matched-pairs test were performed to compare the measurements of the different devices. Repeatability of ANTERION measurements was high, with ICC > 0.98 for all parameters except astigmatism (0.963); all parameters apart from those related to astigmatism revealed a COV < 1%. Repeatability of astigmatism improved when only eyes whose keratometric astigmatism was higher than 1.0 D were investigated. Most measurements by ANTERION and MS-39 showed good agreement. No significant differences were found between measurements by ANTERION and IOLMaster, but for corneal diameter. ANTERION revealed high repeatability of automatic measurements and good agreement with both MS-39 and IOLMaster for most parameters.
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Affiliation(s)
| | - Kenneth J Hoffer
- Stein Eye Institute, University of California, Los Angeles, CA, USA.,St. Mary's Eye Center, Santa Monica, CA, USA
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Visco DM, Bedi R, Packer M. Femtosecond laser-assisted arcuate keratotomy at the time of cataract surgery for the management of preexisting astigmatism. J Cataract Refract Surg 2021; 45:1762-1769. [PMID: 31856987 DOI: 10.1016/j.jcrs.2019.08.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/13/2019] [Accepted: 08/01/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate the outcomes of femtosecond laser-assisted arcuate keratotomy combined with cataract surgery in eyes with low-to-moderate corneal astigmatism. SETTING Eyes of York Private Practice Ophthalmology Clinic, York, Pennsylvania, USA. DESIGN Retrospective case series. METHODS This retrospective analysis included case records of patients with preexisting corneal astigmatism ranging from 0.5 to 2.0 diopter (D). Study parameters included corneal astigmatism, refractive astigmatism, and uncorrected (UDVA) and corrected (CDVA) distance visual acuities. The results, which were analyzed at 3 months postoperatively, included frequency distribution histograms, vector analysis, and single-angle polar plots. RESULTS The study comprised case records of 189 eyes of 143 patients (56 men and 87 women). The postoperative refractive astigmatism was reduced significantly compared with preoperative corneal astigmatism to 0.14 D ± 0.23 (SD) from 0.92 ± 0.34 D (P < .001). One hundred eighty-one eyes (95.8%) demonstrated postoperative refractive astigmatism of 0.5 D or less. The mean surgically induced change along the preoperative steep axis was -0.59 ± 0.56 D, and the change along the orthogonal axis was 0.01 ± 0.35 D. Postoperatively, 171 eyes (90.5%) had astigmatism angle of error of 15 degrees or less. The postoperative mean UDVA and CDVA were 0.09 ± 0.16 logarithm of the minimum angle of resolution (logMAR) and 0.02 ± 0.05 logMAR, respectively. One hundred seventy eyes (90%) had a postoperative UDVA of 20/30 or better. The results demonstrated stability at 12 months postoperatively. No intraoperative or postoperative arcuate keratotomy-related events were observed. CONCLUSION The results suggest that femtosecond laser-assisted arcuate keratotomy represents a safe and effective method for astigmatism correction at the time of cataract surgery with demonstrated stability of correction for at least 1 year postoperatively.
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Affiliation(s)
- Denise M Visco
- Eyes of York Cataract & Laser Center, York, Pennsylvania, USA
| | | | - Mark Packer
- Mark Packer MD Consulting, Inc., Boulder, Colorado, USA.
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Savini G, Taroni L, Schiano-Lomoriello D, Hoffer KJ. Repeatability of total Keratometry and standard Keratometry by the IOLMaster 700 and comparison to total corneal astigmatism by Scheimpflug imaging. Eye (Lond) 2021; 35:307-315. [PMID: 33139878 PMCID: PMC7852681 DOI: 10.1038/s41433-020-01245-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/04/2020] [Accepted: 10/19/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES We aimed (1) to assess the repeatability of Total Keratometry (TK) and standard keratometry (K) measurements, as provided by the IOLMaster 700 (Carl Zeiss Meditec), and (2) to compare the corneal astigmatism measured by TK to the total corneal astigmatism (TCA) measured by a Scheimpflug camera (Pentacam AXL, Oculus). METHODS Two groups of patients were prospectively enrolled: Group A included previously unoperated eyes undergoing cataract surgery, and Group B eyes with previous myopic corneal excimer laser surgery. TK and K were measured three times by the same examiner. Repeatability was assessed based on the within-subject standard deviation (Sw), test-retest variability, coefficient of variation and intraclass correlation coefficient (ICC). In Group A, TCA was measured once and compared to TK astigmatism. Vector analysis was performed according to Næser. RESULTS In Group A (69 eyes) the mean K and TK were, respectively, 43.14 ± 1.37 D and 43.18 ± 1.37 D. In Group B (51 eyes) the mean K and TK were, respectively, 40.14 ± 2.20 D and 39.71 ± 2.35 D. The repeatability of the average K and TK was high (Sw < 0.10D). All measurements revealed an ICC > 0.9. For most measurements the variance of K and TK did not show any statistically significant difference either within groups or between groups. Vectors KP(45) were significantly different between TK astigmatism and TCA. CONCLUSIONS TK measurements offer high repeatability in unoperated and post-excimer laser surgery eyes. TK astigmatism and TCA measurements could not be considered interchangeable.
