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Budiman B, Knoch AMH, Boesoirie SF, Budiman NK, Irfani I, Sugiarti ED, Musa IR. Agreement between IOLMaster 700 and Pentacam AXL for IOL power measurement in patients with high myopia. Indian J Ophthalmol 2024; 72:1021-1025. [PMID: 38905462 DOI: 10.4103/ijo.ijo_1350_23] [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: 05/24/2023] [Accepted: 12/11/2023] [Indexed: 06/23/2024] Open
Abstract
PURPOSE The anterior segment in individuals with high myopia has different features compared to those without myopia. IOLMaster 700 and Oculus Pentacam AXL are two accurate optical biometers. Both devices measure the cornea differently and thus yield different results when measuring intraocular lens (IOL) power. The purpose of this study is to assess the agreement of the IOL power calculation between IOLMaster 700 and Oculus Pentacam AXL in patients with high myopia. METHODS A prospective, analytical cross-sectional study was conducted to assess the agreement between the IOL power calculation with IOLMaster 700 and Oculus Pentacam AXL. In this study, 44 eyes were examined using Oculus Pentacam AXL and IOLMaster 700, and IOL power was calculated using the Barret Universal II formula and the AMO Sensar AR40E. The Bland-Altman plot was used to evaluate the agreement between the two devices. RESULTS Based on the IOLMaster 700 examination, 44 eyes with high myopia had axial lengths ranging from 26.05 to 34.02 mm. The mean IOL power was 8.26 ± 4.755 and 8.58 ± 4.776 based on IOLMaster 700 and Oculus Pentacam AXL, respectively. The Bland-Altman plot revealed good agreement between the two devices, with a mean difference of -0.3182 in the IOL power calculation and a 95% LoA of 0.88099-0.24462 with a 95% confidence interval. CONCLUSION Both devices showed good agreement in the IOL power calculation in patients with high myopia.
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Affiliation(s)
- Budiman Budiman
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
- Cicendo National Eye Hospital, Bandung, Indonesia
| | - Andrew M H Knoch
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
- Cicendo National Eye Hospital, Bandung, Indonesia
| | - Shanti F Boesoirie
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
- Cicendo National Eye Hospital, Bandung, Indonesia
| | - Nadia K Budiman
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
| | - Irawati Irfani
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
- Cicendo National Eye Hospital, Bandung, Indonesia
| | - Emmy D Sugiarti
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
- Cicendo National Eye Hospital, Bandung, Indonesia
| | - Ine R Musa
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
- Cicendo National Eye Hospital, Bandung, Indonesia
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Nicholson M, Singh VM, Murthy S, Gatinel D, Pereira S, Pradhan A, Vasavada S, Dandekar P, Naik M, Sharma S. Current concepts in the management of cataract with keratoconus. Indian J Ophthalmol 2024; 72:508-519. [PMID: 38389251 PMCID: PMC11149527 DOI: 10.4103/ijo.ijo_1241_23] [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: 05/12/2023] [Accepted: 11/22/2023] [Indexed: 02/24/2024] Open
Abstract
This review analyzed all pertinent articles on keratoconus (KCN) and cataract surgery. It covers preoperative planning, intraoperative considerations, and postoperative management, with the aim of providing a simplified overview of treating such patients. Preoperatively, the use of corneal cross-linking, intrastromal corneal ring segments, and topo-guided corneal treatments can help stabilize the cornea and improve the accuracy of biometric measurements. It is important to consider the advantages and disadvantages of traditional techniques such as penetrating keratoplasty and deep anterior lamellar keratoplasty, as well as newer stromal augmentation techniques, to choose the most appropriate surgical approach. Obtaining reliable measurements can be difficult, especially in the advanced stages of the disease. The choice between toric and monofocal intraocular lenses (IOLs) should be carefully evaluated. Monofocal IOLs are a better choice in patients with advanced disease, and toric lenses can be used in mild and stable KCN. Intraoperatively, the use of a rigid gas permeable (RGP) lens can overcome the challenge of image distortion and loss of visual perspective. Postoperatively, patients may need updated RGP or scleral lenses to correct the corneal irregular astigmatism. A thorough preoperative planning is crucial for good surgical outcomes, and patients need to be informed regarding potential postoperative surprises. In conclusion, managing cataracts in KCN patients presents a range of challenges, and a comprehensive approach is essential to achieve favorable surgical outcomes.
