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Barrio AR, Antona B, Morago-Villanueva S, Martínez-Arribas V, González-Pérez M. Intrasession repeatability and agreement of the anterior corneal assessment provided by a multidiagnostic device. Clin Exp Optom 2024:1-7. [PMID: 38494447 DOI: 10.1080/08164622.2024.2324978] [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: 10/07/2023] [Accepted: 02/23/2024] [Indexed: 03/19/2024] Open
Abstract
CLINICAL RELEVANCE Multidiagnostic systems have recently appeared on the market. Knowledge of the repeatability and validity of any instrument is mandatory before its introduction in clinical practice. BACKGROUND The aim of this work is to examine the intrasession repeatability of anterior pole measurements provided by the multidiagnostic device Wave Analyzer Medica 700 (WAM700) and agreement with Pentacam measurements in normal eyes. METHODS In the right eyes of 113 participants, three repeat measurements of central keratometry, central corneal thickness, anterior chamber depth and corneal eccentricity were made with the WAM700 and Pentacam in random order. Intrasession repeatability and agreement were determined. RESULTS Employing WAM700, intrasession repeatability for keratometry, central corneal thickness and anterior chamber depth was good (ICCs ≥ 0.992; CV 0.48-0.98%), yet worse than the values obtained for the Pentacam (ICCs ≥ 0.998; CV 0-0.33%). WAM700 showed excellent intrasession repeatability when used to measure the anterior chamber depth (Sw 0.03 mm). However, the repeatability of this device was inferior for central corneal thickness (Sw 4.24 μm) and keratometry measurements (Sw < 0.21 D) and was poor for corneal eccentricity (Sw 0.07; ICC 0.908; CV 14.58%). Agreement between WAM700 and Pentacam showed a high ICC for the keratometry measurements, central corneal thickness and anterior chamber depth (>0.972) but lower for corneal eccentricity (ICC 0.762). CONCLUSIONS In healthy eyes, the WAM700 multidiagnostic device showed good intrasession repeatability for keratometry, central corneal thickness and anterior chamber depth measurements. Agreement between WAM700 and Pentacam was good for the anterior chamber depth measurement. However, these instruments cannot be considered interchangeable for keratometry, central corneal thickness and eccentricity readings.
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Affiliation(s)
- Ana Rosa Barrio
- Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | - Beatriz Antona
- Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | | | | | - Mariano González-Pérez
- Clinical and Experimental Eye Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
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Huang X, Lin X, Yang Y, Yu J, Wang J, Li K, Wang Y, Savini G, Schiano-Lomoriello D, Zhou X, Huang J. Comparison of a New Scheimpflug Camera and Swept-Source Optical Coherence Tomographer for Measurements of Anterior Segment Parameters. Ophthalmol Ther 2023; 12:3187-3198. [PMID: 37747639 PMCID: PMC10640599 DOI: 10.1007/s40123-023-00813-x] [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: 07/30/2023] [Accepted: 08/31/2023] [Indexed: 09/26/2023] Open
Abstract
INTRODUCTION This study evaluated the differences and agreement between a new Scheimpflug camera (Scansys) and a swept-source anterior segment optical coherence tomographer (CASIA 2) for measurements of the anterior segment of the eye in normal subjects. METHODS This prospective study included 84 eyes from 84 normal adult subjects who underwent three consecutive measurements with the Scansys and the CASIA 2 in random order. The mean keratometry (Km), astigmatism magnitude (AST), J0, and J45 vectors for both anterior and posterior corneal surfaces, central corneal thickness (CCT), thinnest corneal thickness (TCT), and anterior chamber depth (ACD) were obtained by both devices. The difference between these two devices was assessed using paired t test and violin plots. Bland-Altman plots and 95% limits of agreement (LoAs) were used to evaluate agreement. RESULTS No statistically significant differences between the two devices were found for the anterior AST, anterior J45, and posterior J45 (P > 0.05). The remaining parameters were statistically significant (P ≤ 0.05), but the differences not clinically significant. The violin plots showed that the distribution and probability density of the measured parameters were similar for both devices. Bland-Altman plots revealed high agreement for the measured parameters between the Scansys and CASIA 2, with narrow 95% LoAs. CONCLUSIONS In terms of assessing parameters for the anterior segment, our study indicated that Scansys and CASIA 2 generally showed significant agreement. The two devices used in this study's assessment of all the parameters can be used interchangeably in refractive analysis.