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Affiliation(s)
| | - Leonardo Taroni
- S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | | | - Kenneth J Hoffer
- Stein Eye Institute, University of California, Los Angeles, CA, USA
- St. Mary's Eye Center, Santa Monica, CA, USA
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Kansara N, Cui D, Banerjee K, Landis Z, Scott IU, Pantanelli SM. Anterior, posterior, and nonkeratometric contributions to refractive astigmatism in pseudophakes. J Cataract Refract Surg 2021; 47:93-99. [PMID: 32815865 DOI: 10.1097/j.jcrs.0000000000000390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/28/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the relationship between measured anterior (ACA) and posterior (PCA) keratometric astigmatism and postoperative refractive astigmatism (RA) and to quantify noncorneal astigmatism (NCA) contributions to RA. SETTING Penn State College of Medicine, Hershey, Pennsylvania, USA. DESIGN Retrospective consecutive case series. METHODS Consecutive eyes underwent preoperative biometry (IOLMaster 700) and tomography/topography using a dual Scheimpflug-placido disk-based device (Galilei G4), cataract surgery with implantation of a monofocal intraocular lens (IOL), and postoperative manifest refractions. RA was compared with keratometric astigmatism using the following methods: IOLMaster, SimK, CorT, SimK + measured PCA, total corneal power at the corneal plane (TCP2), and CorT(Total). An ocular residual astigmatism (ORA) vector was calculated between RA and each measured astigmatism. RESULTS Analysis was based on 296 eyes. ORA centroids were 0.28 @ 179, 0.45 @ 001, 0.37 @ 001, 0.19 @ 003, 0.19 @ 001, and 0.23 @ 178 diopter (D) for the 6 aforementioned methods, respectively (P < .000001 [ORAx, ORAy]). Based on TCP2 measurements, eyes with against-the-rule ACA and with-the-rule (WTR) ACA had ORA centroids of 0.09 @ 082 and 0.58 @ 001 D (P < .000001 [ORAx, ORAy]), respectively. ORA was nonzero and not entirely explained by the cornea, especially in those with WTR ACA. CONCLUSIONS Total keratometric astigmatism did not explain all ocular astigmatism. Noncorneal contributions were significant, especially in eyes with WTR ACA.