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Affiliation(s)
- Maneck Nicholson
- Department of Cataract and Refractive Surgery, Shantilal Shanghvi Eye Institute, Mumbai, India
| | - Vivek M Singh
- Department of Cataract and Refractive Surgery, LV Prasad Eye Institute, Kallam Anji Reddy Campus, Telangana, India
| | - Somasheila Murthy
- Department of Cataract and Refractive Surgery, Shantilal Shanghvi Eye Institute, Mumbai, India
- Department of Cataract and Refractive Surgery, LV Prasad Eye Institute, Kallam Anji Reddy Campus, Telangana, India
| | - Damien Gatinel
- Department of Cataract and Refractive Surgery, Rothschild Foundation, Paris, France
| | - Savio Pereira
- Department of Cataract and Refractive Surgery, Nethradhama Super Speciality Eye Hospital, Bangalore, India
| | | | - Shail Vasavada
- Department of Cataract and Refractive Surgery, Raghudeep Eye Clinic, Ahmedabad, India
| | - Prajakta Dandekar
- Department of Cataract and Refractive Surgery, Shantilal Shanghvi Eye Institute, Mumbai, India
| | - Mekhla Naik
- Department of Cataract and Refractive Surgery, Shantilal Shanghvi Eye Institute, Mumbai, India
| | - Supriya Sharma
- Department of Cataract and Refractive Surgery, Shantilal Shanghvi Eye Institute, Mumbai, India
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Muzyka-Woźniak M, Woźniak S, Łabuz G. Interchangeability in Automated Corneal Diameter Measurements Across Different Biometric Devices: A Systematic Review of Agreement Studies. J Refract Surg 2024; 40:e182-e194. [PMID: 38466762 DOI: 10.3928/1081597x-20240212-02] [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: 03/13/2024]
Abstract
PURPOSE To provide an up-to-date review of the agreement in automated white-to-white (WTW) measurement between the latest topographic and biometric devices. METHODS In this systematic review, PubMed, Web of Science, and Scopus databases were searched for articles published between 2017 and 2023, focusing on WTW agreement studies on adult, virgin eyes, with or without cataract and no other ocular comorbidities. Studies evaluating WTW measurements performed with autokeratometers, manual calipers, or manual image analysis were excluded. When available, the following metrics for the agreement of WTW measurements between pairs of devices were included: mean difference ± standard deviation, 95% limits of agreement (LoA), LoA width, 95% confidence interval (95 CI%), and intraclass correlation coefficient (ICC). RESULTS Forty-one studies, covering comparisons for 19 devices, were included. Altogether, 81 paired comparisons were performed for 4,595 eyes of 4,002 individuals. The mean difference in WTW measurements between devices ranged from 0.01 mm up to 0.96 mm, with varying CI. The 95% LoA width ranged from 0.31 to 2.45 mm (median: 0.65 mm). The majority of pairwise comparisons reported LoA wider than 0.5 mm, a clinically significant value for phakic intraocular lens sizing. CONCLUSIONS Nearly all analyzed studies demonstrated the lack of interchangeability of the WTW parameter. The corneal diameter, assessed by means of grayscale en-face image analysis, tended to demonstrate the lowest agreement among devices compared to other measured biometric parameters. [J Refract Surg. 2024;40(3):e182-e194.].
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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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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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Aldaba M, Ochando P, Vila-Vidal N, Vinuela-Navarro V, Guisasola L, Perez-Corral J. Precision and agreement of axial length in paediatric population measured with MYAH and AL-Scan biometers. Clin Exp Optom 2023:1-6. [PMID: 37956406 DOI: 10.1080/08164622.2023.2277287] [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: 06/28/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023] Open
Abstract
CLINICAL RELEVANCE Measuring axial length is key in the field of myopia development and control. Hence, the precision and agreement of commercially available biometers is of vital interest to understand their variability and interchangeability in the paediatric population. BACKGROUND Different biometers are available to measure axial length and monitor myopia progression in clinical practice. The purpose of this study was to assess the precision (repeatability and reproducibility) and agreement of the MYAH and AL-Scan biometers in a paediatric population. METHODS Three consecutive measurements were performed using MYAH and AL-Scan biometers in each subject by the same operator to test for repeatability. To test for reproducibility, two measurements were performed for each subject by two different observers with a 5-min interval between measurements. To test the agreement, each subject was measured once with each instrument. RESULTS A total of 187 subjects, with a mean age of 8.5 ± 0.3 years and mean spherical equivalent refractive error of +0.22 ± 0.77 D participated in the study. For the repeatability study, the within-subject standard deviation was 0.01 mm, and the repeatability limit was 0.04 mm for both instruments, with no statistically significant differences among repeated measures (p = 0.162 for MYAH and p = 0.774 for AL-Scan). For the reproducibility study, the within-subject standard deviation was 0.01 mm and the repeatability limit was 0.04 mm. There were statistically significant differences for the repeated measures for the AL-Scan (p = 0.002) but not for the MYAH (p = 0.643). Regarding the agreement between both instruments, the 95% limit of agreement ranged from -0.04 to 0.05 mm, and the differences were statistically significant (p = 0.021). CONCLUSIONS The repeatability, reproducibility, and agreement of the MYAH and AL-Scan biometers seem optimal for following children with myopia.