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Affiliation(s)
- Xiaomin Huang
- Eye Institute and Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Key Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Xuanqiao Lin
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yizhou Yang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jinjin Yu
- Eye Institute and Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Key Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Jiacheng Wang
- Eye Institute and Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Key Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Kexin Li
- Eye Institute and Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Key Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Yiran Wang
- Eye Institute and Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Key Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | | | | | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Key Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Jinhai Huang
- Eye Institute and Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, 200031, China.
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
- Key Laboratory of Myopia, NHC Key Laboratory of Myopia (Fudan University), Chinese Academy of Medical Sciences, Shanghai, China.
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Angelo L, Gokul A, McGhee C, Ziaei M. Comparing Repeatability and Agreement between Commonly Used Corneal Imaging Devices in Keratoconus. Optom Vis Sci 2023; 100:761-769. [PMID: 37890110 DOI: 10.1097/opx.0000000000002079] [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: 10/29/2023] Open
Abstract
SIGNIFICANCE Keratometry and pachymetry are important for diagnosis and monitoring of keratoconus. Many corneal imaging units exist, but comparison to determine repeatability and agreement is paramount for adequate keratoconus management in primary and secondary care. PURPOSE This study aimed to evaluate the repeatability and agreement of a Placido disc-based videokeratoscope (Melbourne, Victoria, Australia) used in primary care with spectral-domain optical coherence tomography (Optopol Technology, Zawiercie, Poland) and Scheimpflug corneal tomography (Oculus, Wetzlar, Germany) in secondary care. METHODS This was a prospective single-center study where one eye was randomized to have central corneal thickness;thinnest corneal thickness (TCT); and maximum, mean, steep, and flat keratometry (Kmax, Kmean, Ksteep, and Kflat, respectively), measured with all three devices. Three measurements were completed per device to assess intraobserver repeatability. RESULTS A total of 110 eyes from 110 patients with keratoconus were analyzed. Repeatability was best with the Pentacam for central corneal thickness, Kmax, Kmean, Ksteep, and Kflat parameters (precision, 9.21, 0.8, 0.38, 0.52, and 0.58). The Medmont had better repeatability than the Revo with Kmax, Kmean, Ksteep, and Kflat (precision, 1.41,1.35,1.43, and 1.59). Revo had the best repeatability with TCT (precision, 3.81). The intraclass correlation coefficient was >0.94 for all parameters in all devices. Agreement was generally poor between devices. However, there was good agreement between Pentacam and Medmont Kflat measurements ( P > .05). CONCLUSIONS Repeatability of keratometry parameters with the Pentacam and Medmont was greater than the Revo, suggesting a lower threshold for detecting change in anterior corneal parameters. The Revo had the greatest repeatability for TCT, suggesting a lower threshold for detecting thinning in disease progression and corneal-crosslinking safety. There was poor agreement between devices, and it is not recommended for them to be used interchangably.
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Affiliation(s)
- Lize Angelo
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Akilesh Gokul
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
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Almorín-Fernández-Vigo I, Sánchez-Guillén I, Fernández-Vigo JI, Burgos-Blasco B, De-Pablo-Gómez-de-Liaño L, Fernández-Vigo JÁ, Macarro-Merino A. Normative Topographic Anterior and Posterior Corneal Astigmatism: Axis Distribution and Its Relations with Ocular and Biometric Parameters. J Clin Med 2023; 12:jcm12113664. [PMID: 37297859 DOI: 10.3390/jcm12113664] [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: 03/22/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Corneal astigmatism correction is a key factor when planning refractive treatment for ametropies with intraocular lenses. We aim to obtain normative anterior and posterior corneal astigmatism (ACA and PCA, respectively) data in a local population and to describe their axis distribution and their association with other parameters. A total of 795 patients with no ocular diseases were evaluated with corneal tomography and optical biometry. Only data of the right eye were included. Mean ACA and PCA were 1.01 ± 0.79 and 0.34 ± 0.17 D, respectively. Vertical steep axis distribution was 73.5% for ACA and 93.3% for PCA. Axis orientation between ACA and PCA matched best for vertical orientation (especially 90° to 120°). Vertical ACA orientation frequency decreased with age, with a more positive sphere and less ACA. Vertical PCA orientation frequency increased with higher PCA. Eyes with vertical ACA orientation were younger and showed a greater white-to-white (WTW) measurement, anterior corneal elevations, ACA and PCA. Eyes with vertical PCA orientation were younger and showed greater anterior corneal elevations and PCA. Normative ACA and PCA data in a Spanish population were presented. Steep axis orientations presented differences with age, WTW, anterior corneal elevations and astigmatism.
