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Wang H, Zhu LS, Pang CJ, Fan Q. Repeatability assessment of anterior segment measurements in myopic patients using an anterior segment OCT with placido corneal topography and agreement with a swept-source OCT. BMC Ophthalmol 2024; 24:182. [PMID: 38649848 PMCID: PMC11036772 DOI: 10.1186/s12886-024-03448-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The precision of anterior segment biometric measurements in eyes has become increasingly important in refractive surgery. The purpose of this study is to assess the repeatability of the automatic measurements provided by a new spectral-domain optical coherence tomograph (SD-OCT)/Placido topographer (MS-39, CSO) and its agreement with a swept-source OCT (SS-OCT) biometer (CASIA SS-1000, Tomey) in patients with myopia. METHODS The right eye of 235 subjects was scanned 3 times with both devices. The evaluated parameters included central corneal radius of the steep meridian, central corneal radius of the flat meridian, mean central corneal radius, thinnest corneal thickness, central corneal thickness, anterior chamber depth, corneal volume and diameter. The intraobserver repeatability of the MS-39 measurements was calculated using intraclass correlation coefficient (ICC), within subject standard deviation, coefficient of repeatability, coefficient of variation and repeated-measures analysis of variance of the 3 repeated measurements. The agreement between the two devices was evaluated by 95% limits of agreement (LoA). RESULTS The majority of the parameters acquired from MS-39 showed high repeatability. The repeatability of corneal diameter was slightly lower than the other measurements, although the ICC remained high. Agreement with the CASIA SS-1000 was good, indicated by the Bland-Altman plots with narrow 95% LoA values for all parameters assessed. CONCLUSIONS The high repeatability of automatic measurements by the new device supports its clinical application in eyes with myopia, and the good agreement between the two devices indicates they could be used interchangeably for the parameters evaluated.
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Affiliation(s)
- Hao Wang
- Department of Refractive Surgery, Henan Provincial People's Hospital, Henan Eye Hospital, People's Hospital Affiliated to Zhengzhou University, People's Hospital Affiliated to Henan University, NO.7 Weiwu Road, 450003, Zhengzhou, China
| | - Li-Shuang Zhu
- Department of Blood Transfusion, Zhengzhou People's Hospital, NO.33 Huanghe Road, 450003, Zhengzhou, China
| | - Chen-Jiu Pang
- Department of Refractive Surgery, Henan Provincial People's Hospital, Henan Eye Hospital, People's Hospital Affiliated to Zhengzhou University, People's Hospital Affiliated to Henan University, NO.7 Weiwu Road, 450003, Zhengzhou, China.
| | - Qi Fan
- Department of Refractive Surgery, Henan Provincial People's Hospital, Henan Eye Hospital, People's Hospital Affiliated to Zhengzhou University, People's Hospital Affiliated to Henan University, NO.7 Weiwu Road, 450003, Zhengzhou, China
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Russo A, Filini O, Savini G, Festa G, Morescalchi F, Boldini A, Semeraro F. Predictability of the vault after implantable collamer lens implantation using OCT and artificial intelligence in White patient eyes. J Cataract Refract Surg 2023; 49:724-731. [PMID: 36913536 PMCID: PMC10284125 DOI: 10.1097/j.jcrs.0000000000001182] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE To compare the predicted vault using machine learning with the achieved vault using the online manufacturer's nomogram in patients undergoing posterior chamber implantation with an implantable collamer lens (ICL). SETTING Centro Oculistico Bresciano, Brescia, Italy, and I.R.C.C.S.-Bietti Foundation, Rome, Italy. DESIGN Retrospective multicenter comparison study. METHODS 561 eyes from 300 consecutive patients who underwent ICL placement surgery were included in this study. All preoperative and postoperative measurements were obtained by anterior segment optical coherence tomography (AS-OCT; MS-39). The actual vault was quantitatively measured and compared with the predicted vault using machine learning of AS-OCT metrics. RESULTS A strong correlation between model predictions and achieved vaulting was detected by random forest regression (RF; R2 = 0.36), extra tree regression (ET; R2 = 0.50), and extreme gradient boosting regression ( R2 = 0.39). Conversely, a high residual difference was observed between achieved vaulting values and those predicted by the multilinear regression ( R2 = 0.33) and ridge regression ( R2 = 0.33). ET and RF regressions showed significantly lower mean absolute errors and higher percentages of eyes within ±250 μm of the intended ICL vault compared with the conventional nomogram (94%, 90%, and 72%, respectively; P < .001). ET classifiers achieved an accuracy (percentage of vault in the range of 250 to 750 μm) of up to 98%. CONCLUSIONS Machine learning of preoperative AS-OCT metrics achieved excellent predictability of ICL vault and size, which was significantly higher than the accuracy of the online manufacturer's nomogram, providing the surgeon with a valuable aid for predicting the ICL vault.