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Affiliation(s)
- Mikel Aldaba
- Center for Sensors, Instruments and Systems Development, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - Pablo Ochando
- Centre Universitari de la Visió, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - Nuria Vila-Vidal
- Centre Universitari de la Visió, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - Valldeflors Vinuela-Navarro
- Visió Optometria i Salut, Department d'Òptica i Optometria de Terrassa, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - Laura Guisasola
- Visió Optometria i Salut, Department d'Òptica i Optometria de Terrassa, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - Joan Perez-Corral
- Centre Universitari de la Visió, Universitat Politècnica de Catalunya, Terrassa, Spain
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Müller M, Wortmann C, Paul J, Pawlowicz K, Hemkeppler E, Kohnen T, Böhm M. Anterior eye parameters and lens thickness measured by an intraoperative OCT and a swept-source OCT: comparison of hyperopic, emmetropic and myopic eyes. Eye (Lond) 2023; 37:3360-3366. [PMID: 37076687 PMCID: PMC10630446 DOI: 10.1038/s41433-023-02506-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/04/2023] [Accepted: 03/09/2023] [Indexed: 04/21/2023] Open
Abstract
PURPOSE To evaluate if anterior chamber depth (ACD) and lens thickness (LT) measured by two different devices are affected by different eye lengths. METHODS ACD and LT of 251 eyes (44 hyperopic, 60 myopic, 147 emmetropic) of 173 patients received with an iOCT-guided femtosecond laser-assisted lens surgery (FLACS) and the IOL Master 700 were compared. RESULTS ACD measured with the IOL Master 700 was -0.026 ± 0.125 mm smaller (p = 0.001) than that with the iOCT for all eye-groups (hyperopic: p = 0.601, emmetropic: p = 0.003; myopic: p = 0.094). However, differences in all groups were not clinically relevant. LT measurements (all eyes: -0.0642 ± 0.0504 mm) shows a statistically significant difference in all evaluated groups (p < 0.001). Only myopic eyes showed a clinically relevant difference in LT. CONCLUSION The two devices show no clinically relevant differences in the eye-length groups (myopic, emmetropic, and hyperopic) for all ACD measurements. LT data shows a clinically relevant difference only for the group of myopic eyes.
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Affiliation(s)
- Michael Müller
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | | | - Julia Paul
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | | | - Eva Hemkeppler
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | - Thomas Kohnen
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.
| | - Myriam Böhm
- Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
- Harvard Medical School, Boston, MA, USA
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Viona V, Soebijantoro I, Gondhowiardjo TD. Combined Femtosecond Laser-Assisted Keratotomy and Cataract Surgery for Enhancing Refractive Outcomes. An Indonesian Case Study. Clin Ophthalmol 2023; 17:2983-2996. [PMID: 37841901 PMCID: PMC10575482 DOI: 10.2147/opth.s416217] [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: 07/18/2023] [Accepted: 10/04/2023] [Indexed: 10/17/2023] Open
Abstract
Purpose We evaluate the reduction of corneal astigmatism and the improvement of visual outcomes of this surgical method in the Indonesian population. We also assess the accuracy and predictability of using femtosecond laser astigmatic keratotomy (FLAK) combined with cataract surgery. Patients and Methods In a retrospective study, a total of 275 subjects (78 with against-the-rule (ATR) astigmatism, 178 with with-the-rule (WTR) astigmatism, and 19 with oblique (OBL) astigmatism) with preexisting corneal astigmatism ranging from 0.75D to 3.00D underwent FLAK. All subjects completed a 3-month follow-up. The femtosecond laser used for creating paired AK 2.2 mm, primary incision, and paracentesis incision was the FEMTO Z8 NEO from Ziemer Ophthalmic System, Switzerland. The surgical approach was guided by the "NAPA" nomogram. Results The reduction in postoperative astigmatism was 56.90% for the WTR group, 49.46% for the ATR group, and 47.33% for the oblique group. A significant reduction in astigmatism was observed at the 1-week, 1-month, and 3-month follow-up intervals in both the WTR and ATR groups. The reduction in astigmatism was more favorable in cases of moderate astigmatism within the WTR group, as compared to the ATR and oblique groups. Postoperative astigmatism reduction was found to be more predictable in the right eye than in the left eye. Conclusion The combination of FLAK can be considered as a potential method for reducing corneal astigmatism ranging from 1.00D to <3.00D. The highest reduction was observed in the WTR group, along with a higher rate of intended correction without astigmatism meridian shift in the right eye for the WTR group. However, factors such as cyclotorsion resulting from the surgical technique, alignment of docking, incision length, and preoperative astigmatism need to be taken into account for further enhancement and predictability of astigmatism reduction with this method.