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Affiliation(s)
| | - Inés Sánchez-Guillén
- Centro Internacional de Oftalmología Avanzada, 06010 Badajoz, Spain
- Department of Ophthalmology, Hospital Perpetuo Socorro, 06010 Badajoz, Spain
| | - José Ignacio Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- Department of Ophthalmology, Hospital Clínico San Carlos, 28040 Madrid, Spain
| | | | | | - José Ángel Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, 06010 Badajoz, Spain
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- School of Medicine, Universidad de Extremadura, 06006 Badajoz, Spain
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Biswas S, Biswas P. Relationship between Diurnal Variation in Intraocular Pressure and Central Corneal Power. Optom Vis Sci 2023; 100:96-104. [PMID: 36705719 DOI: 10.1097/opx.0000000000001974] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
SIGNIFICANCE Relationship between intraocular pressure (IOP) change and central corneal curvature is complicated by measurement techniques and corneal biomechanical parameters. Findings from this study indicate that it is worthwhile to observe the association between diurnal change in IOP and corneal power. PURPOSE This study aimed to investigate the relationship between the diurnal change in IOP and central corneal power among eyes with and without myopia. METHODS Sixty healthy eyes of 24 emmetropes and 36 myopes were recruited for this cross-sectional study. Both anterior and posterior central corneal powers of the steep (Ks), flat (Kf), mean meridian (Km), best-fit spheres, and central corneal thickness were recorded followed by the IOP (Goldmann-correlated IOP [IOPg] and corneal-compensated IOP) and corneal biomechanics (corneal hysteresis and corneal resistance factor). Measurements were obtained every 3 hours from 9.30 am to 6.30 pm . Linear-mixed model was used to determine the relationship between the change in IOP and the associated change in corneal measurements (adjusted for age, sex, refractive error, central corneal thickness, and biomechanics) among the myopic and nonmyopic eyes. RESULTS Group mean, amplitude of change, and the diurnal change in IOPg were (mean ± standard deviation) 15.14 ± 2.50, 3.33 ± 1.44, and 1.81 ± 1.25 mmHg, respectively. Overall, an IOP increase was associated with a decrease in the adjusted anterior corneal powers. Myopic eyes were associated with a decrease of 0.04 D (95% confidence interval [CI], 0.07 to 0.01 D; P = .02) in Ks and 0.03 D (95% CI, 0.06 to 0.001 D; P = .047) in Kf per mmHg increase in IOP, whereas for emmetropes, per mmHg increase in IOP only flattened the Kf by 0.03 D (95% CI, 0.06 to 0.004 D; P = .02). CONCLUSIONS Change in anterior corneal power was inversely related to the change in IOPg, with myopic and nonmyopic eyes reporting a significant but differential impact of IOP. Clinicians must keep in mind the impact of large IOP fluctuation on the anterior corneal power.
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Chen S, Zhang Q, Savini G, Zhang S, Huang X, Yu J, Wang Y, Ning R, Huang J, Tu R. Comparison of a New Optical Biometer That Combines Scheimpflug Imaging With Partial Coherence Interferometry With That of an Optical Biometer Based on Swept-Source Optical Coherence Tomography and Placido-Disk Topography. Front Med (Lausanne) 2022; 8:814519. [PMID: 35223885 PMCID: PMC8866319 DOI: 10.3389/fmed.2021.814519] [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: 11/13/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To evaluate measurement precision and to compare the Pentacam AXL (Oculus Optikgeräte, Wetzlar, German), a new optical biometer based on Scheimpflug imaging and partial coherence interferometry (PCI) with that of the OA-2000 biometer (Tomey, Nagoya, Japan), which combines swept-source optical coherence tomography (SS-OCT) and Placido-disk topography. METHODS Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AQD), mean keratometry (Km), astigmatism vectors J0, J45, and corneal diameter (CD) were measured in triplicate by two technical operators. Within-subject standard deviation (Sw), repeatability and reproducibility (2.77 Sw), coefficient of variation (CoV), and intraclass correlation coefficient (ICC) were used to assess the Pentacam AXL intra-observer repeatability and inter-observer reproducibility. Paired t-test and Bland-Altman plots were used to determine the agreement between the two biometers. RESULTS The new optical biometer had high intra-observer repeatability [all parameters evaluated had low CoV (<0.71%) and high ICC (>0.88)]. Inter-observer reproducibility was also excellent, with high ICC (>0.95) and low CoV (<0.52%). The 95% LoA between the new biometer and OA-2000 were insignificant for most of the parameters evaluated, especially for AL. However, the measurement agreement was moderate for CCT. CONCLUSIONS Intra-observer repeatability and inter-observer reproducibility were excellent for all parameters evaluated using the new optical biometer based on Scheimpflug imaging and PCI. There was a high agreement between the two devices and hence could be clinically interchangeable for the measurement of most ocular parameters.
