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Ma S, Li C, Sun J, Yang J, Wen K, Chen XT, Zhao FY, Gao RY, Tian F. Comparison of ocular biometric parameters between two swept-source optical coherence tomography devices and Scheimpflug tomography in patients with cataract. Int J Ophthalmol 2024; 17:1437-1446. [PMID: 39156774 PMCID: PMC11286440 DOI: 10.18240/ijo.2024.08.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/19/2024] [Indexed: 08/20/2024] Open
Abstract
AIM To assess and compare the variations and agreements across different ocular biometric parameters using swept-source optical coherence tomography (SS-OCT) and Scheimpflug tomography in patients diagnosed with cataract. METHODS This prospective case series was conducted at Tianjin Medical University Eye Hospital. In total, 212 eyes from 212 patients scheduled for phacoemulsification were included. Eyes were evaluated preoperatively using two SS-OCT devices (IOLMaster700 and CASIA2) and Scheimpflug tomography (Pentacam). Central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AQD), white-to-white distance (WTW), flat simulated keratometry (Kf), steep simulated keratometry (Ks), mean keratometry (Km), and total corneal keratometry (TKm) were measured. Intraclass correlation coefficient (ICC), 95% confidence intervals (CI) and limits of agreement (LoA) widths were conducted to assess differences and correlations between devices. RESULTS All parameters, except for Ks, were significantly different. Pairwise comparison revealed no significant differences between keratometry obtained by IOLMaster 700 and Pentacam. LoA widths of all paired comparisons for Ks were >0.80 D. Except for WTW between IOLMaster 700 and CASIA2 and between CASIA2 and Pentacam, other Pearson's coefficients between devices showed a strong correlation (all r>0.95). The ICC of WTW (ICC=0.438, 95%CI 0.167-0.625) showed poor reliability. The reliability of CCT, ACD, and AQD was excellent (all ICC>0.95), whereas that of TKm was good (ICC=0.827, 95%CI 0.221-0.939). A significant linear correlation was also observed among devices. CONCLUSION The ocular parameters derived from the use of IOLMaster700, CASIA2, and Pentacam exhibit significant discrepancies; as such, measurements from these devices should not be deemed as interchangeable.
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Affiliation(s)
- Shan Ma
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300380, China
- Zhengda Guangming Eye Group, Weifang 261000, Shandong Province, China
| | - Cheng Li
- Binzhou Polytechnic, Binzhou 256603, Shandong Province, China
| | - Jing Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300380, China
| | - Jun Yang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300380, China
| | - Kai Wen
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300380, China
| | - Xi-Teng Chen
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300380, China
| | - Fang-Yu Zhao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300380, China
| | - Rong-Yu Gao
- Zhengda Guangming Eye Group, Weifang 261000, Shandong Province, China
| | - Fang Tian
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300380, China
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Achiron A, Yahalomi T, Biran A, Levinger E, Cohen E, Elbaz U, Ali A, Mireskandari K, Tuuminen R, Voytsekhivskyy OV. A Comprehensive Evaluation of 16 Old and New Intraocular Lens Power Calculation Formulas in Pediatric Eyes. Clin Ophthalmol 2024; 18:2225-2238. [PMID: 39135944 PMCID: PMC11318601 DOI: 10.2147/opth.s470425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/25/2024] [Indexed: 08/15/2024] Open
Abstract
Purpose To compare the accuracy of 16 intraocular lens (IOL) power calculation formulas in pediatric cataract eyes. Patients and Methods The data records of pediatric patients who had been implanted with three IOL models (SA60AT, MA60AC, and enVista-MX60) between 2012 and 2018 were analyzed. The accuracy of 16 IOL power calculation methods was evaluated: Barrett Universal II (BUII), Castrop, EVO 2.0, Haigis, Hill-RBF 3.0, Hoffer Q, Hoffer QST, Holladay 1, Kane, LSF AI, Naeser 2, Pearl-DGS, SRK/T, T2, VRF, and VRF-G. The non-optimized (ULIB/IOLcon) and optimized constants were used for IOL power calculation. The mean prediction error (PE), Performance Index (FPI), and all descriptive statistics were calculated. Results Ninety-seven eyes of 97 pediatric patients aged 13.2 (IQR 11.2-17.1) were included. No statistically significant difference (HS-test) was observed (p > 0.818) except for the Hoffer Q, and Naeser 2 (P = 0.014). With optimized lens constants, the best FPI indices were obtained by Hoffer Q (0.256) and VRF-G (0.251) formulas, followed by Hill-RBF 3.0 and BUII, with an index of 0.248. The highest FPI indices with non-optimized constants showed SRK/T and T2 formulas (0.246 and 0.245, respectively), followed by VRF-G and Holladay 1, with an index of 0.244. The best median absolute error values (MedAE) were achieved by Hoffer Q (0.50 D), VRF-G (0.53 D), and Hill-RBF 3.0 (0.54 D), all P ≥ 0.074. Conclusion Our results place the Hoffer Q, VRF-G, Hill-RBF 3.0, and BUII formulas as more accurate predictors of postoperative refraction in pediatric cataract surgery.
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Affiliation(s)
- Asaf Achiron
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Yahalomi
- Department of Ophthalmology, Samson Assuta Ashdod Hospital and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel
| | - Amit Biran
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eliya Levinger
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Cohen
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uri Elbaz
- Department of Ophthalmology, Rabin Medical Center, Petach-Tikva and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asim Ali
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kamiar Mireskandari
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Raimo Tuuminen
- Helsinki Retina Research Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland
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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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Voytsekhivskyy OV. The VRF-L and VRF-GL IOL power calculation methods after radial keratotomy. Eye (Lond) 2024:10.1038/s41433-024-03195-x. [PMID: 38942910 DOI: 10.1038/s41433-024-03195-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 05/15/2024] [Accepted: 06/19/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND To investigate the accuracy of the VRF-L and VRF-GL IOL power calculation methods in cataract surgery after radial keratotomy (RK). METHODS The VRF-L and VRF-GL methods were collated with nine formulas: Barrett True K (No History), Haigis, Hoffer Q, Hoffer Q (Double-K), Holladay 1 (Double-K), Holladay 2 (Double-K), PEARL-DGS (RK), SRK/T (Double-K), and T2 (Double-K). With SS-OCT biometry (IOLMaster 700, Carl Zeiss Meditec), data of 78 eyes from 78 patients with previous RK was included. Optimised lens constants were sourced from the IOL Con website. Subjective refraction was obtained at 4 to 5 months postoperatively. The root mean square absolute error (RMSAE) and median absolute error (MedAE) were chosen as primary outcomes and the percentage of eyes with PEs within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D were analysed. RESULTS Statistical significance (Bootstrap-t test, P < 0.05) was shown by VRF-GL, VRF-L, and Haigis formulas with the lowest RMSAE (0.813 D, 0.816 D and 0.824 D) and MedAE (0.511 D, 0.497 D and 0.533 D) values. The Barrett True K formula was less predictable (0.836 and 0.580, respectively). The VRF-L, VRF-GL, and Haigis achieved the highest percentage of eyes with a PE within ±0.50 D (52.56%, 50.00%, and 46.15%) and ±1.00 D (79.49%, 79.49%, and 80.77% respectively). CONCLUSION The VRF-L and VRF-GL methods demonstrated higher accuracy and were comparable with existing methods in eyes after RK. The Haigis was an alternative option with a higher percentage of eyes with a PE within ±1.00 D (80.77%).
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Affiliation(s)
- Oleksiy V Voytsekhivskyy
- Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Komarov Ave. 3, Medical City, Kyiv, 03680, Ukraine.