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Affiliation(s)
- Viona Viona
- Department of Research, Jakarta Eye Center (JEC) Eye Hospitals and Clinics, Jakarta, Indonesia
| | - Iwan Soebijantoro
- Department of Glaucoma, Jakarta Eye Center (JEC) Eye Hospitals and Clinics, Jakarta, Indonesia
| | - Tjahjono D Gondhowiardjo
- Department of Corneal and Refractive Surgery, Jakarta Eye Center (JEC) Eye Hospitals and Clinics, Jakarta, Indonesia
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Bhardwaj A, Kaur S, Sukhija J, Gupta PC, Ram J. Role of swept-source anterior segment optical coherence tomography in imaging pediatric cataract. Indian J Ophthalmol 2023; 71:2132-2138. [PMID: 37203093 PMCID: PMC10391514 DOI: 10.4103/ijo.ijo_2734_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To determine the morphology of pediatric cataracts and assess the status of the anterior and posterior capsules preoperatively on swept-source anterior segment optical coherence tomography (ASOCT) and compare the findings to those of intraoperative examination. Secondly, we aimed to obtain biometric measurements on ASOCT and compare them to those obtained on A-scan/optical methods. Methods This was a prospective and observational study carried out at a tertiary care referral institute. ASOCT scans for anterior segment were obtained preoperatively for all patients, aged <8 years, scheduled for paediatric cataract surgery. The morphology of the lens and capsule and biometry were performed on ASOCT and the same were assessed intraoperatively. The main outcome measures were comparison of ASOCT findings to intraoperative findings. Results The study included 33 eyes of 29 patients (range 3 months-8 years). The morphological characterization of cataract on ASOCT was accurate in 31/33 (94%) cases. ASOCT accurately identified fibrosis and rupture of the anterior and posterior capsules in 32/33 (97%) cases each. In 30% of eyes, ASOCT gave additional information preoperatively compared to the slit lamp. Intraclass correlation coefficient (ICC) calculation revealed a good agreement between the keratometry values obtained on ASOCT and those obtained preoperatively with a handheld/optical keratometer (ICC = 0.86, P = 0.001). Conclusion ASOCT is a valuable tool that could provide complete preoperative information of the lens and capsule in pediatric cataract cases. In children as young as 3 months of age, intraoperative risks and surprises could be diminished. The keratometric readings are highly dependent on patient cooperation but show good agreement with the handheld/optical keratometer readings.
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Affiliation(s)
- Anand Bhardwaj
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Savleen Kaur
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaspreet Sukhija
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Parul Chawla Gupta
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jagat Ram
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Mirzayev I, Gündüz AK, Aydın Ellialtıoğlu P, Gündüz ÖÖ. Clinical applications of anterior segment swept-source optical coherence tomography: A systematic review. Photodiagnosis Photodyn Ther 2023; 42:103334. [PMID: 36764640 DOI: 10.1016/j.pdpdt.2023.103334] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/25/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Optical coherence tomography (OCT) is a non-invasive method that provides the opportunity to examine tissues by taking cross-sectional images. OCT is increasingly being used to evaluate anterior segment (AS) pathologies. Swept-source (SS) OCT allows greater penetration and achieves better visualization of the internal configuration of AS tissues due to the longer wavelength employed and high scan speeds. We reviewed the utilization of AS SS-OCT in various conditions including glaucoma, ocular surface pathologies, iris tumors, refractive surgery, cataract surgery, and scleral diseases. A systematic literature search was carried out on PubMed, Scopus, and Web of Science databases between January 1, 2008, and September 1, 2022 using the following keywords: AS SS-OCT; dry eye and SS-OCT; ocular surface and SS-OCT; cornea and SS-OCT; dystrophy and SS-OCT; glaucoma and SS-OCT; ocular surface tumors and SS-OCT; conjunctival tumors and SS-OCT; refractive surgery and SS-OCT; cataract and SS-OCT; biometry and SS-OCT; sclera and SS-OCT; iris and SS-OCT; ciliary body and SS-OCT; artificial intelligence and SS-OCT. A total of 221 studies were included in this review. Review of the existing literature shows that SS-OCT offers several advantages in the diagnosis of AS diseases. Exclusive features of SS-OCT including rapid scanning, deeper tissue penetration, and better image quality help improve our understanding of various AS pathologies.
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Affiliation(s)
- Ibadulla Mirzayev
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey; Halil Şıvgın Çubuk State Hospital, Ophthalmology Clinic, Ankara, Turkey
| | - Ahmet Kaan Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey; Private Eye Clinic, Ankara, Turkey.
| | | | - Ömür Özlenen Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
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Kanclerz P, Hoffer KJ, Bazylczyk N, Wang X, Savini G. Optical Biometry and IOL Calculation in a Commercially Available Optical Coherence Tomography Device and Comparison With Pentacam AXL. Am J Ophthalmol 2023; 246:236-241. [PMID: 36252676 DOI: 10.1016/j.ajo.2022.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Optical devices are the gold standard for ocular biometry; however, they are unable to obtain high-quality optical coherence tomography (OCT) images. The current study aimed to evaluate ocular measurements and intraocular lens (IOL) calculation used in an anterior/posterior segment OCT device and to compare the results with those of a validated biometer. DESIGN Prospective evaluation of a diagnostic tool. METHODS This study enrolled healthy subjects at the Hygeia Clinic, Gdańsk, Poland, between October 2021 and November 2021. All individuals had ocular biometry measured with a validated biometer (Pentacam AXL) and with a new module of an anterior/posterior segment OCT device (Revo 80, Optopol Technologies). All IOL calculations were performed for the right eye with keratometric values from the Pentacam for one IOL: the Alcon AcrySof IQ SN60WF, with plano target setting. RESULTS The mean age of the 144 participants was 25.23 ± 7.15 years. The axial length measured with Revo was longer than with Pentacam AXL (24.08 ± 1.13 vs 23.98 ± 1.13; P < .0001), a 0.10 ± 0.04 mm difference. This translated into a significantly lower IOL power to achieve emmetropia for all formulas (-0.34 ± 0.15, -0.32 ± 0.13, -0.34 ± 0.19, and -0.30 ± 0.15 for the Hoffer Q, Holladay I, Haigis, and SRK/T formulas, respectively). The study showed high agreement between the devices: nearly 90% of eyes were within ±0.50 diopters for all of the analyzed formulas (r > 0.99). CONCLUSIONS The present study demonstrates that the results of IOL calculation with the OCT biometer have a very strong correlation with those obtained with the Pentacam AXL; however, axial length measurements and calculated IOL power cannot be considered interchangeable.