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Affiliation(s)
- Shihao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, China
| | - Qiaoyue Zhang
- Department of Ophthalmology, Air Force Medical Center, Beijing, China
| | | | - Shuangzhe Zhang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, China
| | - Xiaomin Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, China
| | - Jinjin Yu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, China
| | - Yirang Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, China
| | - Rui Ning
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, China
| | - Jinhai Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, China.,Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Ruixue Tu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, China
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Posterior Corneal Asphericity Effect on Postoperative Astigmatism after EDOF Intraocular Lens Implantation in Cataract Patients. J Ophthalmol 2021; 2021:1877516. [PMID: 34777856 PMCID: PMC8580693 DOI: 10.1155/2021/1877516] [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: 08/26/2021] [Revised: 09/30/2021] [Accepted: 10/27/2021] [Indexed: 11/30/2022] Open
Abstract
Aim To assess the impact of posterior corneal asphericity on postoperative astigmatism. Methods We included retrospectively 70 eyes of 70 patients that underwent cataract surgery. We included data of the Q value, Kmax, K1, K2, astigmatism AL, and ACD. We performed a vectorial analysis to calculate the astigmatic vectors. Results Seventy eyes were evaluated. 40 eyes were of females (58%) and 30 of males (42%). The average cohort age was 73 ± 8.9 years. Axial length (AL) was 23.5 ± 0.9, anterior chamber depth (ACD) was 3.13 ± 0.3, and the average posterior Q value was −0.35 ± 0.2. The only significant predictive variable for the correction index (CI) was the posterior Q value (r = 0.24, p < 0.05) and for the surgically induced astigmatism (SIA) (β = 0.34, r = 0.58, p < 0.05). Conclusion Posterior corneal surface asphericity significantly influences the surgically induced astigmatism and the overcorrection for cataract patients after Lucidis EDOF IOL implantation.
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Wang D, Wen D, Zhang B, Lin W, Liu G, Du B, Lin F, Li X, Wei R. The Association between Fourier Parameters and Clinical Parameters in Myopic Children Undergoing Orthokeratology. Curr Eye Res 2021; 46:1637-1645. [PMID: 34096430 DOI: 10.1080/02713683.2021.1917619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To explore how Fourier parameters are associated with axial length growth (ALG) and clinical parameters in children who underwent orthokeratology.Materials and Methods: A total of 267 children received orthokeratology. Baseline cycloplegic autorefraction was performed. Axial length was measured at baseline and one year after the lens dispatch, and the difference was defined as ALG. Corneal topography was performed at the same two visits. Central treatment zone (CTZ) was identified from the difference between the two tangential maps, and its center distance to corneal center was defined as decentration. A relative refractive corneal power (RCRP) map was derived by subtracting the center value from every point on the one-year axial map. It was decomposed into 3 Fourier components: a mean (F0), a single-cycle sinewave (F1), and a double-cycle sinewave (F2). Linear regressions were used to reveal the association between ALG and these parameters.Results: At baseline, the age was 10.18 ± 1.48 year, spherical equivalent (SE) was - 3.10 ± 1.15D, astigmatism was 1.17 ± 0.58D, and axial length was 24.69 ± 0.81 mm. The mean ALG was 0.181 ± 0.22 mm. In multiple regression, ALG was negatively associated with F1 (p < .001), not F0 and F2. Amplitude-wise, F0 and F1 were correlated with decentration (p < .01) and SE (p < .01), and F2 was associated with astigmatism (p < .001). Direction-wise, F1 was correlated with decentration (p < .001) and F2 was associated with astigmatism (p < .001).Conclusions: Among Fourier parameters, F0 and F1 were negatively associated with ALG in myopic children undergoing orthokeratology. Their associations to SE and CTZ decentration may partially explain the effect on ALG retardation.