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Affiliation(s)
- Andrea Russo
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Ottavia Filini
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Giacomo Savini
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Giulia Festa
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Francesco Morescalchi
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Alessandro Boldini
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Francesco Semeraro
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
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Distribution of Corneal Volume and Its Associated Factors in an Elderly Population: Tehran Geriatric Eye Study. Cornea 2022:00003226-990000000-00159. [PMID: 36730423 DOI: 10.1097/ico.0000000000003177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/07/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE The aim of this study was to determine the distribution of corneal volume (CV) using Pentacam and its relationship with demographic and ocular factors in an elderly population older than 60 years. METHODS The present report is a part of the Tehran Geriatric Eye Study. The sampling was performed using the multistage stratified random cluster sampling method. The preliminary ocular examinations were performed for all individuals including visual acuity measurement, objective and subjective refraction, and slit-lamp biomicroscopy. Finally, study participants underwent anterior segment imaging and ocular biometry using Pentacam AXL. RESULTS The mean CV was 57.92 mm3 [95% confidence interval (CI): 57.76-58.08] in the whole sample. The mean CV was 57.69 mm3 (95% CI: 57.52-57.87) after excluding diabetic patients. The mean CV was 57.79 mm3 (95% CI: 57.57-58.01) and 58.04 mm3 (95% CI: 57.83-58.26) in men and women, respectively. The mean CV was 57.96 mm3 (95% CI: 57.71-58.21), 57.84 mm3 (95% CI: 57.49-58.19), and 57.92 mm3 (95% CI: 57.7-58.13) in individuals with emmetropia, myopia, and hyperopia, respectively. The CV decreased significantly with advancing age. Moreover, the anterior chamber depth, central corneal thickness, mean keratometry, anterior corneal asphericity (Q value), and posterior corneal astigmatism were significantly directly related to CV, whereas axial length and white-to-white distance had a statistically significant inverse association with the CV. CONCLUSIONS Aging is one of the important factors in reducing CV that should be considered. Some other topographic and biometric indices also have a significant relationship with CV.
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Savini G, Lupardi E, Hoffer KJ, Aramberri J, Schiano-Lomoriello D. Corneal diameter measurements by 3 optical biometers and their effect on phakic intraocular lens sizing. J Cataract Refract Surg 2022; 48:1292-1296. [PMID: 35616506 DOI: 10.1097/j.jcrs.0000000000000976] [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: 01/26/2022] [Accepted: 05/22/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare phakic intraocular lens size calculations based on corneal diameter (CD) measurements by 3 instruments. SETTING G.B. Bietti Foundation I.R.C.C.S., Rome, Italy. DESIGN Retrospective interventional case series. METHODS Preoperatively, CD was measured with the Aladdin, IOLMaster 700, and Pentacam AXL Wave. The simulated ICL size was computed by entering CD measurements into the manufacturer's calculator. Postoperatively, vaulting was measured by anterior segment optical coherence tomography. The optimal ICL size (OIS) was calculated and compared with the commercially available OIS (CAOIS). RESULTS 54 eyes (29 patients) with the implantable collamer lens (ICL) were enrolled. The mean CD was 12.02 ± 0.36 mm with the Aladdin, 12.35 ± 0.39 mm with the IOLMaster 700, and 12.22 ± 0.41 mm with the Pentacam AXL Wave ( P &lt; .0001), with the closest agreement between the Pentacam AXL Wave and IOLMaster 700 (95% limits of agreement: -0.43 to +0.17 mm). Vaulting (mean: 558 ± 261 μm) was within 251 and 1000 μm in 49 eyes (83.3%). The mean difference between the simulated ICL size and OIS ranged between -0.11 ± 0.35 mm and 0.10 ± 0.30 mm ( P &lt; .0001), with no statistically significant difference between the IOLMaster 700 and Pentacam AXL Wave. The simulated ICL size was equal to CAOIS in 38 eyes (70.37%) with the Aladdin, 37 eyes (68.52%) with the IOLMaster 700, and 39 eyes (72.22%) with the Pentacam AXL Wave, without any statistically significant difference. CONCLUSIONS CD measurements by the 3 devices lead to similar percentages of eyes with an ICL size equal to the OIS. Agreement is closer between the IOLMaster 700 and Pentacam AXL Wave.