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Affiliation(s)
- Piotr Kanclerz
- From the Hygeia Clinic (P.K., N.B.), Gdańsk, Poland; Helsinki Retina Research Group Faculty of Medicine (P.K.), University of Helsinki, Helsinki, Finland.
| | - Kenneth J Hoffer
- Stein Eye Institute University of California (K.J.H.), Los Angeles, California, USA; St. Mary's Eye Center (K.J.H.), Santa Monica, California, USA
| | | | - Xiaogang Wang
- Shanxi Eye Hospital (X.W.), Shanxi Medical University, Taiyuan, Shanxi, China
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Du Y, Jin C, Yin S, Wang G, Ma Q, Li Y, Chen B, Wang H, Qiu K, Zhang M. Comparison of Vault Measurements Using a Swept-Source OCT-Based Optical Biometer and Anterior Segment OCT. Front Med (Lausanne) 2022; 9:865719. [PMID: 35814765 PMCID: PMC9259877 DOI: 10.3389/fmed.2022.865719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo newly describe the vault measurement by using a widely used swept-source OCT-based optical biometer (IOLMaster700) and accessd the accuracy of vault measurement.MethodsThis was a retrospective, cross-sectional study. All patients underwent implantable Collamer lens (ICL) implantation surgery without complications. IOLMaster700 and AS-OCT analyses were conducted for each eye on the same day in the same condition. Measurements of anterior chamber depth (ACD), corneal-ICL (C-ICL), and vault values were made and recorded. The repeatability of the IOL Master700 measurements was quantified based upon intraclass correlation coefficient (ICC) values. Correlations between IOL Master700 and AS-OCT measurements made with these different analytical approaches were assessed. The agreement of instruments was evaluated using Bland-Altman plots.ResultsThe IOLMaster700 instrument yielded highly reliable measurements of vault, C-ICL, and ACD (ICC = 0.996, 0.995, 0.995, respectively). Vault, C-ICL and ACD values as measured using the IOLMaster700, was slightly smaller than that measured via AS-OCT, but these differences were not significant (p = 0.652, p = 0.121 and p = 0.091, respectively). The vault, C-ICL, and ACD measurements by these two instruments were strongly correlated (r = 0.971, r = 0.944, and r = 0.963, respectively; all p < 0.001). The 95% limits of agreement for vault, C-ICL, and ACD measurements between the two devices were−0.08 to 0.08 mm,−0.14 to 0.11 mm, and−0.13 to 0.10 mm, respectively.ConclusionsThe IOLMasrer700 can measure implanted ICL vault with a high degree of accuracy and repeatability. Good correlations and agreement were observed between IOLMaster700 and AS-OCT in measuring vault, C-ICL, and ACD measurements.
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Affiliation(s)
- Yali Du
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
| | | | | | | | | | | | | | | | - Kunliang Qiu
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
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13
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Rocha-de-Lossada C, Rodríguez-Vallejo M, Rachwani-Anil R, Burguera N, Fernández J. Predicted Refraction Variability Due to Reliability of Nine Optical Biometers for Intraocular Lens Power Calculation. J Refract Surg 2022; 38:120-127. [DOI: 10.3928/1081597x-20211122-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Effect of Implantable Collamer Lens on Anterior Segment Measurement and Intraocular Lens Power Calculation Based on IOLMaster 700 and Sirius. J Ophthalmol 2022; 2021:8988479. [PMID: 34970453 PMCID: PMC8714341 DOI: 10.1155/2021/8988479] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 12/04/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose To investigate the possible effect of an implantable collamer lens (ICL) on ocular biometrics and intraocular lens (IOL) power calculation. Methods Ocular measurements were taken preoperatively and at the two-month follow-up using IOLMaster 700 and Sirius in 85 eyes (43 patients) who had previously undergone ICL surgery. IOL power was calculated using either IOLMaster 700 (Barrett Universal II formula) or Sirius (ray-tracing). All data were compared using the paired t-test. Results The difference between preoperative and postoperative anterior chamber depth (ACD), lens thickness (LT), and keratometry on the steep axis (K2) measured by IOLMaster 700 was statistically significant (p < 0.001). In 11 of 85 eyes, IOLMaster misjudged the anterior surface of the ICL as that of the lens, leading to an error in ACD and LT. There were no significant differences between preoperative and postoperative axial length (AL) (p = 0.223), white to white (WTW) (p = 0.100), keratometry on flat axis (K1) (p = 0.117), or central corneal thickness (CCT) (p = 0.648), measured using IOLMaster. The difference in IOL power calculated using the Barrett II formula was significant (p = 0.013). Regression analysis showed that AL and K had the greatest influence on IOL calculation (p < 0.001), and ACD and LT had less influence (p = 0.002, p = 0.218, respectively). K1 and K2 were modified to exclude the influence of K2, and modified IOLs showed no difference between pre and postoperation (p = 0.372). Preoperative and postoperative ACD measured using Sirius were significantly different (p < 0.001); however, the IOL power calculated using ray-tracing technology showed no significant differences (p > 0.05). Conclusions The ocular biometric apparatus may misjudge the anterior surface of the lens, resulting in measurement errors of ACD and LT, which has little effect on the calculation of IOL power when using IOLMaster 700 (Barrett Universal II formula) and Sirius (ray-tracing).