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Affiliation(s)
- Neal Kansara
- From the Department of Ophthalmology, Penn State College of Medicine (Kansara, Scott, Pantanelli), Hershey, Penn State College of Medicine (Cui), Hershey, Department of Public Health Sciences, Penn State College of Medicine (Banerjee, Scott), Hershey, Eye Associates of Lancaster (Landis), Lancaster, Pennsylvania, USA
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Posterior and total corneal astigmatism measured with optical coherence tomography–based biometer and dual Scheimpflug analyzer. J Cataract Refract Surg 2020; 46:1652-1658. [DOI: 10.1097/j.jcrs.0000000000000327] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lee DC, Lee SY. Analysis of astigmatism outcomes after horizontal rectus muscle surgery in patients with intermittent exotropia. PLoS One 2020; 15:e0240026. [PMID: 33031390 PMCID: PMC7544045 DOI: 10.1371/journal.pone.0240026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/18/2020] [Indexed: 11/19/2022] Open
Abstract
This study examined the factors affecting corneal curvature change after lateral rectus recession and medial rectus resection surgery in patients with intermittent exotropia. This was a retrospective cross-sectional study in intermittent exotropia patients who underwent rectus resection surgery. The study involved 41 male and 42 female patients (mean age: 9.55 ± 5.03 years, range: 3-28 years). Corneal astigmatism analysis was performed using the Galilei G4 Dual Scheimpflug Analyzer. The values of simulated and ray tracing corneal keratometry (K) of astigmatism, including axis changes, were determined preoperatively and at 1 week and 3 months postoperatively. The factors found to affect corneal curvature change were sex, extent of surgery, and axial length. Simulated and ray tracing changes were significant preoperatively and at 1 week and 3 months after rectus resection surgery (p < 0.05); however, there were no differences in astigmatism (D) at any time. The spherical equivalent had a myopic change after rectus resection surgery with cycloplegic refraction, and in ray tracing mode, flat K was decreased at 1 week from baseline and increased 3 months later. Steep, mean K, and axis increased continuously from baseline to 1 week and 3 months. Astigmatism, in contrast, was increased at 1 week, but decreased at 3 months, with no return to baseline. Univariable linear regression analyses showed that the extent of surgery had an effect on flat K change and that sex had an effect on steep K and axis. Additionally, axial length affected steep K and astigmatism, while age had no effect on any variable. Ray tracing values were significantly different from simulated values. In ray tracing mode, rectus resection surgery may result in astigmatism shifted toward with-the-rule, and myopic changes may be caused by differences in thickness and flexibility of the sclera. Notably, age did not affect any variable.
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Affiliation(s)
- Dong Cheol Lee
- Department of Ophthalmology, School of Medicine, and Institute for Medical Science, Keimyung University, Daegu, Korea
| | - Se Youp Lee
- Department of Ophthalmology, School of Medicine, Keimyung University, Daegu, Korea
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Tañá-Rivero P, Aguilar-Córcoles S, Ruiz-Mesa R, Montés-Micó R. Repeatability of whole-cornea measurements using a new swept-source optical coherence tomographer. Eur J Ophthalmol 2020; 31:1709-1719. [PMID: 32686488 DOI: 10.1177/1120672120944022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of this study was to evaluate the repeatability of several corneal parameters provided by a high-resolution swept-source optical coherence tomographer (SS-OCT). METHODS One eye from each of 74 patients was measured five times consequently using the ANTERION SS-OCT. The following corneal parameters were analyzed: average, steep and flat keratometry (K), astigmatism for anterior, posterior and total at 3-mm, average K and astigmatism at 6-mm, anterior and posterior eccentricity, higher-order aberrations (HOA) and spherical aberration (Z40), and anterior and posterior best-fit sphere at 8-mm. The intrasubject standard deviation (Sw), coefficient of variation (CoV), coefficient of repeatability (CoR) and intraclass correlation coefficient (ICC) were calculated for each parameter to assess the repeatability. RESULTS We have not found statistically significant differences between repeated measurements (p > 0.05). Repeatability was good considering the different metrics used. Sw values were <0.09, varying from 0.035 (posterior average K at 6-mm) to 0.0878 (anterior flat K at 3-mm). CoV values were also low and similar among the different parameters (from 0.08% to 0.21%), except for anterior, posterior and total astigmatism (from 2.25% to 8.46%). Both anterior and posterior eccentricity, and corneal aberrations (HOA and Z40) CoV values were also high. The CoR values were low for all parameters showing those related to the posterior cornea the lowest values (about 0.01). ICC values were >0.98. CONCLUSIONS The ANTERION SS-OCT showed good repeatability when reconstructed different parameters for the whole cornea. This device produces measurements with high repeatability that could be useful for clinical research.