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Affiliation(s)
- Giacomo Savini
- From the I.R.C.C.S., G.B. Bietti Foundation, Rome, Italy (Savini, Schiano-Lomoriello); University Eye Clinic, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy (Lupardi); Stein Eye Institute, University of California, Los Angeles, California (Hoffer); St. Mary's Eye Center, Santa Monica, California (Hoffer); Clínica Miranza Begitek, San Sebastian and Clinica Miranza Ókular, Vitoria, Spain (Aramberri)
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Moon JY, Cho SC, Kim HJ, Jun RM, Han KE. Agreement Between Two Swept-source Optical Coherence Tomography Biometers and A Partial Coherence Interferometer. KOREAN JOURNAL OF OPHTHALMOLOGY 2022; 36:326-337. [PMID: 35766049 PMCID: PMC9388892 DOI: 10.3341/kjo.2022.0017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/26/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the level of agreement between ANTERION (Heidelberg Engineering, Heidelberg, Germany), OA-2000 (Tomey, Nagoya, Japan), and IOLMaster 500 (Carl Zeiss AG, Jena, Germany). Methods Fifty-one eyes of 51 patients were included in the study. Flat keratometry (K) and steep K, vector component of astigmatism (Jackson cross-cylinder at 0° and 90° [J0] and Jackson cross-cylinder at 45° and 135° [J45]), anterior chamber depth, and axial length were compared using the three devices. Repeated measures analysis of variance was conducted to compare the mean values of the biometrics. Pearson correlation test was conducted to analyze the correlations of the measured values, and a Bland-Altman plot was used to assess the agreement between the three devices. The predicted intraocular lens power of each device was compared to the others using the SRK/T, Haigis, Barrett Universal II, and Kane formulas. Results All K values measured using ANTERION were flatter than those of other instruments. However, good agreement was observed for flat K (ANTERION - OA-2000; 95% limits of agreement [LoA], 0.86 diopters [D]) and steep K (ANTERION - OA-2000; 95% LoA, 0.93 D) and OA-2000 - IOLMaster 500 (95% LoA, 0.93 D). J0 and J45 vector components of astigmatism were not statistically different; however, the agreements were poor between the devices (95% LoA ≥1.97 D). Anterior chamber depth values of ANTERION and OA-2000 were interchangeable (95% LoA, 0.15 mm). The axial length showed a high agreement (95% LoA ≤0.17 mm) among the three devices. The predicted intraocular lens powers of the three devices were not interchangeable regardless of formulas (95% LoA ≥1.04 D). Conclusions Significant differences in ocular biometrics were observed between ANTERION and the other two devices. This study demonstrated that only axial length showed good agreement among devices.
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Affiliation(s)
- Ji Young Moon
- Department of Ophthalmology, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, Republic of Korea
| | - Soo Chang Cho
- Department of Ophthalmology, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, Republic of Korea
| | - Hyun Jin Kim
- Department of Ophthalmology, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, Republic of Korea
| | - Roo Min Jun
- Department of Ophthalmology, Ewha Womans University College of Medicine, Seoul Hospital, Seoul, Republic of Korea
| | - Kyung Eun Han
- Department of Ophthalmology, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, Republic of Korea
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Ivan D, Ohlerth S, Richter H, Verdino D, Rampazzo A, Pot S. 3T high-resolution magnetic resonance imaging, conventional ultrasonography and ultrasound biomicroscopy of the normal canine eye. BMC Vet Res 2022; 18:67. [PMID: 35144606 PMCID: PMC8829979 DOI: 10.1186/s12917-021-03108-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 12/03/2021] [Indexed: 12/16/2022] Open
Abstract
Background Advances in MRI coil technology and increased availability of high-field MRI in veterinary medicine enable the acquisition of images of increasingly high spatial resolution while preserving signal-to-noise ratio.The purpose of the present study was to compare 3T high-resolution magnetic resonance imaging (HR-MRI) with ultrasound (US) and ultrasound biomicroscopy (UBM) in the normal canine eye, to assess its potential to depict normal ocular anatomy. Results HR-MRI was compared with US and UBM in 10 eyes from 10 healthy beagle dogs. Ocular structures (cornea, anterior chamber, iridocorneal angle, iris, lens, ciliary body, choroid, vitreous body, posterior wall of the eye, optic nerve and optic nerve sheath, extraocular muscles) were assessed subjectively and