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15
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Montés-Micó R. Evaluation of 6 biometers based on different optical technologies. J Cataract Refract Surg 2022; 48:16-25. [PMID: 34091551 PMCID: PMC8700306 DOI: 10.1097/j.jcrs.0000000000000690] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate repeatability and agreement between various biometric parameters using 6 biometers based on different optical technologies. SETTING University of Valencia, Spain. DESIGN Prospective, comparative case series. METHODS 150 eyes were measured using the Aladdin, AL-Scan, Argos, IOLMaster700, Lenstar LS900, and OA-2000 biometers. Keratometry (K1 and K2), J0 and J45, central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), axial length (AL), white to white (WTW), and pupil size (PS) were measured 5 times with each device. Intrasubject SD, coefficient of variability (CoV), coefficient of repeatability, intraclass correlation coefficient, and Bland -Altman graphs were analyzed. RESULTS CoV values were <0.30% for K1, K2, and AL and up to 1.61% for CCT, ACD, LT, and WTW. PS values were higher (from 4.2% to 7.68%). There was statistically significant differences between biometers for all parameters evaluated (P < .001), and these differences varied as a function of the parameter analyzed. The limit of agreement (LoA) width of some comparisons for K1 and the majority for K2 were >0.50 diopter. A similar pattern was found for J0/J45. For CCT, many comparisons showed LoA width values of >25 μm. The LoA width for ACD ranged from 0.366 mm to 0.175 mm and for LT was about 0.2 mm. AL showed a highest LoA width of 0.225 mm. The LoA width for WTW was, in most cases, about ≥0.50 mm. The LoA width for PS ranged from 1.578 mm to 3.541 mm. CONCLUSIONS The 6 biometers provided repeatable measurements for the different parameters analyzed. The LoA obtained for each comparison should be analyzed carefully to consider the interchangeability of these devices.
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Tañá-Sanz P, Rodríguez-Carrillo MD, Ruiz-Santos M, Montés-Micó R, Ruiz-Mesa R, Tañá-Rivero P. Agreement of predicted intraocular lens power using swept-source optical coherence tomography and partial coherence interferometry. Expert Rev Med Devices 2021; 18:1219-1234. [PMID: 34806515 DOI: 10.1080/17434440.2021.2008908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To analyze the agreement of the predicted intraocular lens (IOL) power obtained with ANTERION, IOLMaster 700 and Pentacam AXL biometers. METHODS We calculated the monofocal and trifocal IOL power using the SRK/T, Haigis, Barrett Universal II and Hoffer Q formulas for 106 eyes. IOL power agreement between devices was evaluated using the Bland-Altman method. RESULTS We found significant differences between biometers comparisons (p < 0.001). ANTERION and IOLMaster 700 did not produce significant IOL power differences (p > 0.05), with the same outcomes for medium- and long-eyes. No significant differences were found using the SRK/T, Haigis, or Hoffer Q formulas for short-eyes (p > 0.1). However, Barrett Universal II formula produced significant differences (p < 0.05) and these differences lay between the ANTERION and Pentacam AXL. ANTERION versus IOLMaster 700 comparison showed limits of agreement (LoA) varying from 1.1071D in SRK/T monofocal medium-eyes to 1.6828D in Hoffer Q trifocal all-eyes. The largest LoA (about 3.0D) was found for short-eyes when comparing the Pentacam AXL with the other two devices. CONCLUSIONS These devices provided statistically significant but clinically insignificant mean differences in predicted IOL power. However, wide LoA values suggest that for specific eyes these outcomes could be clinically significant.