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Li Q, Liu X, Yang J, Dai Y, Li W. Comparison of Barrett TK Universal II and Barrett Universal II TCRP Formulas in Power Calculations for 3 Presbyopia-Correcting Intraocular Lenses. Clin Ophthalmol 2024; 18:1457-1465. [PMID: 38818525 PMCID: PMC11137930 DOI: 10.2147/opth.s461195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/17/2024] [Indexed: 06/01/2024] Open
Abstract
Purpose To compare Barrett TK Universal II and Barrett Universal II TCRP calculations in the power calculations for 3 presbyopia-correcting intraocular lenses (PC-IOL). Methods This observational study involved 64 eyes from 64 patients who prepared to undergo extraction of crystalline lenses combined with PC-IOL (Symfony ZXR00, PanOptix TFNT00, or AT LISA tri 839MP) implantation. All eyes underwent ocular biometric measurements with IOLMaster 700 and Pentacam HR, and the interdevice agreement of measurements including total keratometry (TK, IOLMaster 700) and total corneal refractive power (TCRP, Pentacam HR) was evaluated. IOL power calculations were performed using TK-based Barrett TK Universal II and TCRP-based Barrett Universal II calculations, respectively. Results Paired t-tests showed that the differences in white-to-white diameter, central corneal thickness, anterior chamber depth, and mean TK between IOLMaster 700 and Pentacam HR were slight but significant (all P<0.05), and the differences in recommended IOL power for emmetropia between two Barrett calculations were also significant in 3 PC-IOLs (all P<0.05). The ROC curve showed that the AUC was 0.917 (95% CI, 0.820-0.971) for the absolute value of the difference between TK and TCRP in discriminating the difference of ≥ ±0.5 D in predicted IOL power with best cutoff values of 0.4 D. Conclusion The novel Barrett TK Universal II formula built in IOLMaster 700 is comparable to TCRP-based Barrett Universal II calculation for IOL power calculation of PC-IOLs, and the convenience of using the Barrett TK Universal II formula should be founded on measurement consistency between devices.
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Affiliation(s)
- Qingchen Li
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Shanghai, 201103, People’s Republic of China
- Department of Ophthalmology, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, 410011, People’s Republic of China
| | - Xinyi Liu
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Shanghai, 201103, People’s Republic of China
| | - Jiasong Yang
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Shanghai, 201103, People’s Republic of China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, 410015, People’s Republic of China
| | - Yumeng Dai
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Shanghai, 201103, People’s Republic of China
| | - Wensheng Li
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Shanghai, 201103, People’s Republic of China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, 410015, People’s Republic of China
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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] [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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Sorkin N, Zadok R, Savini G, Kan-Tor Y, Benjamini Y, Levinger E, Bardugo J, Abulafia A. Comparison of Intraocular Lens Power Prediction Accuracy Between 2 Swept-Source Optical Coherence Tomography Biometry Devices. Am J Ophthalmol 2024; 265:156-164. [PMID: 38643892 DOI: 10.1016/j.ajo.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/14/2024] [Accepted: 04/14/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE To compare intraocular lens (IOL) power prediction accuracy of the Eyestar 900 (EyeS900) and the IOLMaster 700 (IOLM700) based on estimated and measured posterior corneal power. DESIGN Retrospective, interinstrument reliability study. METHODS Setting: Institutional. PARTICIPANTS Two hundred twenty-five eyes of 225 cataract surgery patients. MEASUREMENTS Patients underwent measurements by both devices preoperatively. MAIN OUTCOME MEASURES Spherical Equivalent Prediction Error (SEQ-PE), spread of the SEQ-PE (precision) and the absolute SEQ-PE (accuracy) of each device using Barrett Universal II (BUII) formula with either estimated posterior keratometry (E-PK) or measured posterior keratometry (M-PK). RESULTS Trimmed mean SEQ-PEs of EyeS900 E-PK, EyeS900 M-PK, IOLM700 E-PK, and IOLM700 M-PK were 0.03, 0.08, 0.02, and 0.09 D, respectively with no significant differences between EyeS900 E-PK and IOLM700 E-PK (P = 0.31) as well as between EyeS900 M-PK and IOLM700 M-PK (P = 0.31). Statistically significant SEQ-PE differences were found when E-PK and M-PK were compared, regardless of the device used, showing hyperopic SEQ-PE in M-PK calculations. Excellent correlation and agreement in SEQ-PE were found between the devices for both E-PK (P < 0.001, r = 0.848, mean bias: +0.01 D, 95% LOA of -0.32 to +0.34 D) and M-PK (P < 0.001, r = 0.776, mean bias: -0.01 D, 95% LOA of -0.42 to +0.39 D). No significant differences were found comparing absolute SEQ-PE and precision of the devices. CONCLUSION The Eyestar 900 and the IOLMaster 700 show comparable IOL power prediction accuracy by the BUII formula using either estimated or measured posterior keratometry. An adjusted lens factor may be required for BUII when utilizing measured posterior keratometry in both devices.
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Affiliation(s)
- Nir Sorkin
- Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Rotem Zadok
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Yoav Kan-Tor
- The Alexander Grass Center for Bioengineering, School of Computer Science and Engineering, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yuval Benjamini
- Department of Statistics and Data Science, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eliya Levinger
- Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Judith Bardugo
- Department of Ophthalmology, Shaare Zedek Medical Center and the Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Adi Abulafia
- Department of Ophthalmology, Shaare Zedek Medical Center and the Hebrew University-Hadassah Medical School, Jerusalem, Israel
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Coutinho CP, Schiano-Lomoriello D, Mazzotta C, Ferrise M, Hoffer KJ, Ribeiro FJ, Dias JM, Savini G. Differences Between Simulated Keratometry and Total Corneal Power in Eyes With Keratoconus and a Formula to Improve IOL Power Calculation Results. J Refract Surg 2024; 40:e253-e259. [PMID: 38593262 DOI: 10.3928/1081597x-20240311-06] [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: 04/11/2024]
Abstract
PURPOSE To compare simulated keratometry (SimK) and total corneal power (TCP) in keratoconic eyes, to determine whether the differences are systematic and predictable and to evaluate an adjusted TCP-based formula for intraocular lens (IOL) power calculation. METHODS In a consecutive series of keratoconic eyes, measurements of SimK, TCP, posterior keratometry, and anterior and posterior corneal asphericities (Q-values) were retrospectively collected. The difference between SimK and TCP was linearly correlated to the biometric parameters. In a separate sample of keratoconic eyes that had undergone cataract surgery, IOL power was calculated with the Barrett Universal II, Hoffer QST, Holladay 1, Kane, and SRK/T formulas using the SimK and an adjusted TCP power. The respective prediction errors were calculated. RESULTS A total of 382 keratoconic eyes (271 patients) were enrolled. An increasing overestimation of SimK by TCP was detected from stage I to III, with a significant correlation between the SimK and TCP difference and SimK in the whole sample (P < .0001, r2 = 0.1322). Approximately 7% of cases presented an underestimation of SimK by TCP. IOL power calculation with the adjusted TCP improved outcomes, achieving a maximum of 80% of eyes with a prediction error within ±0.50 diopters with the Hoffer QST, Holladay 1, and Kane formulas. CONCLUSIONS Overall, SimK overestimated TCP. Such a difference could not be predicted by any variable. The proposed TCP-adjustment formula (TCPadj = TCP + 0.56 diopters) in keratoconic eyes for IOL power calculation might be valuable for improving refractive outcomes. [J Refract Surg. 2024;40(4):e253-e259.].