central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AQD), anteroposterior, mediolateral and dorsoventral lens diameter (APLD, MLLD, DVLD), anteroposterior diameter of the globe including and excluding the scleroretinal rim (APDSRR, APD), vitreous chamber depth (VCD) and optic nerve sheath diameter (ONSD) were measured in HR-MRI and in US. Optic nerve diameter (OND) was measured in HR-MRI. HR-MRI and UBM appearance of the anterior segment were subjectively compared. Detailed reference high-resolution MRI images of normal eyes of Beagle dogs are provided. Conclusions HR-MRI allowed assessment of all structures identified with US and UBM. The MRI examinations were performed under general anesthesia with the addition of a neuromuscular blocking agent, while US and UBM examinations were performed in conscious animals. Visibility of the entire ocular wall, the lens, the structures caudal to the ciliary body and the optic nerve and its sheath was superior with HR-MRI. HR-MRI allowed the distinction of retina, choroid and sclera, and the delineation of structures not previously identified in canine eyes with MRI, including Tenon’s capsule and the sub-Tenon’s space.Plane selection was more accurate with HR-MRI compared to US. In general, the range of measurements was narrower for MRI than for US. CCT, AQD, APLD, MLLD, APD, APDSRR and ONSD differed significantly between HR-MRI and US, respectively (p = 0.005-0.027).Micro-MRI may be useful for the assessment of ocular pathologies in the future.
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Affiliation(s)
- Daniel Ivan
- Clinic for Diagnostic Imaging, Department for Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
| | - Stefanie Ohlerth
- Clinic for Diagnostic Imaging, Department for Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Henning Richter
- Clinic for Diagnostic Imaging, Department for Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Dagmar Verdino
- Veterinary Anesthesia Services International GmbH, Winterthur, Switzerland
| | - Antonella Rampazzo
- Ophthalmology Section, Equine Department, Vetsuisse Faculty, Zurich, Switzerland
| | - Simon Pot
- Ophthalmology Section, Equine Department, Vetsuisse Faculty, Zurich, Switzerland
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Lei Q, Tu H, Feng X, Ortega-Usobiaga J, Cao D, Wang Y. Distribution of ocular biometric parameters and optimal model of anterior chamber depth regression in 28,709 adult cataract patients in China using swept-source optical biometry. BMC Ophthalmol 2021; 21:178. [PMID: 33849464 PMCID: PMC8045194 DOI: 10.1186/s12886-021-01932-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background The purpose of this study was to evaluate the ocular biometric parameters in adult cataract patients from China and create an anterior chamber depth (ACD) regression model. Methods The ocular biometric records of 28,709 right eyes of cataract surgery candidates who were treated at Aier Eye Hospitals in nine cities from 2018 to 2019 were retrospectively analyzed. All measurements were taken with IOLMaster 700. We included patients who were at least 40 years old and were diagnosed with cataract. Results The mean age of the patients was 68.6 ± 11.0 years. The mean values recorded were as follows: axial length (AL), 24.17 ± 2.47 mm; mean keratometry (Km) value, 44.26 ± 1.70 D; corneal astigmatism (CA), 1.06 ± 0.96 D; ACD, 3.02 ± 0.45 mm; lens thickness (LT), 4.52 ± 0.45 mm; central corneal thickness (CCT), 0.534 ± 0.04 mm; and white to white (WTW) corneal diameter, 11.64 ± 0.46 mm. ACD correlated positively with AL (Spearman coefficient, 0.544) and WTW (0.300), but negatively with LT (-0.660) and age (-0.285) (all P < 0.01). In the multivariate regression analysis of ACD, which included LT, AL, WTW, sex, Km, CCT, and age, there was a reasonable prediction with adjusted R2 = 0.641. Conclusions Cataract patients with longer AL and wider WTW have deeper ACD. With increasing age and lens thickening ACD becomes shallower. Based on the standardized coefficients of ACD multivariate regression analysis from the study, LT is the main factor that affects ACD, and is followed by AL.
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Affiliation(s)
- Qiong Lei
- Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Haixia Tu
- Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Xi Feng
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Julio Ortega-Usobiaga
- Department of Cataract and Refractive Surgery, Cl í nica Baviera-AIER Eye Hospital Group, Bilbao, Spain
| | - Danmin Cao
- Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Yong Wang
- Aier Eye Hospital of Wuhan University, Wuhan, China. .,Aier School of Ophthalmology, Central South University, Changsha, China.