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Affiliation(s)
- Di Wang
- 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, People's Republic of China
| | - Dejia 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, People's Republic of China
| | - Bin Zhang
- College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Weiping Lin
- 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, People's Republic of China
| | - Guihua Liu
- 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, People's Republic of China
| | - Bei Du
- 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, People's Republic of China
| | - Fang Lin
- Eye Hospital Tianyi Yuanjing, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xiaorong Li
- 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, People's Republic of China
| | - Ruihua Wei
- 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, People's Republic of China
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Hou M, Ding Y, Liu L, Xu Y, Li J, Wu M. Accuracy evaluation of objective refraction using the wavefront aberrometer in pseudophakic eyes. Graefes Arch Clin Exp Ophthalmol 2020; 258:2213-2221. [PMID: 32577855 DOI: 10.1007/s00417-020-04806-5] [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: 03/19/2020] [Revised: 05/21/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the accuracy of wavefront-derived objective refraction in pseudophakic eyes. METHODS Retrospective case series. A total of 356 eyes (356 patients) that underwent phacoemulsification and posterior chamber intraocular lens implantation were included. Noncycloplegic subjective manifest refraction (MR) and objective refraction results from the wavefront aberrometer were obtained and compared. Subgroup analysis of objective refraction at 2.6-mm zone was performed based on axial length (AL) and average keratometry. RESULTS The biases (at the 2.6-mm, 3-mm, and 4-mm zones) were - 0.29 ± 0.37 D, - 0.53 ± 0.41 D, and - 0.51 ± 0.60 D for sphere; - 0.27 ± 0.36 D, - 0.52 ± 0.38 D, and - 0.53 ± 0.51 D for spherical equivalent (SE); 0.03 ± 0.20 D, 0.03 ± 0.22 D, and 0.04 ± 0.27 D for J0; and 0.01 ± 0.16 D, 0.03 ± 0.22 D, and 0.01 ± 0.22 D for J45, respectively. Objective refraction for sphere, SE, and J0 (at 2.6 mm, 3 mm, and 4 mm) was significantly different from MR (P < 0.05), while J45 values were equal. The objective refraction at 2.6 mm was the most accurate in short eyes (≤ 22.5 mm) with a minimum bias for SE (- 0.15 ± 0.28 D) and highest percentage of SE within ± 0.25 to ± 0.75 D of MR. However, there was no difference between the keratometry subgroups. CONCLUSIONS The wavefront aberrometer achieved the best accuracy at 2.6 mm in pseudophakic eyes with short AL. It still needs modification to be used as a substitute for MR in such patients.
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Affiliation(s)
- Min Hou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Guangzhou, People's Republic of China
| | - Yujie Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Guangzhou, People's Republic of China
| | - Liangping Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Guangzhou, People's Republic of China
| | - Yanxin Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Guangzhou, People's Republic of China
| | - Jianbing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Guangzhou, People's Republic of China
| | - Mingxing Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, No.7 Jinsui Road, Guangzhou, People's Republic of China.
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Rampat R, Debellemanière G, Malet J, Gatinel D. Using Artificial Intelligence and Novel Polynomials to Predict Subjective Refraction. Sci Rep 2020; 10:8565. [PMID: 32444650 PMCID: PMC7244728 DOI: 10.1038/s41598-020-65417-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/22/2020] [Indexed: 11/09/2022] Open
Abstract
This work aimed to use artificial intelligence to predict subjective refraction from wavefront aberrometry data processed with a novel polynomial decomposition basis. Subjective refraction was converted to power vectors (M, J0, J45). Three gradient boosted trees (XGBoost) algorithms were trained to predict each power vector using data from 3729 eyes. The model was validated by predicting subjective refraction power vectors of 350 other eyes, unknown to the model. The machine learning models were significantly better than the paraxial matching method for producing a spectacle correction, resulting in a mean absolute error of 0.301 ± 0.252 Diopters (D) for the M vector, 0.120 ± 0.094 D for the J0 vector and 0.094 ± 0.084 D for the J45 vector. Our results suggest that subjective refraction can be accurately and precisely predicted from novel polynomial wavefront data using machine learning algorithms. We anticipate that the combination of machine learning and aberrometry based on this novel wavefront decomposition basis will aid the development of refined algorithms which could become a new gold standard to predict refraction objectively.
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Affiliation(s)
- Radhika Rampat
- Foundation Adolphe de Rothschild Hospital, Paris, France
| | | | - Jacques Malet
- Foundation Adolphe de Rothschild Hospital, Paris, France
| | - Damien Gatinel
- Foundation Adolphe de Rothschild Hospital, Paris, France.