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Wendelstein JA, Hoffmann PC, Hoffer KJ, Langenbucher A, Findl O, Ruiss M, Bolz M, Riaz KM, Pantanelli SM, Debellemanière G, Gatinel D, Cooke DL, Galzignato A, Yeo TK, Seiler TG, Zinkernagel M, Savini G. Differences Between Keratometry and Total Keratometry Measurements in a Large Dataset Obtained With a Modern Swept Source Optical Coherence Tomography Biometer. Am J Ophthalmol 2024; 260:102-114. [PMID: 38092314 DOI: 10.1016/j.ajo.2023.12.003] [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: 09/26/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE This study aimed to explore the concept of total keratometry (TK) by analyzing extensive international datasets representing diverse ethnic backgrounds. The primary objective was to quantify the disparities between traditional keratometry (K) and TK values in normal eyes and assess their impact on intraocular lens (IOL) power calculations using various formulas. DESIGN Retrospective multicenter intra-instrument reliability analysis. METHODS The study involved the analysis of biometry data collected from ten international centers across Europe, the United States, and Asia. Corneal power was expressed as equivalent power and astigmatic vector components for both K and TK values. The study assessed the influence of these differences on IOL power calculations using different formulas. The results were analyzed and plotted using Bland-Altman and double angle plots. RESULTS The study encompassed a total of 116,982 measurements from 57,862 right eyes and 59,120 left eyes. The analysis revealed a high level of agreement between K and TK values, with 93.98% of eyes exhibiting an absolute difference of 0.25 D or less. Astigmatism vector differences exceeding 0.25 D and 0.50 D were observed in 39.43% and 1.08% of eyes, respectively. CONCLUSIONS This large-scale study underscores the similarity between mean K and TK values in healthy eyes, with rare clinical implications for IOL power calculation. Noteworthy differences were observed in astigmatism values between K and TK. Future investigations should delve into the practicality of TK values for astigmatism correction and their implications for surgical outcomes.
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Affiliation(s)
- Jascha A Wendelstein
- From the Institut für Refraktive und Ophthalmo-Chirurgie (IROC) (J.A.W., T.G.S.), Zurich, Switzerland; Department for Ophthalmology and Optometry (J.A.W., M.B.), Kepler University Hospital GmbH, Linz, Austria; Johannes Kepler University Linz (J.A.W., M.B.), Linz, Austria; Institute of Experimental Ophthalmology (J.A.W., A.L.), Saarland University, Homburg, Germany.
| | | | - Kenneth J Hoffer
- Stein Eye Institute (K.J.H.), University of California, Los Angeles, California, CA, USA; St. Mary's Eye Center (K.J.H.), Santa Monica, California, CA, USA
| | - Achim Langenbucher
- Institute of Experimental Ophthalmology (J.A.W., A.L.), Saarland University, Homburg, Germany
| | - Oliver Findl
- Department of Ophthalmology (O.F., M.R.), Hanusch Hospital, Vienna Institute for Research in Ocular Surgery (VIROS), Vienna, Austria
| | - Manuel Ruiss
- Department of Ophthalmology (O.F., M.R.), Hanusch Hospital, Vienna Institute for Research in Ocular Surgery (VIROS), Vienna, Austria
| | - Matthias Bolz
- Department for Ophthalmology and Optometry (J.A.W., M.B.), Kepler University Hospital GmbH, Linz, Austria; Johannes Kepler University Linz (J.A.W., M.B.), Linz, Austria
| | - Kamran M Riaz
- Dean A. McGee Eye Institute, University of Oklahoma (K.M.R.), Oklahoma City, OK, USA
| | - Seth M Pantanelli
- Department of Ophthalmology (S.M.P.), Penn State College of Medicine, Hershey, PA, USA
| | | | - Damien Gatinel
- Rothschild Foundation Hospital (G.D., D.G.), Department of Ophthalmology, Paris, France
| | - David L Cooke
- Great Lakes Eye Care (D.L.C.), Saint Joseph, MI, USA; Department of Neurology and Ophthalmology (D.L.C.), Michigan State University, College of Osteopathic Medicine, East Lansing, MI, USA
| | | | - Tun Kuan Yeo
- Tan Tock Seng Hospital (T.K.Y.), Department of Ophthalmology, Singapore, Singapore
| | - Theo G Seiler
- From the Institut für Refraktive und Ophthalmo-Chirurgie (IROC) (J.A.W., T.G.S.), Zurich, Switzerland; Inselspital Bern (T.G.S., M.Z.), Universitätsklinik für Augenheilkunde, Bern, Switzerland; Klinik für Augenheilkunde (T.G.S.), Universitätsklinikum Düsseldorf, Duesseldorf, Germany
| | - Martin Zinkernagel
- Inselspital Bern (T.G.S., M.Z.), Universitätsklinik für Augenheilkunde, Bern, Switzerland
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10
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Martínez-Plaza E, Molina-Martín A, Piñero DP. Reliability and Agreement of Keratometry Measurements Obtained With Eye Surface Profilometry and Partial Coherence Interferometry. Cornea 2024; 43:343-348. [PMID: 37487176 DOI: 10.1097/ico.0000000000003348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/09/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE The aim of this study was to assess the repeatability of keratometry parameters obtained using the Eye Surface Profiler (ESP) system and their agreement with the IOL Master 500 device. METHODS Seventy-one eyes of 71 healthy participants were evaluated. Three repeated measurements were performed using the ESP system. Simulated keratometry in the flat (SimKf) and steep (SimKs) meridians, astigmatism, and axis were obtained. The same parameters were measured using the IOL Master 500 device. The J0 and J45 vector components of the astigmatism were calculated. The intrasession repeatability was analyzed using within-subject SD (Sw) and intraclass correlation coefficient (ICC). Agreement was assessed using paired statistical tests and the Bland-Altman method. RESULTS The Sw was 0.07 mm, 0.04 mm, 0.51 D, 0.33 D, and 0.22 D, and the ICC was 0.96, 0.98, 0.74, 0.61, and 0.55 for SimKf, SimKs, astigmatism, J0, and J45, respectively. The mean difference and limits of agreement when comparing the ESP system with the IOL Master 500 device were 0.37 mm (0.08/0.66) for SimKf ( P < 0.001), 0.18 mm (0.00/0.35) for SimKs ( P < 0.001), -0.93 D (-2.42/0.56) for astigmatism ( P < 0.001), 0.51 D (-0.22/1.24) for J0 ( P < 0.001), and 0.06 D (-0.48/0.60) for J45 ( P = 0.09). CONCLUSIONS The ESP system provides consistent values for simulated keratometry, showing moderate consistency for astigmatism parameters. Contact lens practitioners should be aware that the ESP system and IOL Master 500 device provide different simulated keratometry from a clinically viewpoint.
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Affiliation(s)
- Elena Martínez-Plaza
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- University of Valladolid, Valladolid, Spain; and
| | - Ainhoa Molina-Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
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11
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Langenbucher A, Szentmáry N, Cayless A, Hoffmann P, Wendelstein J, Cooke D. Repeatability of biometric measures from the IOLMaster 700 in a cataractous population. PLoS One 2024; 19:e0297869. [PMID: 38330090 PMCID: PMC10852222 DOI: 10.1371/journal.pone.0297869] [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: 11/07/2023] [Accepted: 01/05/2024] [Indexed: 02/10/2024] Open
Abstract
PURPOSE The purpose of this study was to investigate the repeatability of biometric measures and also to assess the interactions between the uncertainties in these measures for use in an error propagation model, using data from a large patient cohort. METHODS In this cross-sectional non-randomised study we evaluated a dataset containing 3379 IOLMaster 700 biometric measurements taken prior to cataract surgery. Only complete scans with at least 3 successful measurements for each eye performed on the same day were considered. The mean (Mean) and standard deviations (SD) for each sequence of measurements were derived and analysed. Correlations between the uncertainties were assessed using Spearman rank correlations. RESULTS In the dataset with 677 eyes matching the inclusion criteria, the within subject standard deviation and repeatability for all parameters match previously published data. The SD of the axial length (AL) increased with the Mean AL, but there was no noticeable dependency of the SD of any of the other parameters on their corresponding Mean value. The SDs of the parameters are not independent of one another, and in particular we observe correlations between those for AL, anterior chamber depth, aqueous depth, lens thickness and corneal thickness. CONCLUSIONS The SD change over Mean for AL measurement and the correlations between the uncertainties of several biometric parameters mean that a simple Gaussian error propagation model cannot be used to derive the effect of biometric uncertainties on the predicted intraocular lens power and refraction after cataract surgery.