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Comparison of Anterior Ocular Biometric Measurements Using Swept-Source and Time-Domain Optical Coherence Tomography. J Ophthalmol 2020; 2020:9739878. [PMID: 32953169 PMCID: PMC7487088 DOI: 10.1155/2020/9739878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/27/2020] [Indexed: 12/18/2022] Open
Abstract
Purpose To compare central corneal thickness (CCT), aqueous depth (AQD), and anterior chamber depth (ACD) measurements using the swept-source (CASIA SS-1000, Tomey, Japan) and time-domain (Visante, Carl Zeiss Meditec, USA) anterior segment optical coherence tomographers (OCT) in normal eyes. Methods Sixty-eight eyes of 68 subjects were included. Three consecutive scans of each subject were obtained using both devices in a random order by one experienced operator. Standard deviation (S w), coefficient of repeatability (CoR), coefficients of variation (CoV), and intraclass correlation coefficients (ICC) were used to evaluate the intraoperator repeatability. Agreement was assessed using the Bland-Altman plots and 95% limits of agreement (LoA). Results All measurements of the swept-source OCT (SS-OCT) and time-domain OCT (TD-OCT) showed high repeatability with low CoR (CCT: 2.34 μm and 6.16 μm; AQD: 0.05 mm and 0.09 mm; ACD: 0.06 mm and 0.09 mm), low CoV (CCT: 0.16% and 0.42%; AQD: 0.61% and 0.97%; ACD: 0.53% and 0.83%), and high ICC (>0.98). The mean CCT with SS-OCT was slightly thicker than the results with TD-OCT (difference = 4.55 ± 2.62 μm, P < 0.001). There was no statistically significant difference in AQD or ACD measurements between the two devices (0.01 ± 0.05 mm, P=0.111; 0.02 ± 0.05 mm, P=0.022, respectively). The 95% LoA between the SS-OCT and TD-OCT were -0.59 to 9.69 μm for CCT, -0.10 to 0.12 mm for AQD, and -0.09 to 0.12 mm for ACD. Conclusions High levels of repeatability and agreement were found between the two devices for all three parameters, suggesting interchangeability. SS-OCT demonstrated superior repeatability compared with TD-OCT.
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Update on Intraocular Lens Power Calculation Study Protocols: The Better Way to Design and Report Clinical Trials. Ophthalmology 2020; 128:e115-e120. [PMID: 32653457 DOI: 10.1016/j.ophtha.2020.07.005] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/15/2020] [Accepted: 07/06/2020] [Indexed: 11/21/2022] Open
Abstract
It was almost 40 years ago when one of the authors (K.J.H.) published an organized system to quantify the accuracy of intraocular lens (IOL) power calculation formulas, methods, and instruments. At the behest of the editor of the American Journal of Ophthalmology, the IOL Power Club (along with a statistician) published an editorial in 2015 modernizing and quantifying the proper protocols for these studies. Over the past decade, so many new optical biometers, formulas, and methods (whose accuracies have yet to be completely tested) have been introduced that we were asked to modernize and update these guidelines yet again to help others design and report correctly the results of clinical studies on IOL power calculation and biometry for 2020. We evaluated guidelines to enroll patients, including visual acuity minimums, exclusion of bilateral eyes, sample size issues, demographics (age, gender, and ethnicity), and whether such studies should not be performed using the same data that were used to develop the formula being tested. We showed the absolute need for constant optimization, which formulas should be tested for comparison, refraction measurement (testing distance), as well as the analysis of the prediction error (median and mean absolute errors; standard deviation; range of errors; percentage of eyes with a prediction within ±0.25 diopter [D], ±0.50 D, ±0.75 D, and ±1.00 D; and interquartile displays) and statistical methods of analyses. We present methods of ranking formula accuracy, including the new Haigis IOL Formula Performance Index. We also point out the issues of who programmed the formulas being tested, that all formulas used in the study must be referenced, and the software version number of all instruments used in the study should be stated clearly. The definition of anterior chamber depth should be stated as measured from the corneal epithelium to the lens. We hope that these recommendations will help researchers to improve the validity and accuracy of their studies with the ultimate goal to improve the accuracy of IOL power calculation.