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Affiliation(s)
| | | | | | - Robert Montés-Micó
- Oftalvist Clinic, Alicante, Spain.,Optics and Optometry & Vision Sciences Department, University of Valencia, Valencia, Spain
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Schiano-Lomoriello D, Bono V, Abicca I, Savini G. Repeatability of anterior segment measurements by optical coherence tomography combined with Placido disk corneal topography in eyes with keratoconus. Sci Rep 2020; 10:1124. [PMID: 31980662 PMCID: PMC6981210 DOI: 10.1038/s41598-020-57926-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 01/06/2020] [Indexed: 02/07/2023] Open
Abstract
Corneal tomography is an important tool to identify and follow up eyes with keratoconus. Our study evaluate the repeatability of the automatic measurements provided in keratoconic eyes by a new anterior-segment optical coherence tomographer (AS-OCT) combined with Placido-disk topography (MS-39, CSO) and assess their agreement with the corresponding measurements taken with a rotating Scheimpflug camera combined with Placido-disk topography (Sirius, CSO). Mean simulated keratometry, posterior and total corneal power, total corneal astigmatism, corneal asphericity, thinnest corneal thickness, epithelial thickness, corneal diameter, and aqueous depth were evaluated. Repeatability was assessed using test–retest variability, the coefficient of variation, and the intraclass correlation coefficient; agreement was assessed by the 95% limits of agreement. Good repeatability was achieved for most parameters. Moderate repeatability was found for total corneal astigmatism measurements. The repeatability of mean simulated keratometry and total corneal power measurements worsened with more severe stages of keratoconus with a statistically significant relationship between the individual coefficient of variation and corneal power values. Agreement with the Scheimpflug camera was moderate for aqueous depth and thinnest corneal thickness and poor for most other measured parameters. The good repeatability of automatic measurements suggests the new AS-OCT device to be a viable option in clinical practice of eyes with keratoconus.
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Lu W, Miao Y, Li Y, Hu X, Hu Q, Huang J. Comparison of Multicolored Spot Reflection Topographer and Scheimpflug-Placido System in Corneal Power and Astigmatism Measurements With Normal and Post-refractive Patients. J Refract Surg 2019; 35:370-376. [PMID: 31185102 DOI: 10.3928/1081597x-20190510-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 05/09/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the repeatability of corneal power and astigmatism derived by a novel multicolored spot reflection topographer system (Cassini; i-Optics, Hague, Netherlands) and compare its agreement with a Placido-Scheimpflug system (Sirius; Costruzione Strumenti Oftalmici, Florence, Italy) in normal and post-refractive patients. METHODS This prospective study comprised patients who underwent myopic excimer laser refractive surgery (96 eyes) and normal patients (102 eyes). Each patient was measured three times with the Cassini and Sirius. The simulated keratometry (SimK), total corneal power (TCP), and astigmatism were recorded. The repeatability was assessed by one-way analysis of variance. The paired t test was used to compare the differences, whereas the agreement was evaluated by Bland-Altman analysis. RESULTS All parameters obtained by the Cassini demonstrated high repeatability, except for total corneal astigmatism (TCA) in the post-refractive group. The intraclass correlation coefficients of all parameters were greater than 0.85, the correlation of variation values was less than 0.55%, and the test-retest repeatability was less than 0.85 diopters (D). The paired t test showed significant differences in steep keratometry, astigmatism, TCP, and TCA in the normal group and in J0, TCP, and TCA in the post-refractive group. The 95% limits of agreement (LoA) in the normal group demonstrated good agreement, except for TCP. Only J0 and J45 of astigmatism and TCA remained narrow for 95% LoA in the post-refractive group. CONCLUSIONS These results suggested that the Cassini provided high repeatable measurements in corneal power and astigmatism, except the TCA of post-refractive patients. The parameters could be used interchangeably in normal patients, except for TCP, whereas only J0 of astigmatism and J0, J45 of TCA showed good agreement in post-refractive patients. [J Refract Surg. 2019;35(6):370-376.].