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Affiliation(s)
- Achim Langenbucher
- Department of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
| | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg/Saar, Germany
- Department of Ophthalmology, Semmelweis-University, Budapest, Hungary
| | - Alan Cayless
- School of Physical Sciences, The Open University, Milton Keynes, United Kingdom
| | - Peter Hoffmann
- Augen- und Laserklinik Castrop-Rauxel, Castrop-Rauxel, Germany
| | - Jascha Wendelstein
- Department of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
- Department of Ophthalmology, Johannes Kepler University Linz, Linz, Austria
| | - David Cooke
- Great Lakes Eye Care, Saint Joseph, MI, United States of America
- Department of Neurology and Ophthalmology, Michigan State University, College of Osteopathic Medicine, East Lansing, MI, United States of America
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12
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Schlatter A, Palkovits S, Ruiss M, Fisus AD, Hirnschall N, Schmidl D, Garhöfer G, Findl O. Repeatability of biometry in patients with meibomian gland dysfunction before and after vectored thermal pulsation therapy: A randomized, controlled trial. Acta Ophthalmol 2024; 102:e60-e68. [PMID: 37203877 DOI: 10.1111/aos.15711] [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: 02/25/2023] [Revised: 04/23/2023] [Accepted: 05/05/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE To evaluate the effect of vectored thermal pulsation therapy (VTPT) on the repeatability of biometry readings of two different optical biometers in patients with meibomian gland dysfunction (MGD). METHODS Patients affected by MGD were included in this prospective, randomized, controlled, investigator-masked study. One eye was randomized to VTPT (LipiFlow®, Johnson & Johnson), and the contralateral eye served as a control. Three visits were scheduled at baseline, 2 weeks and 3 months after the treatment. The main outcome parameter of the study was the repeatability of three calculations of emmetropic intraocular lens power (EIOLP) at the 3 months visit as compared to baseline using an optical biometer (IOLMaster® 700, Carl Zeiss Meditec AG). Repeatability of different keratometry values obtained by the optical biometer and a Placido-disc topographer (MS-39®, CSO) served as secondary outcome parameters. RESULTS Twenty-nine patients were included in the final analysis. While tear film parameters improved in the study eyes, there were no significant differences regarding the repeatability of three EIOLP measurements between baseline and 3-months-visit in both eyes (p > 0.05) and keratometry measurements in both the optical biometer and the Placido-disc topographer. Remarkably, throughout all study visits, there were some outliers regarding the repeatability of measurements. CONCLUSION While both devices showed high repeatability regarding EIOLP and keratometry, future studies are needed to detect high-risk patients for poor repeatability.
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Affiliation(s)
- Andreas Schlatter
- VIROS - Vienna Institute for Research in Ocular Surgery, Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Stefan Palkovits
- VIROS - Vienna Institute for Research in Ocular Surgery, Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
| | - Manuel Ruiss
- VIROS - Vienna Institute for Research in Ocular Surgery, Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
| | - Andreea-Dana Fisus
- VIROS - Vienna Institute for Research in Ocular Surgery, Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
| | - Nino Hirnschall
- Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Linz, Austria
- Johannes Kepler University Linz, Medical Faculty, Linz, Austria
| | - Doreen Schmidl
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Oliver Findl
- VIROS - Vienna Institute for Research in Ocular Surgery, Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
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13
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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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Shah Y, Jacques A, Or L, Barrett G. Comparison of toric intraocular lens calculation with the integrated K method and three single biometric devices. J Cataract Refract Surg 2023; 49:1201-1208. [PMID: 37982774 DOI: 10.1097/j.jcrs.0000000000001301] [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: 02/23/2023] [Accepted: 08/29/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE To compare astigmatic outcomes using the Integrated K method and anterior surface keratometry from 3 different biometric devices. SETTING Lions Eye Institute, Perth, Australia. DESIGN Retrospective case series. METHODS Eyes of patients who underwent uneventful cataract surgery were analyzed. Predicted postoperative astigmatism was calculated for Integrated K method, IOLMaster 700, Lenstar and Pentacam. The mean centroid error in predicted postoperative refractive astigmatism (PE), mean absolute PE and percentage of eyes within 0.5 diopter (D), 0.75 D and 1 D of absolute magnitude of PE were compared. A subset analysis was done where the difference in cylinder magnitude between the 2 methods was more than 0.25 D. Spherical prediction outcomes were also analyzed. RESULTS 241 eyes of 139 patients were included in the study. The mean centroid PE of Integrated K method (-0.07 @ 69) was significantly different from IOLMaster and Pentacam. The mean absolute PE with Integrated K method (0.33 ± 0.17) was significantly lower than all 3 devices. The percentage of eyes within 0.5 D and 0.75 D of absolute magnitude of PE was 82% and 99% for Integrated K method, 76% and 95% for IOLMaster and Lenstar, and 60% and 86% for Pentacam. In the subset analysis, the improvement in accuracy of the Integrated K method compared with a single device was greater in terms of the percentage of eyes predicted within 0.5 D. The Integrated K method did not impact the spherical prediction outcomes. CONCLUSIONS The integrated K method is more accurate and precise than anterior surface keratometry from a single biometric device.
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Affiliation(s)
- Yachana Shah
- From the Sir Charles Gairdner Hospital, Perth, Australia (Shah, Or); Lions Eye Institute, Perth, Australia (Shah, Or, Barrett); Institute for Health Research, The University of Notre Dame, Perth, Australia (Jacques); Department of Research, Sir Charles Gairdner Hospital, Perth, Australia (Jacques); Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia (Barrett)
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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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Voytsekhivskyy O, Tutchenko L. Comparison of the prediction accuracy of 13 formulas in long eyes. Graefes Arch Clin Exp Ophthalmol 2023; 261:2575-2583. [PMID: 37074410 DOI: 10.1007/s00417-023-06060-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/26/2023] [Accepted: 04/04/2023] [Indexed: 04/20/2023] Open
Abstract
PURPOSE To investigate the accuracy of modern intraocular lens (IOL) power calculation formulas in eyes with axial length (AL) ≥ 26.00 mm. METHODS A total of 193 eyes with one type of lens were analysed. An IOL Master 700 (Carl Zeiss Meditec, Jena, Germany) was used for optical biometry. Thirteen formulas and their modifications were evaluated: Barrett Universal II, Haigis, Hoffer QST, Holladay 1 MWK, Holladay 1 NLR, Holladay 2 NLR, Kane, Naeser 2, SRK/T, SRK/T MWK, T2, VRF and VRF-G. The User Group for Laser Interference Biometry lens constants were used for IOL power calculation. The mean prediction error (PE) and its standard deviation (SD), the median absolute error (MedAE), the mean absolute error (MAE) and the percentage of eyes with PEs within ± 0.25 D, ± 0.50 D and < ± 1.00 D were calculated. RESULTS The modern formulas (Barrett Universal II, Hoffer QST, Kane, Naeser 2 and VRF-G) produced the smallest MedAE among all methods (0.30 D, 0.30 D, 0.30 D, 0.29 D and 0.28 D, respectively). The percentage of eyes with a PE within ± 0.50 D ranged from 67.48% to 74.85% for SRK/T and Hoffer QST, Naeser 2 and VRF-G, respectively. CONCLUSIONS Dunn's post hoc test of the absolute errors revealed statistically significant differences (P < 0.05) between some of the newer formulas (Naeser 2 and VRF-G) and the remaining ones. From a clinical perspective the Hoffer QST, Naeser 2 and VRF-G formulas were more accurate predictors of postoperative refraction with the largest proportion of eyes within ± 0.50 D.