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Shajari M, Sonntag R, Niermann T, Holland D, Kohnen T, Priglinger S, Mayer WJ. Determining and Comparing the Effective Lens Position and Refractive Outcome of a Novel Rhexis-Fixated Lens to Established Lens Designs. Am J Ophthalmol 2020; 213:62-68. [PMID: 31953058 DOI: 10.1016/j.ajo.2020.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/05/2020] [Accepted: 01/06/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE WE sought to evaluate differences in effective lens position (ELP) based on the lens design. Intraocular lenses (IOLs) with plate-haptic, c-loop haptic, and a rhexis-fixated lens were compared. DESIGN Retrospective, multicenter, comparative case series. METHODS The study included patients having age-related cataract surgery with implantation of either a plate-haptic, c-loop haptic, or a novel rhexis-fixated IOL. Biometry and refraction measurements were conducted preoperatively and 3 months postoperatively. Lens constant optimization was performed. RESULTS Seventy eyes of 56 subjects were included. ELP for rhexis-fixated IOL was shortest (4.29 ± 0.24 mm), followed by c-loop haptic (4.41 ± 0.42 mm) and plate-haptic (4.51 ± 0.26 mm) IOL. Difference in ELP was significant between rhexis-fixated IOL and both plate-haptic (P = .001) and c-loop haptic IOL (P = .000). Anterior chamber depth adjustment based on lens design showed a significant effect on refraction and IOL power predictions for all formulas and lenses (P < .05). For the rhexis-fixated IOL the differences in refraction ranged from -0.039 diopters (D) for the Hill-Radial Basis Function to -0.096 D for Haigis. The other 2 lenses showed mean differences in refraction between +0.046 D for Hill-Radial Basis Function and +0.097 D for Haigis. CONCLUSION The difference in IOL fixation and its resulting position in the capsular bag have a significant effect on the effective lens position and consequently a significant effect on the prediction of postoperative refraction.
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Affiliation(s)
- Mehdi Shajari
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany; Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - Ruven Sonntag
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - Theresa Niermann
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | | | - Thomas Kohnen
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | | | - Wolfgang J Mayer
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
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Kanclerz P, Hoffer KJ, Rozema JJ, Przewłócka K, Savini G. Repeatability and reproducibility of optical biometry implemented in a new optical coherence tomographer and comparison with a optical low-coherence reflectometer. J Cataract Refract Surg 2019; 45:1619-1624. [DOI: 10.1016/j.jcrs.2019.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 06/21/2019] [Accepted: 07/01/2019] [Indexed: 12/28/2022]
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Fukuda S, Ueno Y, Fujita A, Mori H, Tasaki K, Murakami T, Beheregaray S, Oshika T. Comparison of anterior segment and lens biometric measurements in patients with cataract. Graefes Arch Clin Exp Ophthalmol 2019; 258:137-146. [DOI: 10.1007/s00417-019-04482-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/02/2019] [Accepted: 09/13/2019] [Indexed: 11/28/2022] Open
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Repeatability assessment of anterior segment biometric measurements under accommodative and nonaccommodative conditions using an anterior segment OCT. Graefes Arch Clin Exp Ophthalmol 2017; 256:113-123. [PMID: 29098383 DOI: 10.1007/s00417-017-3832-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/06/2017] [Accepted: 10/16/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE As accommodation is a dynamic process changing anterior ocular structures, we aim to compare the repeatability between the biometric measurements taken with and without accommodation. METHODS Thirty healthy right eyes were measured in a baseline and an accommodative state using Visante-OCT. Three repeated measurements were taken to obtain central corneal thickness (CCT), anterior chamber depth (ACD), angle-to-angle distance (ATA), iridocorneal angles (IA), and crystalline lens thickness (LT). Repeatability was evaluated by the calculation of coefficient of repeatability (CoR), coefficient of variation (CoV), and intraclass correlation coefficient (ICC). In addition, the Passing-Bablok regression method was applied. RESULTS For the nonaccommodative state, the CoR for CCT, ACD, ATA, and LT was 20.02 μm, 0.09 mm, 0.25 mm, and 0.12 mm respectively. The CoR for CCT, ACD, ATA, and LT in the 6D-accommodative state was 20.85 μm, 0.08 mm, 0.26 mm, and 0.14 mm respectively. IA had similar results for both states; the CoR ranged between 3 and 4°, CoV was less than 4%, and the ICC was between 0.984-0.988. There were no significant differences between the three repeated measurements for any measurement. CONCLUSIONS Visante-OCT provides good repeatability for anterior segment measurements for both accommodative and nonaccommodative states.