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Affiliation(s)
| | | | | | - Robert Montés-Micó
- Oftalvis Clinic, Alicante, Spain.,Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
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Güçlü H, Akaray İ, Kaya S, Sattarpanah S, Çınar AC, Sakallıoğlu K, Korkmaz S, Gürlü V. Agreement of Anterior Segment Parameters Between Schiempflug Topography and Swept-Source Optic Coherence Based Optic Biometry in Keratoconus and Healthy Subjects. Eye Contact Lens 2021; 47:539-545. [PMID: 33813587 DOI: 10.1097/icl.0000000000000787] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study is to compare anterior segment parameters, including corneal thickness (CCT), keratometry and anterior chamber depth (ACD), and white to white corneal diameter (WTW), obtained by Pentacam Schiempflug imaging and intraocular lens (IOL) Master 700 swept-source optic coherence tomography biometry in keratoconus patients and healthy subjects. METHODS This prospective cross-sectional instrument agreement analysis includes 88 eyes of 50 keratoconus patients and 87 eyes of 50 healthy subjects. Biometry was performed using IOL Master 700, and topography was performed using Pentacam. The keratometry values (Kf, Ks, Km, and Kmax), ACD, WTW, CCT, axial length (AL), anterior chamber angle (ACA), and lens thickness (LT) were evaluated. Levels of agreement between devices were evaluated by Bland-Altman plots with 95% limits of agreement. RESULTS Intraocular lens Master 700 showed higher WTW, ACD, pupil diameter, and CCT values than Pentacam in both the keratoconus and control groups. However, there were no statistically significant differences in flat keratometry (Kf) and steep keratometry (Ks) values between the groups. CONCLUSION Pentacam and IOL Master 700 may be used interchangeably in normal eyes and keratoconus eyes for the measurement of keratometry values and axis; however, these two devices should not be considered interchangeable for WTW, ACD, pupil diameter, and CCT measurements in both keratoconus patients and healthy subjects.
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Affiliation(s)
- Hande Güçlü
- Department of Ophthalmology (H.G., İ.A., S. Kaya, S.S., A.C.Ç., K.S., V.G.), Trakya University of Medicine, Edirne, Turkey; and Department of Biostatistics and Medical Informatics (S. Korkmaz), Trakya University of Medicine, Edirne, Turkey
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Kanclerz P, Przewłócka K, Wang X. Inter-device measurement variability of vital data parameters for keratorefractive and cataract refractive surgery. Ther Adv Ophthalmol 2021; 13:25158414211045750. [PMID: 34568748 PMCID: PMC8458669 DOI: 10.1177/25158414211045750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/24/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction: The measurements of corneal white-to-white (WTW) diameter and pupil size are critical for decision making in refractive surgery. Currently, automatic measurement of keratometry, corneal WTW, and pupil size are implemented in several ocular devices. The purpose of this study was to examine the agreement between two commonly used devices, an autorefractor and an optical biometer, for these parameters. Methods: Measurements were performed with both a Lenstar LS-900 and Nidek ARK-1 by an experienced examiner in random order. The devices were placed in close proximity within the same dimly lit room. Results: The measurements of 65 right eyes were analyzed. The results of the flat, steep, and mean keratometric reading were not significantly different (p = 0.96, p = 0.90, p = 0.93, respectively). Corneal WTW distances showed only moderate agreement between devices and were found to be significantly different (r = 0.8071; p < 0.01). Pupil diameters showed poor agreement between devices and were significantly different (r = 0.4890; p < 0.01). Agreement between implantable contact lens sizing, based on the measurements obtained by the two devices, was achieved for 19 of the 51 eyes (37.3%). Conclusion: We found a significant difference in WTW and pupil size measurements between ARK-1 and Lenstar. Results for both of the devices cannot be considered interchangeable for these data parameters.
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Affiliation(s)
- Piotr Kanclerz
- Hygeia Clinic, ul. Jaśkowa Dolina 57, 80-286 Gdańsk, Poland
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Montés-Micó R, Pastor-Pascual F, Ruiz-Mesa R, Tañá-Rivero P. Ocular biometry with swept-source optical coherence tomography. J Cataract Refract Surg 2021; 47:802-814. [PMID: 33315731 DOI: 10.1097/j.jcrs.0000000000000551] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/07/2020] [Indexed: 12/24/2022]
Abstract
This study aimed to summarize the outcomes reported when swept-source optical coherence tomography (SS-OCT) is used for ocular biometry. A literature search was performed to identify publications reporting clinical outcomes of patients measured with commercial SS-OCT. Twenty-nine studies were included in this review. A comprehensive analysis of the available data was performed, focusing on parameters used for intraocular lens (IOL) power calculation in cataract surgery, including keratometry, central corneal thickness, white-to-white distance, anterior chamber depth, lens thickness, axial length, IOL power, and pupil diameter. Different metrics for repeatability, reproducibility, and agreement between devices were analyzed. In general, SS-OCT biometers provide excellent repeatability and reproducibility outcomes; however, the differences obtained for some parameters measured in agreement studies should be carefully analyzed to validate the interchangeability between devices. The good outcomes reported lead us to conclude that optical biometers based on SS-OCT technology are likely to become the gold standard for ocular biometry.