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Affiliation(s)
- Oleksiy Voytsekhivskyy
- Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Medical City, Komarov Ave. 3, Kiev, 03680, Ukraine.
| | - Larysa Tutchenko
- Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Medical City, Komarov Ave. 3, Kiev, 03680, Ukraine
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Martínez-Albert N, Nieto-Fernández JC, García-Marqués JV. Keratometry Agreement Between Two Swept-Source OCT Devices in Healthy and Post-refractive Surgery Eyes. J Refract Surg 2023; 39:347-353. [PMID: 37162395 DOI: 10.3928/1081597x-20230202-02] [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: 05/11/2023]
Abstract
PURPOSE To evaluate the keratometry agreement between two swept-source devices for healthy and post-refractive surgery eyes and compare them. METHODS One hundred volunteers between 20 and 55 years of age were recruited for this study including both healthy and post-refractive surgery eyes. Three consecutive measurements of simulated keratometry (Sim K), posterior keratometry (PK), and total keratometry (TK) were obtained with the IOLMaster 700 and Anterion. The agreement was assessed through the Bland-Altman method. Limits of agreement (LoA) were calculated as mean difference ±1.96·SD and it represents the 95% of the differences between devices. RESULTS For both groups, Sim K measurements exhibited a mean difference close to 0 and within a range of ±0.30 and ±0.36 diopters (D) for the control and post-refractive surgery groups, respectively. Meanwhile, the IOLMaster 700 provided flatter PK values (0.30 D on average) for both groups. In general, the post-refractive surgery group exhibited slightly greater mean differences and wider 95% LoA than the control group for Sim K and PK. Steeper TK values were obtained by the IOLMaster in both groups (control = 0.50 D and post-refractive surgery = 0.75 D). TK differences between devices were significantly greater in the post-refractive surgery group (ranging from 0.38 to 1.14 D) compared to the control group (ranging from 0.15 to 0.85 D). CONCLUSIONS The IOLMaster 700 and Anterion are not interchangeable for TK measurements and eyes that had corneal refractive surgery even decreased the agreement between devices. Differences between devices for Sim K and PK measurements should be clinically judged, particularly in eyes with previous corneal surgery. [J Refract Surg. 2023;39(5):347-353.].
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Qin Y, Liu L, Mao Y, Ding Y, Ye S, Sun A, Wu M. Accuracy of Intraocular Lens Power Calculation Based on Total Keratometry in Patients With Flat and Steep Corneas. Am J Ophthalmol 2023; 247:103-110. [PMID: 36375590 DOI: 10.1016/j.ajo.2022.11.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/06/2022] [Accepted: 11/06/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE To analyze the accuracy of the current intraocular lens power calculation formulas using standard keratometry (K) and total keratometry (TK) data in patients with flat and steep corneas. DESIGN Retrospective consecutive cross-sectional study. METHODS An optical biometer with swept-source optical coherence tomography was used in this retrospective study. The standard deviation (SD), mean absolute error (MAE), median absolute error (MedAE), and the proportion of eyes with prediction error (PE) within ±0.25 diopter (D), ±0.5 D, ±0.75 D, and ±1.00 D were calculated to evaluate the refractive outcomes of each formula. RESULTS A total of 231 eyes from 231 patients were included. In the entire study cohort, the Emmetropia Verifying Optical (EVO) formula using TK data showed the lowest SD (0.383) and MAE (0.30) and the highest percentage of cases with a PE within ±0.5 D (81.4%). In the flat keratometry group, the EVO (P = .042), Haigis (P = .043), Hoffer Q (P = .038) and Holladay 1 (P = .013) formulas using TK data had significantly lower SD than using K data. The EVO formula using TK data showed the lowest SD (0.357) and MAE (0.28). In the steep keratometry group, the Hoffer Q (P = .036) and SRK/T (P = .029) formulas using TK data had significantly lower SD than using K data. The BUII TK formula showed the lowest SD (0.431), MedAE (0.26), and MAE (0.32). CONCLUSION The TK data set showed a better trend of refractive outcomes, especially in the flat and steep keratometry groups. EVO (TK) and BUII TK formulas were suggested for eyes with K values lower than 42 D and K values higher than 46 D, respectively.
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Affiliation(s)
- Yingyan Qin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China; Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Liangping Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China; Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yan Mao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China; Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yujie Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China; Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Shaobi Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China; Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ao Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China; Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Mingxing Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China; Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China..
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Rémignon CH, Levron A, Agard E, Douma I, El-Chehab H, Brunet O, Sejournet L, Billant J, Dot C. Impact of Total Corneal Astigmatism Estimated With the Abulafia-Koch Formula Versus Measured With a SS-OCT Biometer on the Refractive Outcomes of a Toric Intraocular Lens in Cataract Surgery. J Refract Surg 2023; 39:171-179. [PMID: 36892238 DOI: 10.3928/1081597x-20230103-04] [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: 03/10/2023]
Abstract
PURPOSE To compare the impact of total corneal astigmatism (TCA) estimated with the Abulafia-Koch formula (TCAABU) versus measured by Total Keratometry (TK), swept-source optical coherence tomography (OCT) coupled with telecentric keratometry (TCATK) on the refractive outcomes after cataract surgery with toric intraocular lens (IOL) implantation. METHODS Two hundred one eyes of 146 patients who underwent cataract surgery with toric IOL implantation (XY1AT; HOYA Corporation) were included in this single-center, retrospective study. For each eye, TCAABU (estimated from the anterior keratometry values measured with the IOLMaster 700 [Carl Zeiss Meditec AG]) and TCATK (measured using TK IOLMaster 700) were entered into the HOYA Toric Calculator. Patients were operated on based on TCAABU. For each eye, centroid and mean absolute error in predicted residual astigmatism (EPA) were calculated according to TCA used (TCAABU or TCATK). The cylinder power and the axis of the posterior chamber IOL were compared. RESULTS The mean uncorrected distance visual acuity was 0.07 ± 0.12 logMAR, the mean spherical equivalent was 0.11 ± 0.40 D, and mean residual astigmatism was 0.35 ± 0.36 D. Mean centroid EPA was 0.28 D at 132° with TCAABU and 0.35 D at 148° with TCATK (P(x) < .001; P(y) < .01). Mean absolute EPA was 0.46 ± 0.32 D with TCAABU and 0.50 ± 0.37 D with TCATK (P < .01). In the with-the-rule astigmatism subgroup, a deviation from the target of less than 0.50 D was achieved in 68% of eyes with TCAABU versus 50% of eyes with TCATK. The proposed posterior chamber IOL was different depending on the calculation methods used in 86% of cases. CONCLUSIONS Both calculation methods showed excellent results. However, the predictability error was significantly reduced when TCAABU was used compared to TCATK measured with the IOLMaster 700 in the whole cohort. Finally, TCA was overestimated by TK in the with-the-rule astigmatism subgroup. [J Refract Surg. 2023;39(3):171-179.].
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Jeon S, Taroni L, Lupardi E, Hoffer KJ, Fontana L, Schiano-Lomoriello D, Kwon H, Savini G. Accuracy of Nine Formulas to Calculate the Powers of an Extended Depth-of-Focus IOL Using Two SS-OCT Biometers. J Refract Surg 2023; 39:158-164. [PMID: 36892239 DOI: 10.3928/1081597x-20221221-03] [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] [Indexed: 03/10/2023]
Abstract
PURPOSE To evaluate the accuracy of nine formulas to calculate the power of a new extended depth-of-focus intraocular lens (EDOF IOL), the AcrySof IQ Vivity (Alcon Laboratories, Inc), using measurements from two optical biometers, the IOLMaster 700 (Carl Zeiss Meditec AG) and Anterion (Heidelberg Engineering GmbH). METHODS After constant optimization, the accuracy of these formulas was analyzed in 101 eyes: Barrett Universal II, EVO 2.0, Haigis, Hoffer Q, Holladay 1, Kane, Olsen, RBF 3.0, and SRK/T. Both standard and total keratometry from the IOLMaster 700 and standard keratometry from the Anterion were used for each formula. RESULTS Constant optimization provided slightly different values for the A-constant, which ranged between 118.99 and 119.16, depending on the formula and the optical biometer. According to the heteroscedastic test, within each keratometry modality the standard deviation of the SRK/T was significantly higher compared to that of the Holladay 1, Kane, Olsen, and RBF 3.0 formulas. The SRK/T formula provided less accurate results also when the absolute prediction errors were compared by Friedman test. According to McNemar's test with Holm corrections, statistically significant differences were found within each keratometry modality between the percentage of eyes with a prediction error within ±0.25 diopters obtained with the Olsen formula compared to the Holladay 1 and Hoffer Q formulas. CONCLUSIONS Constant optimization remains a mandatory step to achieve the best outcomes with the new EDOF IOL: the same constant should not be used for all formulas and for both optical biometers. Different statistical tests revealed that older IOL formulas have lower accuracy compared to newer formulas. [J Refract Surg. 2023;39(3):158-164.].