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11
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The effect of sodium fluorescein on anterior eye surface measurements. Cont Lens Anterior Eye 2020; 43:402-407. [PMID: 32146117 DOI: 10.1016/j.clae.2020.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE During image acquisition, certain topographers require the addition of sodium fluorescein (NaFl) dye to the tear film. This study investigates the effect of NaFl dye on corneal topography and tear surface quality. METHOD The E300 corneal topographer (Medmont International Pty Ltd., Victoria, Australia) was used to measure ocular surface topography and quality of 57 eyes of 57 healthy individuals without dry eye symptoms, age 35.1 ± 15.2 years (mean ± standard deviation) ranging between 19 and 65 years. The mean of three simulated keratometry values, a variety of corneal shape descriptors, and Tear Film Surface Quality (TFSQ) were measured under three different conditions; without NaFl (baseline), with the addition of a single dose NaFl, and using a double dose of NaFl. RESULTS Compared to baseline, the Inferior-Superior (IS) index decreased significantly after a single dose (P = 0.034) or double dose of NaFl (P = 0.030). The corneal surface was significantly more regular without NaFl (P = 0.003) or one insertion of NaFl (P = 0.024) when compared to two doses of NaFl. There was no association with age, or dry eye signs or symptoms on the variance observed in any of the indices between baseline, intervention I, and intervention II (P > 0.05). Agreement between corneal surface indices reduced following the addition of NaFl. CONCLUSION In comparison to measurements taken without an ocular dye, one dose of NaFl resulted in increased reliability and consistency in corneal topography measurements using the E300 topographer, but 2 doses decreased reliability and consistency. Practitioners ought to be aware that tear film surface regularity and inferior-superior corneal power changed significantly following the addition of NaFl in those with healthy corneas. Its effect in diseased corneas is unknown.
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Multivariate Regression Analysis to Predict Postoperative Refractive Astigmatism in Cataract Surgery. J Ophthalmol 2020; 2020:9842803. [PMID: 32411437 PMCID: PMC7201842 DOI: 10.1155/2020/9842803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/26/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess the correlation between postoperative refractive astigmatism and preoperative parameters in cataract surgery. Methods Left eyes of 100 consecutive patients scheduled for cataract surgery with a 2.4 mm clear corneal incision were examined prospectively. Refractive astigmatism was measured using an autokerato/refractometer. Corneal astigmatism of the total cornea was calculated using a Scheimpflug camera. The vertical/horizontal component (J0) and oblique component (J45) of refractive and total corneal astigmatism were determined using power vector analysis. Refractive astigmatism at 8 weeks postoperatively was estimated using multivariate linear regression analysis. Independent variables analyzed included age, sex, refractive astigmatism, total corneal astigmatism, sphere, intraocular pressure, corneal thickness, anterior chamber depth, lens thickness, axial length, and pupil diameter. Results Multivariate regression analysis identified total corneal J0 and age as significant contributors to postoperative refractive J0 (P < 0.001 and P=0.029, respectively). The standard partial regression coefficients in the multiple regression analysis were 0.59 and −0.16 for total corneal J0 and age, respectively. Significant contributors to postoperative refractive J45 were total corneal J45 and lens thickness (P < 0.001 and P=0.015, respectively). The standard partial regression coefficients were 0.79 and −0.15 for total corneal J45 and lens thickness, respectively. Conclusion These results suggest that preoperative total corneal astigmatism is the most significant predictor of postoperative refractive astigmatism when performing astigmatism correction in cataract surgery.
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Núñez MX, Henriquez MA, Escaf LJ, Ventura BV, Srur M, Newball L, Espaillat A, Centurion VA. Consensus on the management of astigmatism in cataract surgery. Clin Ophthalmol 2019; 13:311-324. [PMID: 30809088 PMCID: PMC6376888 DOI: 10.2147/opth.s178277] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This project was aimed at achieving consensus on the management of astigmatism during cataract surgery by ophthalmologists from Latin America using modified Delphi technique. Relevant peer-reviewed literature was identified, and 21 clinical research questions associated with the definition, classification, measurement, and treatment of astigmatism during cataract surgery were formulated. Twenty participants were divided into seven groups, and each group was assigned three questions to which they had to respond in written form, after thoroughly reviewing the literature. The assigned questions with corresponding responses by each group were discussed with other participants in round 4 – presentation of findings. The consensus was achieved if approval was obtained from at least 80% of participants. The present paper provides several agreements and recommendations for management of astigmatism during cataract surgery, which could potentially minimize the variability in practice patterns and help ophthalmologists adopt optimal practices for cataract patients with astigmatism and improve patient satisfaction.