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Kim BK, Mun SJ, Yang YH, Kim JS, Moon JH, Chung YT. Comparison of anterior segment changes after femtosecond laser LASIK and SMILE using a dual rotating Scheimpflug analyzer. BMC Ophthalmol 2019; 19:251. [PMID: 31829164 PMCID: PMC6907211 DOI: 10.1186/s12886-019-1257-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 11/22/2019] [Indexed: 12/27/2022] Open
Abstract
Background To compare the changes in the anterior segment after femtosecond laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) using a dual rotating Scheimpflug (DRS) analyzer (Galilei®; Ziemer Ophthalmology, Port, Switzerland). Methods A total of 218 eyes of 109 patients who underwent FS-LASIK or SMILE for myopic correction were retrospectively studied. Ninety-eight eyes of 49 patients who underwent FS-LASIK were compared to 120 eyes of 60 patients treated with SMILE. A DRS analyzer was used for preoperative and 6-month postoperative anterior segment analyses. Measured variables included the central corneal thickness (CCT), anterior chamber depth (ACD), anterior and posterior keratometry (K), anterior and posterior best-fit sphere radius, and maximum posterior elevation (MPE). Results After the procedure, the amount of CCT decrease was higher in the SMILE group than in the FS-LASIK group, but it was not statistically significant. The MPE was significantly increased after both procedures (p < 0.001 and p = 0.001 in the FS-LASIK and SMILE groups, respectively), with the amount of elevation being higher after FS-LASIK than after SMILE even though it was not statistically significant. And there was a significant change in the steep and average posterior K in the FS-LASIK group (p = 0.006 and 0.001, respectively), but not in the SMILE group. Conclusions Regarding changes in the MPE and posterior K, changes in the posterior corneal surface were greater after FS-LASIK than after SMILE. Trial registration The trial registration number: KCT0003628. Date of registration: 15 March 2019.
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Affiliation(s)
- Bu Ki Kim
- Onnuri Smile Eye Clinic, Hyobong building 9F 1, Gangnam-daero 65 gil, Seocho-gu, Seoul, Republic of Korea
| | - Su Joung Mun
- Onnuri Eye Hospital, 325, Baekje-daero, Wansan-gu, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Young Hoon Yang
- Onnuri Eye Hospital, 325, Baekje-daero, Wansan-gu, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Ji Sun Kim
- Onnuri Smile Eye Clinic, Hyobong building 9F 1, Gangnam-daero 65 gil, Seocho-gu, Seoul, Republic of Korea
| | - Jun Hyung Moon
- Onnuri Eye Hospital, 325, Baekje-daero, Wansan-gu, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Young Taek Chung
- Onnuri Eye Hospital, 325, Baekje-daero, Wansan-gu, Jeonju-si, Jeollabuk-do, Republic of Korea.
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Piñero DP, Camps VJ, de Fez D, García C, Caballero MT. Validation of posterior corneal curvature measurements with color light-emitting diode topography. Eur J Ophthalmol 2019; 30:1261-1267. [PMID: 31432704 DOI: 10.1177/1120672119870738] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the intrasession repeatability and validity of posterior corneal curvature and astigmatism measurements provided by a color light-emitting diode reflection topography system in healthy eyes. METHODS A total of 40 healthy eyes of 40 patients (age, 16-66 years) were enrolled. A complete eye examination was performed in all cases including posterior topographic analysis with two systems: the Scheimpflug-based system (Pentacam; Oculus Optikgeräte GmbH, Wetzlar, Germany) and the Cassini system (i-Optics; Ophthec, The Hague, The Netherlands). With this last system, three consecutive measurements were taken to assess the level of intrasession repeatability (within-subject standard deviation, Sw; intraclass correlation coefficient). The Bland & Altman analysis was used to evaluate the interchangeability of both devices. RESULTS The Sw was ⩽0.06 mm for all posterior corneal radius measurements, with intraclass correlation coefficient of ⩾0.960. The Sw for the magnitude of astigmatism, J0, and J45 were 0.15, 0.04, and 0.04 D, respectively, with intraclass correlation coefficient values of 0.876, 0.897, and 0.840, respectively. Statistically significant differences between devices were found in all parameters evaluated (p ⩽ 0.025). The interchangeability analysis revealed the presence of clinically relevant limits of agreement for the flattest (0.03 to 0.50 mm) and steepest posterior corneal radii (-0.01 to 0.39 mm). In contrast, limits of agreements were not clinically relevant for the magnitude of posterior astigmatism (-0.17 to 0.27 D) and their power vector components (-0.11 to 0.15 D). CONCLUSION The Cassini system provides consistent measures of posterior corneal curvature and astigmatism in healthy eyes, but only measures of posterior astigmatism can be considered as interchangeable with those provided by the Pentacam.