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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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Danjo Y, Ohji R, Maeno S. Lower refractive prediction accuracy of total keratometry using intraocular lens formulas loaded onto a swept-source optical biometer. Graefes Arch Clin Exp Ophthalmol 2023; 261:137-146. [PMID: 35881200 DOI: 10.1007/s00417-022-05777-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 07/08/2022] [Accepted: 07/19/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To compare refractive outcomes calculated using intraocular lens (IOL) power calculation formulas loaded onto the IOLMaster 700 with the employment of anterior keratometry (K) and total keratometry (TK). METHODS A total of 225 eyes of 225 patients underwent uneventful cataract surgery and implantation of a single model of nontoric monofocal IOL by a single surgeon. All eyes underwent preoperative ocular biometric measurements with the IOLMaster 700. Refractive outcomes, including the mean numerical prediction error (MNE); standard deviation (SD); adjusted mean absolute prediction error (MAE); adjusted median absolute prediction error (MedAE); percentages of eyes with adjusted prediction error (PE) within ± 0.25, ± 0.50, ± 0.75, and ± 1.00 diopter; and IOL Formula Performance Index (FPI), were compared between the K-based formula and the TK-based formula of Barrett Universal II (BUII), Haigis, SRK/T, Holladay 2, and Hoffer Q. Axial length (short, medium, and long) subgroup analyses and anterior and posterior keratometry (flat, medium, and steep) subgroup analyses were conducted. RESULTS The K-based formula performed better than the TK-based formula in the accuracy of refractive prediction of each IOL calculation formula: BUII-K (FPI 0.690), BUII-TK (0.677), Haigis-K (0.617), Haigis-TK (0.584), SRK/T-K (0.608), SRK/T-TK (0.595), Holladay 2-K (0.419), Holladay 2-TK (0.406), Hoffer Q-K (0.364), and Hoffer Q-TK (0.356). The subgroup analyses of refractive prediction outcomes showed that TK influenced the refractive outcomes in eyes with relatively normal ranges of axial length and anterior keratometry. CONCLUSIONS Using TK instead of K leads to lower refractive prediction accuracy of the IOL power calculation formulas loaded on the IOLMaster 700.
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Affiliation(s)
- Yukitaka Danjo
- Department of Ophthalmology, Osaka Minato Central Hospital, Japan Community Health Care Organization (JCHO), 1-7-1 Isoji, Minato-ku, Osaka, 552-0003, Japan.
| | - Reina Ohji
- Department of Ophthalmology, Osaka Minato Central Hospital, Japan Community Health Care Organization (JCHO), 1-7-1 Isoji, Minato-ku, Osaka, 552-0003, Japan
| | - Sayo Maeno
- Department of Ophthalmology, Osaka Minato Central Hospital, Japan Community Health Care Organization (JCHO), 1-7-1 Isoji, Minato-ku, Osaka, 552-0003, Japan
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Measurements of Anterior and Posterior Corneal Curvatures with OCT and Scheimpflug Biometers in Patients with Low Total Corneal Astigmatism. J Clin Med 2022; 11:jcm11236921. [PMID: 36498495 PMCID: PMC9736849 DOI: 10.3390/jcm11236921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Posterior keratometry measurements are evolving features of the optical biometers. The differences between devices have bigger impact for the low astigmatism values. The majority of adults present the corneal astigmatism below 1.5 D. Objectives: To compare the total corneal astigmatism measured with two different technologies in cataract patients with corneal astigmatism below 1.5 D. Material and Methods: Three automated exams were performed on each of the two devices: swept-source optical coherence tomography (SS-OCT) and Scheimpflug biometers. The anterior and total corneal astigmatism and power were analysed. Statistical comparisons were performed for within-subject standard deviation, repeatability, Bland−Altman and vector analysis. Results: Twenty-nine eyes of twenty-seven patients were included. The limits of agreement between anterior and total corneal astigmatism were narrower for the SS-OCT than for the Scheimpflug biometer (−0.16 to 0.29 D and −0.40 to 0.39 D, respectively). The >0.5 D difference between SS-OCT and Scheimpflug total astigmatism was noticed in 5 (17%) of cases. The difference between mean total keratometric power for both devices was statistically significant (0.2 D, p < 0.001). SS-OCT total corneal flat measurements had worse repeatability than Scheimpflug (p = 0.007). Conclusions: For the corneal astigmatism <1.5 D, the difference between anterior and total corneal astigmatism measured with SS-OCT was clinically not significant. The mean anterior and total keratometry values obtained with Scheimpflug and SS-OCT biometers are not interchangeable.
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Wang Z, Song Y, Yang W, Li D, Chen W, Zhao Q, Liu Q, Zhai C. Comparing Standard Keratometry and Total Keratometry Before and After Myopic Corneal Refractive Surgery With a Swept-Source OCT Biometer. Front Med (Lausanne) 2022; 9:928027. [PMID: 35903314 PMCID: PMC9318577 DOI: 10.3389/fmed.2022.928027] [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: 04/27/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background More recently, the swept-source OCT biometer-IOLMaster 700 has provided direct total corneal power measurement, named total keratometry. This study aims to evaluate whether standard keratometry (SK) and total keratometry (TK) with IOLMaster 700 can accurately reflect the corneal power changes induced by myopic corneal refractive surgery. Methods In this study, the biometric data measured with the swept-source OCT biometer—IOLMaster 700 before and 3 months after the myopic corneal refractive surgery were recorded. The changes of biological parameters, including SK, posterior keratometry (PK), and TK, and the difference between SK and TK were compared. In addition, the changes of SK and TK induced by the surgery were compared with the changes of spherical equivalent at the corneal plane (ΔSEco). Results A total of 74 eyes (74 patients) were included. The changes of SK, PK, TK, axial length, anterior chamber depth, and lens thickness after refractive surgery were all statistically significant (all p < 0.01), while the change of white-to-white was not (p = 0.075). The difference between SK and TK was −0.03 ± 0.10D before the corneal refractive surgery and increased to −0.78 ± 0.26D after surgery. The changes of SK and the changes of TK induced by the surgery had a good correlation with the changes of SEco (r = 0.97). ΔSK was significantly smaller than ΔSEco, with a difference of −0.65 ± 0.54D (p < 0.01). However, the difference between ΔTK and ΔSEco (0.10 ± 0.50D) was not statistically significant (p = 0.08). Conclusions Using SK to reflect the changes induced by the myopic corneal refractive surgery may lead to underestimation, while TK could generate a more accurate result. The new parameter, TK, provided by the IOLMaster 700, appeared to provide an accurate, objective measure of corneal power that closely tracked the refractive change in corneal refractive surgery.
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Asawaworarit R, Satitpitakul V, Taweekitikul P, Pongpirul K. Agreement of total corneal power between 2 swept-source optical coherence tomography and Scheimpflug tomography in normal and keratoconic patients. PLoS One 2022; 17:e0268856. [PMID: 35609043 PMCID: PMC9129016 DOI: 10.1371/journal.pone.0268856] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/09/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To evaluate agreement of total corneal power (TCP) measured by swept-source anterior segment optical coherence tomography (CASIA 2), Scheimpflug tomography (Pentacam AXL), and swept-source optical biometer (IOLMaster 700) in normal and keratoconic patients. METHODS This is a prospective observational study conducted at King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Biometric values were measured by each device for three times by two operators to evaluate repeatability and reproducibility of TCP. The agreement of TCP and other parameters including total corneal astigmatism, anterior keratometry, anterior corneal astigmatism, posterior keratometry, posterior corneal astigmatism, anterior chamber depth, white-to-white corneal diameter (WTW), central corneal thickness, and intraocular power were also evaluated. RESULTS This study enrolled 100 healthy participants and 34 patients with keratoconus. The repeatability and reproducibility of TCP were high in all devices (ICC > 0.9). The agreement of TCP was excellent among three devices in both groups (ICC > 0.9). However, the agreement of TCP between CASIA 2 and IOLMaster 700 was slightly lower in healthy participants (ICC = 0.867) and keratoconic patients (ICC = 0.852) with mean differences of more than 1.0 diopter is clinically significant. Wider 95% limit of agreement were found in keratoconic eyes. Most of other parameters showed good to excellent agreement except WTW which showed poor to moderate agreement in both groups. IOL power showed clinically significant differences in patients with keratoconus. CONCLUSIONS The agreement of TCP measured by three devices was excellent in normal and keratoconic patients. However, TCP cannot be used interchangeably between devices.