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Affiliation(s)
- Robert Montés-Micó
- From the University of Valencia, Spain (Montés-Micó); Oftalvist, Spain (Montés-Micó, Pastor-Pascual, Ruiz-Mesa, Tañá-Rivero)
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Agreement of white-to-white measurements with swept-source OCT, Scheimpflug and color LED devices. Int Ophthalmol 2020; 41:57-65. [PMID: 32860152 DOI: 10.1007/s10792-020-01552-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/16/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To assess the interchangeability of different devices for measuring white-to-white (WTW) distance. METHODS WTW distance was measured in 53 eyes of 53 patients using Anterion swept-source optical coherence topographer (SS-OCT), IOLMaster 700 SS-OCT, Pentacam HR Scheimpflug and Cassini color LED. Statistical analysis was done by means of the Friedman test and the post hoc Tukey test. The Bland-Altman analysis was applied to carry out pairwise comparisons with the average difference, 95% confidence interval of the average difference and limits of agreement 95% (LoA). RESULTS WTW values obtained by the Anterion, IOLMaster 700, Pentacam HR and Cassini were: 11.84 ± 0.41 mm, 11.96 ± 0.41 mm, 11.68 ± 0.38 mm and 12.65 ± 0.52 mm, respectively. Statistically significant differences were found in all pairwise comparison (p < 0.001). The lowest mean difference was found between the Anterion and IOLMaster 700 (- 0.11 mm) and the highest between the Pentacam HR and Cassini (- 0.96 mm). The widest LoA ranges were those that compared any device with the Cassini. LoA ranges when the other three devices were compared among them were similar: Anterion versus IOLMaster 700, Anterion versus Pentacam HR and IOLMaster versus Pentacam HR (about 0.2 mm). CONCLUSIONS Our results show that there were statistically significant differences in WTW measurement among the four devices, but under a clinical point of view, we believe that Anterion and IOLMaster 700 may be considered interchangeable and so Anterion and Pentacam HR, however, IOLMaster 700 and Pentacam HR may not and neither is Cassini with any of the other three devices.
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Kane JX, Chang DF. Intraocular Lens Power Formulas, Biometry, and Intraoperative Aberrometry: A Review. Ophthalmology 2020; 128:e94-e114. [PMID: 32798526 DOI: 10.1016/j.ophtha.2020.08.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 12/16/2022] Open
Abstract
The refractive outcome of cataract surgery is influenced by the choice of intraocular lens (IOL) power formula and the accuracy of the various devices used to measure the eye (including intraoperative aberrometry [IA]). This review aimed to cover the breadth of literature over the previous 10 years, focusing on 3 main questions: (1) What IOL power formulas currently are available and which is the most accurate? (2) What biometry devices are available, do the measurements they obtain differ from one another, and will this cause a clinically significant change in IOL power selection? and (3) Does IA improve refractive outcomes? A literature review was performed by searching the PubMed database for articles on each of these topics that identified 1313 articles, of which 166 were included in the review. For IOL power formulas, the Kane formula was the most accurate formula over the entire axial length (AL) spectrum and in both the short eye (AL, ≤22.0 mm) and long eye (AL, ≥26.0 mm) subgroups. Other formulas that performed well in the short-eye subgroup were the Olsen (4-factor), Haigis, and Hill-radial basis function (RBF) 1.0. In the long-eye group, the other formulas that performed well included the Barrett Universal II (BUII), Olsen (4-factor), or Holladay 1 with Wang-Koch adjustment. All biometry devices delivered highly reproducible measurements, and most comparative studies showed little difference in the average measures for all the biometric variables between devices. The differences seen resulted in minimal clinically significant effects on IOL power selection. The main difference found between devices was the ability to measure successfully through dense cataracts, with swept-source OCT-based machines performing better than partial coherence interferometry and optical low-coherence reflectometry devices. Intraoperative aberrometry generally improved outcomes for spherical and toric IOLs in eyes both with and without prior refractive surgery when the BUII and Hill-RBF, Barrett toric calculator, or Barrett True-K formulas were not used. When they were used, IA did not result in better outcomes.
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Affiliation(s)
- Jack X Kane
- Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
| | - David F Chang
- University of California, San Francisco, San Francisco, California
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22
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Carreras H, G. García Á, Piñero DP. Comparison of Standard and Total Keratometry Astigmatism Measured with three Different Technologies. Open Ophthalmol J 2020. [DOI: 10.2174/1874364102014010059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
To compare the keratometric and total corneal astigmatism measures provided by three different technologies as well as to assess the level of interchangeability among them.
Methods:
A Prospective, comparative study enrolling 94 eyes from 53 patients (age, 29-77 years) was carried out. All participants were patients with the diagnosis of cataract or patients with a transparent crystalline lens but seeking surgical presbyopia correction. A complete eye examination was performed in all eyes, including corneal analysis with three different devices: IOL-Master 700 (Carl Zeiss Meditec), Cassini (i-Optics), and Pentacam (Oculus Optikgeräte GmbH). Interchangeability of standard and total keratometric readings (equivalent keratometric readings for Pentacam) and astigmatism measures with these three systems were evaluated with the Bland-Altman analysis.
Results:
Significantly higher standard and total keratometric readings were obtained with the IOL-Master compared to the other two systems (p<0.001). Likewise, a significantly higher magnitude of standard and total keratometric astigmatism was obtained with the Cassini system (p<0.001). Ranges of the agreement for corneal power measurements between devices varied from 0.58 D to 1.53 D, whereas they ranged from 0.46 D to 1.37 D for standard and total astigmatism measurements.
Conclusion:
Corneal power and astigmatism measures obtained with IOL-Master 700, Cassini, and Pentacam systems cannot be used interchangeably. The impact of these differences on the refractive predictability achieved with different types of intraocular lenses (IOL) should be evaluated in the future in order to define which is the best corneal evaluation approach for optimizing the IOL power calculations.
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