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Comparison of ocular biometric measurements between a new swept-source optical coherence tomography and a common optical low coherence reflectometry. Sci Rep 2017; 7:2484. [PMID: 28559547 PMCID: PMC5449389 DOI: 10.1038/s41598-017-02463-z] [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: 11/08/2016] [Accepted: 03/14/2017] [Indexed: 12/28/2022] Open
Abstract
The purpose of the current study was to compare the measurements between a new optical biometer based on swept-source optical coherence tomography (SS-OCT), the OA-2000 (Tomey, Japan), and an optical biometer based on optical low coherence reflectometry (OLCR), the Lenstar (Haag-Streit, Switzerland). Ninety-nine eyes of 99 healthy subjects were included. The axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AD), lens thickness (LT), keratometry (K) readings, including flat K (Kf), steep K (Ks), mean K (Km), astigmatism vectors J0, J45 at diameters of 2.5 and 3.0 mm, and white-to-white diameter (WTW) were measured three times each using both biometer in normal eyes by random sequence. Bland-Altman analysis showed good agreement between the SS-OCT and OLCR devices for AL, AD, ACD, LT, with narrow 95% LoA (−0.05 to 0.07 mm, −0.09 to 0.10 mm, −0.10 to 0.09 mm, and −0.06 to 0.22 mm, respectively), and the P values of ACD were both >0.05. The CCT, Kf, Ks, Km, J0, J45 and WTW values provided by the OA-2000 were in good agreement with the Lenstar, and statistically significant differences were detected for some of them but not clinical differences. The agreement was excellent especially for AL.
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Comparison between a New Optical Biometry Device and an Anterior Segment Optical Coherence Tomographer for Measuring Central Corneal Thickness and Anterior Chamber Depth. J Ophthalmol 2016; 2016:6347236. [PMID: 27403339 PMCID: PMC4923600 DOI: 10.1155/2016/6347236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 05/09/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose. To compare between a new optical biometer (AL-Scan, Nidek Co., Aichi, Japan) and an anterior segment optical coherence tomographer (Visante AS-OCT, Carl Zeiss Meditec, Dublin, USA) for measuring central corneal thickness (CCT), anterior chamber depth (ACD), and aqueous depth (AD). Methods. Sixty-three eyes of 63 normal subjects were examined with AL-Scan and Visante AS-OCT in this prospective study. One eye per subject was measured three times with both devices to record their CCT, ACD, and AD. All procedures were performed by the same operator. Agreement between the two devices was assessed using paired t-tests, Bland-Altman plots, and 95% limits of agreement (LoA). Results. The mean CCT, ACD, and AD measured by AL-Scan were 538.59 ± 27.37 μm, 3.70 ± 0.30 mm, and 3.16 ± 0.30 mm, respectively. The mean values obtained by the Visante OCT were 536.14 ± 26.61 μm for CCT, 3.71 ± 0.29 mm for ACD, and 3.17 ± 0.29 mm for AD. The mean CCT by the AL-Scan was higher than that obtained by the Visante AS-OCT (difference = 2.45 ± 6.07 μm, P < 0.05). The differences in ACD and AD measurements were not statistically significant. The 95% LoA of CCT, ACD, and AD were between -9.44 and 14.35 μm, -0.15 and 0.12 mm, and -0.15 and 0.12 mm, respectively. Conclusions. Since these two devices were comparable for measuring CCT, ACD, and AD, their results can be interchangeably used in the clinic.