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Affiliation(s)
- David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - Vicent J Camps
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Dolores de Fez
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Celia García
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
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Comparison of Color Light-Emitting Diode Corneal Topographer and Dual Rotating Scheimpflug-Placido Topographer. J Ophthalmol 2018; 2018:6764805. [PMID: 30687546 PMCID: PMC6327256 DOI: 10.1155/2018/6764805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 12/01/2018] [Accepted: 12/09/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To compare measurements of anterior and posterior keratometric values, using a color light-emitting diode corneal topographer and a dual rotating Scheimpflug-Placido topographer. Methods Anterior and posterior corneal index measurements were performed using a color light-emitting diode corneal topographer (Cassini) and a dual rotating Scheimpflug-Placido topographer (Galilei G4) and then compared. The paired t-test, intraclass correlation coefficients (ICCs), and Bland-Altman plots were used to evaluate the agreement between measurements. Results Sixty postrefractive surgery eyes and 60 normal eyes were evaluated. Both the color light-emitting diode corneal topographer and the dual rotating Scheimpflug-Placido topographer provided highly repeatable corneal measurements (ICC > 0.969). The agreement levels between the 2 devices for anterior corneal power, astigmatism magnitude, and J0 and J45 values were ICC > 0.906 for the total group. However, the ICC values for posterior corneal power, astigmatism magnitude, and J0 and J45 values were lower than 0.681 for the total group. Conclusions The anterior keratometric values obtained by the color light-emitting diode corneal topographer and the dual rotating Scheimpflug-Placido topographer showed high agreement levels, but the posterior keratometric values showed lower agreement levels.
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Savini G, Schiano-Lomoriello D, Hoffer KJ. Repeatability of automatic measurements by a new anterior segment optical coherence tomographer combined with Placido topography and agreement with 2 Scheimpflug cameras. J Cataract Refract Surg 2018; 44:471-478. [DOI: 10.1016/j.jcrs.2018.02.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 02/03/2018] [Accepted: 02/05/2018] [Indexed: 11/17/2022]
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Corneal Topographic and Aberrometric Measurements Obtained with a Multidiagnostic Device in Healthy Eyes: Intrasession Repeatability. J Ophthalmol 2017; 2017:2149145. [PMID: 28133542 PMCID: PMC5241482 DOI: 10.1155/2017/2149145] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/10/2016] [Accepted: 12/05/2016] [Indexed: 12/12/2022] Open
Abstract
Purpose. To evaluate the intrasession repeatability of corneal curvature, eccentricity, and aberrometric measurements obtained with a multidiagnostic device in healthy eyes. Methods. This study enrolled 107 eyes of 107 patients ranging in age from 23 to 65 years. All of them underwent a complete anterior segment examination with the VX120 system (Visionix-Luneau Technologies, Chartres, France). Three consecutive measurements were obtained. The within-subject standard deviation (Sw), intrasubject precision (1.96 × Sw), and intraclass correlation coefficient (ICC) were calculated. Results. All Sw for corneal power measurements were below 0.26 D, with ICC above 0.982. The Sw for corneal astigmatism at different areas (3, 5, and 7 mm) was below 0.21 D, with ICC above 0.913. Concerning the axis of astigmatism, its Sw was below 11.27°, with ICC above 0.975. The Sw and ICC for corneal eccentricity were 0.067 and 0.957, respectively. The Sw and ICC for high-order aberration root mean square (RMS) were 0.048 µm and 0.901, respectively. For 3rd- and 4th-order aberrometric parameters, all Sw were below 0.037 µm and all ICC were higher than 0.84, except for quadrafoil RMS (ICC: 0.689). Conclusions. The multidiagnostic device evaluated is able to provide consistent measurements of corneal power, eccentricity, and third- and fourth-order aberrations in healthy eyes.
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Martínez-Albert N, Esteve-Taboada JJ, Montés-Micó R. Repeatability of whole-cornea measurements using an anterior segment imaging device based on OCT and Placido-disk. Expert Rev Med Devices 2017; 14:169-175. [DOI: 10.1080/17434440.2017.1281739] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Noelia Martínez-Albert
- Optometry Research Group (GIO), Department of Optics and Optometry and Vision Sciences, University of Valencia, Burjassot, Spain
| | - José J. Esteve-Taboada
- Optometry Research Group (GIO), Department of Optics and Optometry and Vision Sciences, University of Valencia, Burjassot, Spain
| | - Robert Montés-Micó
- Optometry Research Group (GIO), Department of Optics and Optometry and Vision Sciences, University of Valencia, Burjassot, Spain
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