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Affiliation(s)
- Maria X Núñez
- Unit of Cornea, Cataract and Refractive Surgery, Grupo de Investigacion Vision Sana, Clinica de Oftalmología de Cali, Universidad Javeriana, Cali, Colombia,
| | - Maria A Henriquez
- Department of Cataract, Department of Research, Oftalmosalud Instituto de Ojos, Lima, Peru
| | - Luis J Escaf
- Clinica Oftalmologica del Caribe (Cofca), Universidad Javeriana, Barranquilla, Colombia
| | - Bruna V Ventura
- Department of Cataract, Altino Ventura Foundation, HOPE Eye Hospital, Recife, Brazil
| | - Miguel Srur
- Centro de la Visión, Filial Clínica Las Condes, Universidad de Los Andes, Santiago de Chile, Chile
| | | | - Arnaldo Espaillat
- Cataract and refractive surgery service, Espaillat Cabral Institute, Santo Domingo, Dominican Republic
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14
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Hayashi K, Sato T, Yoshida M, Yoshimura K. Corneal shape changes of the total and posterior cornea after temporal versus nasal clear corneal incision cataract surgery. Br J Ophthalmol 2018; 103:181-185. [PMID: 29777048 PMCID: PMC6362889 DOI: 10.1136/bjophthalmol-2017-311710] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/03/2018] [Indexed: 11/07/2022]
Abstract
Aim To compare changes in the shape and astigmatism of the total and posterior cornea between eyes with a nasal clear corneal incision (CCI) and eyes with a temporal CCI in cataract surgery. Methods The left eyes of 100 patients undergoing phacoemulsification were randomly assigned to undergo a 2.4 mm nasal (nasal CCI group) or temporal CCI (temporal CCI group). Corneal astigmatic changes were compared between groups using power vector analysis, and corneal shape changes were compared using videokeratography maps at 2 days, and at 2, 4 and 8 weeks postoperatively. Results The mean J0 and J45 values of the total cornea were significantly greater in the nasal CCI group than in the temporal CCI group at 2 and 4 weeks postoperatively (p≤0.0392), but did not differ significantly between groups at 2 days and 8 weeks. The videokeratography maps revealed a wedge-shaped flattening in the total cornea and a steepening in the posterior cornea around the CCIs in both groups at 2 days postoperatively; those were more prominent in the nasal CCI group than in the temporal CCI group. The wound-related changes diminished by 8 weeks postoperatively in the total and posterior cornea, and were not markedly different between groups at 8 weeks postoperatively. Conclusion Corneal shape and astigmatic changes were comparable between groups at 8 weeks postoperatively, although the changes were greater after nasal CCI than after temporal CCI in the early postoperative periods, indicating that nasal or temporal CCI can be selected based on the surgeon’s preference.
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Mülhaupt M, Dietzko S, Wolffsohn J, Bandlitz S. Corneal topography with an aberrometry-topography system. Cont Lens Anterior Eye 2018; 41:436-441. [PMID: 29748095 DOI: 10.1016/j.clae.2018.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE To investigate the agreement between the central corneal radii and corneal eccentricity measurements generated by the new Wave Analyzer 700 Medica (WAV) compared to the Keratograph 4 (KER) and to test the repeatability of the instruments. METHODS 20 subjects (10 male, mean age 29.1 years, range 21-50 years) were recruited from the students and staff of the Cologne School of Optometry. Central corneal radii for the flat (rc/fl) and steep (rc/st) meridian as well as corneal eccentricity for the nasal (enas), temporal (etemp), inferior (einf) and superior (esup) directions were measured using WAV and KER by one examiner in a randomized order. RESULTS Central radii of the flat (rc/fl) and steep (rc/st) meridian measured with both instruments were statically significantly correlated (r = 0.945 and r = 0.951; p < 0.001). Comparison between the WAV and KER showed that rc/fl and rc/st measured with WAV were significantly steeper than those measured with KER (p < 0.001). Corneal eccentricities were statistically significantly correlated in all meridians (p < 0.05). Compared to KER, etemp and esup measured with WAV were greater (p < 0.05), while there were no statistically significant differences for enas and einf (p = 0.350 and p = 0.083). For the central radii, repeated measurements were not significantly different for the KER or WAV (p > 0.05). Limits of agreement (LoA) indicate a better repeatability for the KER compared to WAV. CONCLUSIONS Corneal topography measurements captured with the WAV were strongly correlated with the KER. However, due to the differences in measured corneal radii and eccentricities, the devices cannot be used interchangeably. For corneal topography the KER demonstrated better repeatability.