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Li J, Chen H, Savini G, Lu W, Yu X, Bao F, Wang Q, Huang J. Measurement agreement between a new biometer based on partial coherence interferometry and a validated biometer based on optical low-coherence reflectometry. J Cataract Refract Surg 2016; 42:68-75. [DOI: 10.1016/j.jcrs.2015.05.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/09/2015] [Accepted: 05/29/2015] [Indexed: 11/27/2022]
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The Repeatability Assessment of Three-Dimensional Capsule-Intraocular Lens Complex Measurements by Means of High-Speed Swept-Source Optical Coherence Tomography. PLoS One 2015; 10:e0142556. [PMID: 26600254 PMCID: PMC4658094 DOI: 10.1371/journal.pone.0142556] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 10/25/2015] [Indexed: 12/13/2022] Open
Abstract
Purpose To rebuild the three-dimensional (3-D) model of the anterior segment by high-speed swept-source optical coherence tomography (SSOCT) and evaluate the repeatability of measurement for the parameters of capsule-intraocular lens (C-IOL) complex. Methods Twenty-two pseudophakic eyes from 22 patients were enrolled. Three continuous SSOCT measurements were performed in all eyes and the tomograms obtained were used for 3-D reconstruction. The output data were used to evaluate the measurement repeatability. The parameters included postoperative aqueous depth (PAD), the area and diameter of the anterior capsule opening (Area and D), IOL tilt (IOL-T), horizontal, vertical, and space decentration of the IOL, anterior capsule opening, and IOL-anterior capsule opening. Results PAD, IOL-T, Area, D, and all decentration measurements showed high repeatability. Repeated measure analysis showed there was no statistically significant difference among the three continuous measurements (all P > .05). Pearson correlation analysis showed high correlation between each pair of them (all r >0.90, P<0.001). ICCs were all more than 0.9 for all parameters. The 95% LoAs of all parameters were narrow for comparison of three measurements, which showed high repeatability for three measurements. Conclusion SSOCT is available to be a new method for the 3-D measurement of C-IOL complex after cataract surgery. This method presented high repeatability in measuring the parameters of the C-IOL complex.
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Hoffer KJ, Aramberri J, Haigis W, Olsen T, Savini G, Shammas HJ, Bentow S. Protocols for studies of intraocular lens formula accuracy. Am J Ophthalmol 2015; 160:403-405.e1. [PMID: 26117311 DOI: 10.1016/j.ajo.2015.05.029] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 05/27/2015] [Accepted: 05/28/2015] [Indexed: 10/23/2022]
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Wang Q, Ding X, Savini G, Chen H, Feng Y, Pan C, Hua Y, Huang J. Anterior chamber depth measurements using Scheimpflug imaging and optical coherence tomography: repeatability, reproducibility, and agreement. J Cataract Refract Surg 2014; 41:178-85. [PMID: 25465212 DOI: 10.1016/j.jcrs.2014.04.038] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 04/01/2014] [Accepted: 04/03/2014] [Indexed: 11/15/2022]
Abstract
PURPOSE To determine the repeatability, reproducibility, and agreement of anterior chamber depth (ACD) measurements obtained with 3 Scheimpflug cameras and an anterior segment optical coherence tomography (AS-OCT) device. SETTING Eye Hospital of Wenzhou Medical University, Zhejiang, China. DESIGN Observational cross-sectional study. METHODS Two observers took 3 consecutive measurements in healthy right eyes using each device to assess intraoperator repeatability. The mean values obtained at different sessions by the first operator were used to determine the intersession reproducibility. Three consecutive measurements obtained by the first operator at the first session were averaged and used to assess agreement. RESULTS The ACD measurements obtained by 2 observers in 71 eyes were highly repeatable using the 4 devices, with a test-retest repeatability of 0.04 to 0.07 mm for intraoperator repeatability. The interoperator and intersession reproducibility of ACD measurements were high, and the test-retest repeatability ranges of interoperator and intersession reproducibility were 0.06 to 0.07 mm and 0.05 to 0.08 mm, respectively. The ACD measurements of the 4 systems were sorted from the thickest to the thinnest (Galilei G2 > Visante > Sirius > Pentacam). The differences in the measurements were statistically significant except between the ACD measurements obtained by the Sirius device and the Visante device. However, good agreement with narrow 95% limits of agreement was found between these devices. CONCLUSIONS The 4 devices provided high intraoperator repeatability and interoperator and intersession reproducibility for ACD measurements. Good agreement in ACD measurements was found between the devices in healthy eyes. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Qinmei Wang
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Xixia Ding
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Giacomo Savini
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Hao Chen
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Yifan Feng
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Chao Pan
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Yanjun Hua
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy
| | - Jinhai Huang
- From the School of Optometry and Ophthalmology and Eye Hospital (Wang, Ding, Chen, Feng, Pan, Hua, Huang), Wenzhou Medical University, and the Key Laboratory of Vision Science (Wang, Ding, Chen, Huang), Ministry of Health P.R. China, Wenzhou, Zhejiang, China; G.B. Studio Oculistico d'Azeglio (Savini), Bologna, Italy.
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Savini G, Hoffer KJ, Carbonelli M. Anterior Chamber and Aqueous Depth Measurement in Pseudophakic Eyes: Agreement Between Ultrasound Biometry and Scheimpflug Imaging. J Refract Surg 2013; 29:121-5. [DOI: 10.3928/1081597x-20130117-07] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 11/15/2012] [Indexed: 11/20/2022]
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