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Affiliation(s)
- Rosepon Asawaworarit
- Department of Ophthalmology, Faculty of Medicine, Excellence Center for Cornea and Limbal Stem Cell Transplantation, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Vannarut Satitpitakul
- Department of Ophthalmology, Faculty of Medicine, Excellence Center for Cornea and Limbal Stem Cell Transplantation, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
- * E-mail:
| | - Parichart Taweekitikul
- Department of Ophthalmology, Faculty of Medicine, Excellence Center for Cornea and Limbal Stem Cell Transplantation, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Krit Pongpirul
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Hashemi H, Sardari S, Yekta A, Khabazkhoob M. The repeatability and agreement of biometric measurements by dual Scheimpflug device with integrated optical biometer. Sci Rep 2022; 12:7748. [PMID: 35546610 PMCID: PMC9095872 DOI: 10.1038/s41598-022-11953-8] [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: 10/26/2021] [Accepted: 04/15/2022] [Indexed: 11/09/2022] Open
Abstract
To determine the repeatability of biometric measurements by dual Scheimpflug Devices with Integrated Optical Biometers and its agreement with partial coherence interferometry according to the axial length (AL), and the presence of cataracts. The present population-based cross-sectional study was conducted on the geriatric population in Tehran. For participants, imaging was performed by dual Scheimpflug Devices with Integrated Optical Biometers (Galilei G6) and partial coherence interferometry (IOL Master 500). All measurements were performed by one person. In both normal and cataractous eyes, the ICC values were above 0.99 for three measurements of AL, intraocular lens (IOL) power target, anterior chamber depth (ACD), central corneal thickness (CCT), flat and steep keratometry readings, and mean total corneal power (MTCP). The repeatability coefficient for the AL measurements was 0.003 and 0.002 in eyes with and without cataracts, respectively. The mean difference of AL between IOL Master 500 and Galilei G6 in normal and cataractous eyes was 0.015 and -0.003 mm, respectively. The 95% limits of agreement (LoA) of AL between these two devices were -0.09 to 0.12 mm in normal and -0.09 to 0.08 mm in cataractous eyes. The 95% LoA of ACD between the two devices was -0.13 to 0.36 mm and -0.10 to 0.31 mm in eyes without and with cataracts, respectively. The 95% LoA of steep K between the two devices was -0.63 to 0.32 and -1.04 to 0.89 diopter in normal and cataractous eyes, respectively. The results of the present study indicate the high repeatability of Galilei G6 in ocular biometric measurements. Galilei biometric measurements, had a very high agreement with the IOL Master 500.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Sara Sardari
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Agreement between two swept-source ocular coherence tomography biometry devices. J Cataract Refract Surg 2022; 48:1107-1112. [PMID: 35333792 DOI: 10.1097/j.jcrs.0000000000000942] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 03/18/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the agreement between two swept-source ocular coherence tomography (SS-OCT) biometry devices, Anterion and IOLMaster 700. SETTING Tertiary referral centre, Brisbane, Australia. DESIGN Prospective comparative study. METHODS Bland Altman analysis was used to assess agreement between devices for flat (K1), steep (K2) and mean (Km) keratometry for anterior, posterior and total cornea, lens thickness (LT), anterior chamber depth (ACD), central corneal thickness (CCT), white to white (WTW) and axial length (AL). Generalised Estimating Equations were used to control for within-patient between-eye correlations. Inter-device differences were considered clinically significant if they were likely to alter the spherical refractive outcome by 0.25D or more. RESULTS 159 eyes of 91 patients (41 male, 50 female) were included. Statistically significant differences were found for K1, K2 and Km for anterior, posterior and total cornea. When Anterion was compared to IOLMaster 700, the mean differences were as follows: anterior K1: -0.17D, anterior K2: -0.18D, anterior Km: -0.17D, posterior K1: -0.38D, posterior K2: -0.36D, posterior Km: -0.37D, total K1: -0.65D, total K2: -0.82D, total Km: -0.74D. The difference in posterior and total K metrics were clinically significant. Statistically significant differences were noted for LT: 0.159mm, CCT: -0.004mm, ACD: 0.054mm and WTW: -0.152mm, although these were not found to be clinically significant. There was no significant difference between devices for AL. CONCLUSION This study found statistically and clinically significant differences for both posterior and total keratometry between Anterion and IOLMaster 700. Posterior and total corneal parameters cannot be considered interchangeable between devices.
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Abulafia A, Barrett GD, Porat-Rein A, Tsessler M, Zadok D, Kan-Tor Y, Mourits MP, Lapid-Gortzak R. Measured Corneal Astigmatism Versus Pseudophakic Predicted Refractive Astigmatism in Cataract Surgery Candidates. Am J Ophthalmol 2022; 240:225-231. [PMID: 35288068 DOI: 10.1016/j.ajo.2022.02.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/17/2022] [Accepted: 02/27/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To compare standard and total corneal astigmatism measurements to the predicted pseudophakic (nontoric) refractive astigmatism in candidates for cataract surgery. DESIGN A retrospective, cross-sectional study. METHODS A single-center analysis of consecutive eyes measured with a swept-source optical coherence tomography biometer at a large tertiary medical center between February 2018 and June 2020. Corneal astigmatism was calculated based on standard keratometry astigmatism (KA), total corneal astigmatism (TCA), and predicted refractive astigmatism (PRA) for a monofocal nontoric intraocular lens (IOL) implantation calculated by the Barrett toric calculator using the predicted posterior corneal astigmatism (PRA(Predicted-PCA)) and the measured posterior corneal astigmatism (PRA(Measured-PCA)) options. Separate analyses were performed for each eye. SETTING Ophthalmology Department, Shaare Zedek Medical Center, Jerusalem, Israel. RESULTS In total, 8152 eyes of 5320 patients (4221 right eyes [OD] and 3931 left eyes [OS], mean age 70.6±12.2 years, 54.2% females) were included in the study. The mean vector values (centroid) for KA, TCA, PRA(Predicted-PCA), and PRA(Measured-PCA) were 0.07 diopters [D] at 19.5°, 0.27 D at 7.5°, 0.44 D at 2.9°, and 0.43 D at 179.3°, respectively (P < .01), for OD and 0.02 D at 150.3°, 0.23 D at 169.7°, 0.40 D at 179.4°, and 0.42 D at 169.5°, respectively (P < .01), for OS. More than 73% of eyes had a PRA >0.5 D. CONCLUSIONS Standard and total corneal astigmatism measurements differ significantly from the PRA by the Barrett toric calculator. The PRA, rather than the KA or TCA, should be used as the reference guide for astigmatism correction with toric IOL implantation.
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Ruiz-Mesa R, Ruiz-Santos M, Blanch-Ruiz J, Jiménez-Nieto A. Acquisition Time for Swept-Source Optical Biometry Plus Corneal Power Measurement During Cataract Evaluation. Clin Ophthalmol 2022; 16:661-668. [PMID: 35282169 PMCID: PMC8906856 DOI: 10.2147/opth.s351845] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/26/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ramón Ruiz-Mesa
- Cataract and Refractive Surgery Department, Oftalvist Jerez de la Frontera, Jerez de la Frontera, Spain
- Correspondence: Ramón Ruiz-Mesa, Oftalvist Jerez de la Frontera, Avenida Puerta del Sur S/N, Jerez de la Frontera, Cádiz, 11408, Spain, Email
| | - Maria Ruiz-Santos
- Cataract and Refractive Surgery Department, Oftalvist Jerez de la Frontera, Jerez de la Frontera, Spain
| | - Julia Blanch-Ruiz
- Cataract and Refractive Surgery Department, Oftalvist Jerez de la Frontera, Jerez de la Frontera, Spain
| | - Ana Jiménez-Nieto
- Cataract and Refractive Surgery Department, Oftalvist Jerez de la Frontera, Jerez de la Frontera, Spain
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Total Keratometric Power (TKP) versus Total Corneal Power (TCP). J Cataract Refract Surg 2022; 48:858. [DOI: 10.1097/j.jcrs.0000000000000890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/11/2022] [Indexed: 11/27/2022]
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Tsessler M, Cohen S, Wang L, Koch DD, Zadok D, Abulafia A. Evaluating the prediction accuracy of the Hill-RBF 3.0 formula using a heteroscedastic statistical method. J Cataract Refract Surg 2022; 48:37-43. [PMID: 34016821 DOI: 10.1097/j.jcrs.0000000000000702] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/09/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the accuracy of the Hill-RBF 3 formula, with and without direct measurements of total corneal power, using a heteroscedastic statistical method for analysis. SETTING Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel. DESIGN Retrospective, consecutive case series. METHODS Records of consecutive patients who underwent routine cataract surgery between February 2018 and June 2020 were retrospectively reviewed. The prediction accuracy of the Hill-RBF 3.0 formula was compared with that of the Barrett Universal II, Emmetropia Verifying Optical 2.0, Haigis, Hill-RBF 2.0, Hoffer Q, Holladay 1, Holladay 2, Kane, Olsen, and SRK/T formulas, based on biometry measurements by swept-source optical coherence tomography (SS-OCT) with standard keratometry (K), SS-OCT with total keratometry (TK), and an optical low-coherence reflectometer (OLCR). Statistical analysis was applied according to a heteroscedastic statistical method with SD of prediction errors as the main parameter for formula performance. RESULTS The study included 153 eyes of 153 patients. The SD values that were obtained by Hill-RBF 3.0 (0.266 to 0.285 diopters [D]) were significantly lower compared with those by Hill-RBF 2.0 (0.290 to 0.309 D), Hoffer Q (0.387 to 0.407 D), Holladay 1 (0.367 to 0.385 D), Holladay 2 (0.386 to 0.401 D), and SRK/T (0.377 to 0.399 D) formulas (P < .036). The prediction accuracy of the Hill-RBF 3.0 was similar across the SS-OCT (K), SS-OCT (TK), and OLCR methods of measurement (P > .51). CONCLUSIONS The Hill-RBF 3.0 was more accurate than the Hill-RBF 2.0 and older generation formulas and had similar prediction accuracy compared with new generation formulas. The use of TK did not provide significant improvement to its prediction accuracy.
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Affiliation(s)
- Maria Tsessler
- From the Department of Ophthalmology, Shaare Zedek Medical Center and the Hebrew University-Hadassah Medical School, Jerusalem, Israel (Tsessler, Cohen, Zadok, Abulafia); Department of Ophthalmology, Baylor College of Medicine, Houston, Texas (Wang, Koch)
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Lupardi E, Taroni L, Hoffer KJ, Schiano-Lomoriello D, Savini G. Comparison of Corneal Power Calculation by Standard Keratometry and Total Keratometry in Eyes With Previous Myopic FS-LASIK. J Refract Surg 2021; 37:848-852. [PMID: 34914555 DOI: 10.3928/1081597x-20211213-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To compare the accuracy of Total Keratometry (TK) and standard keratometry (K) with the IOLMaster 700 (Carl Zeiss Meditec) in evaluating the corneal refractive change in eyes with previous myopic femtosecond laser-assisted LASIK (FS-LASIK). METHODS A series of consecutive patients who had undergone myopic FS-LASIK was prospectively enrolled. The refractive change in spherical equivalent (ΔSE) was defined as the difference between the preoperative target correction entered into the laser software and the postoperative cycloplegic refraction. The difference between the postoperative and the preoperative K (ΔK) and the difference between the postoperative and the preoperative TK (ΔTK) were compared to the ΔSE. Only the right eye of each patient was selected for the statistical analysis. RESULTS Twenty-five eyes of 25 patients were enrolled. The mean ΔSE was -4.41 ± 1.68 diopters (D). The mean ΔK (-3.82 ± 1.60 D) revealed a statistically significant underestimation of the laser-induced refractive change (P < .0001), whereas the mean ΔTK (-4.36 ± 1.78 D) did not show any significant difference (P = .45). The difference between ΔK and ΔTK was statistically significant (P < .0001). Linear regression between the laser-induced refractive change and the individual difference between the postoperative K and TK disclosed a statistically significant relationship (r = -0.6930, r2 = 0.4803, P < .0001), thus revealing that higher refractive corrections increase the difference between the postoperative values of K and TK. CONCLUSIONS TK does not underestimate the laser-induced corneal changes and can be considered a reliable option for intraocular lens power calculation after myopic excimer laser surgery. [J Refract Surg. 2021;37(12):848-852.].
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Abulafia A, Rein AP, Weill Y, Zadok D, Mourits MP, Lapid-Gortzak R. Comparison of corneal surgically induced astigmatism calculations based on keratometry measurements made by 2 biometric devices. J Cataract Refract Surg 2021; 47:1542-1547. [PMID: 33974371 DOI: 10.1097/j.jcrs.0000000000000671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/06/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare calculated corneal surgically induced astigmatism (SIA) by means of anterior-based keratometry (K) and total keratometry (TK) measurements made by 2 biometric devices. SETTING Ophthalmology Department, Shaare Zedek Medical Center, Jerusalem, Israel. DESIGN Retrospective, consecutive case series. METHODS The medical records of patients who had undergone cataract surgery through a 2.4 mm temporal clear corneal incision by a single surgeon between March 2018 and November 2020 were retrospectively reviewed. Patients for whom there were preoperative and postoperative K measurements assessed by 2 biometric devices, optical low-coherence reflectometry (OLCR) (Lenstar LS900, Haag-Streit, software v. eye suite i/9.1.0.0) and swept-source optical coherence tomography (SS-OCT) (IOLMaster700, Carl Zeiss Meditec AG, software v. 1.80.6.60340), were identified. Corneal SIA (mean vector value) was calculated by vector analysis for 3 groups: SS-OCT(K), SS-OCT(TK), and OLCR(K). Bivariate analyses were applied for comparisons. RESULTS 147 eyes of 123 patients (73 right eyes and 74 left eyes) were enrolled in the study. The right eye corneal SIA values were 0.09 diopters (D) @ 136 degrees, 0.09 D @ 141 degrees, and 0.07 D @ 123 degrees for the SS-OCT(K), SS-OCT(TK), and OLCR, respectively. The corresponding left eye corneal SIA values were 0.13 D @ 120 degrees, 0.11 D @ 123 degrees, and 0.08 D @ 120 degrees. There were no statistically significant differences between the mean vector value and variance of the corneal SIA for the right (P = .78 and P = .65) and the left (P = .75 and P = .37) eyes of the 3 groups. CONCLUSIONS Corneal SIA values were low (0.07 to 0.13 D) and similar for the SS-OCT and the OLCR biometric devices with standard K measurements. TK measurements yielded similar corneal SIA values compared with anterior corneal-based measurements.
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Affiliation(s)
- Adi Abulafia
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel, affiliated to the Hebrew University, Jerusalem, Israel (Abulafia, Rein, Weill, Zadok); Department of Ophthalmology, Amsterdam UMC, location AMC, University of Amsterdam, the Netherlands (Mourits, Lapid-Gortzak)
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