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Affiliation(s)
- Michael Mülhaupt
- Höhere Fachschule für Augenoptik Köln (Cologne School of Optometry), Cologne, Germany
| | - Sven Dietzko
- Höhere Fachschule für Augenoptik Köln (Cologne School of Optometry), Cologne, Germany
| | - James Wolffsohn
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK
| | - Stefan Bandlitz
- Höhere Fachschule für Augenoptik Köln (Cologne School of Optometry), Cologne, Germany; Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK.
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Comparison of anterior segment parameters and axial length measurements performed on a Scheimpflug device with biometry function and a reference optical biometer. Int Ophthalmol 2018; 39:1115-1122. [PMID: 29700651 DOI: 10.1007/s10792-018-0927-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/13/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE To compare measurements of axial length (AL), corneal curvature (K), anterior chamber depth (ACD) and white-to-white (WTW) distance on a new device combining Scheimpflug camera and partial coherence interferometry (Pentacam AXL) with a reference optical biometer (IOL Master 500). To evaluate differences between IOL power calculations based on the two biometers. METHODS Ninety-seven eyes of 97 consecutive cataract or refractive lens exchange patients were examined preoperatively on IOL Master 500 and Pentacam AXL units. Comparisons between two devices were performed for AL, K, ACD and WTW. Intraocular lens (IOL) power targeting emmetropia was calculated with SRK/T and Haigis formulas on both devices and compared. RESULTS There were statistically significant differences between two devices for all measured parameters (P < 0.05), except ACD (P = 0.36). Corneal curvature measured with Pentacam AXL was significantly flatter then with IOL Master. The mean difference in AL was clinically insignificant (0.01 mm; 95% LoA 0.16 mm). Pentacam AXL yielded higher IOL power in 75% of eyes for Haigis formula and in 62% of eyes for SRK/T formula, with a mean difference within ± 0.5 D for 72 and 86% of eyes, respectively. CONCLUSIONS There were statistically significant differences between AL, K and WTW measurements obtained with the compared biometers. Flatter corneal curvature measurements on Pentacam AXL necessitate formulas optimisation for Pentacam AXL.
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Detailed Distribution of Corneal Epithelial Thickness and Correlated Characteristics Measured with SD-OCT in Myopic Eyes. J Ophthalmol 2017; 2017:1018321. [PMID: 28607770 PMCID: PMC5457757 DOI: 10.1155/2017/1018321] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/18/2017] [Accepted: 03/23/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the detailed distribution of corneal epithelial thickness in single sectors and its correlated characteristics in myopic eyes. Methods SD-OCT was used to measure the corneal epithelial thickness distribution profile. Differences of corneal epithelial thickness between different parameters and some correlations of characteristics were calculated. Results The thickest and thinnest part of epithelium were found at the nasal-inferior sector (P < 0.05) and at the superior side (P < 0.05). respectively. Subjects in the low and moderate myopia groups have thicker epithelial thickness than those in the high myopia group (P < 0.05). Epithelial thickness was 1.39 μm thicker in male subjects than in female subjects (P < 0.001). There was a slight negative correlation between corneal epithelial thickness and age (r = −0.13, P = 0.042). Weak positive correlations were found between corneal epithelial thickness and corneal thickness (r = 0.148, P = 0.031). No correlations were found between corneal epithelial thickness, astigmatism axis, corneal front curvature, and IOP. Conclusions The epithelial thickness is not evenly distributed across the cornea. The thickest location of the corneal epithelium is at the nasal-inferior sector. People with high myopia tend to have thinner corneal epithelium than low–moderate myopic patients. The corneal epithelial thickness is likely to be affected by some parameters, such as age, gender, and corneal thickness.
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Repeatability and agreement of Scheimpflug-based and swept-source optical biometry measurements. Cont Lens Anterior Eye 2017; 40:318-322. [PMID: 28342729 DOI: 10.1016/j.clae.2017.03.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/14/2017] [Accepted: 03/14/2017] [Indexed: 01/02/2023]
Abstract
PURPOSE To evaluate the repeatability and comparability of biometry parameters between a Scheimpflug-based topography with axial length measurement (Pentacam AXL, Oculus, Wetzlar, Germany) and a swept-source optical biometry (IOLMaster 700, Carl Zeiss Meditec AG, Jena, Germany). METHODS A total of 50 eyes from 50 adult subjects had biometry measurements in one session three times using the Pentacam AXL and the IOLMaster 700. Keratometry, anterior chamber depth (ACD) and axial length (AL) values were obtained by both devices. Mean keratometry (Kmean) was calculated and the corneal spherocylinder was converted into power vectors (J0, J45). Repeatability was assessed based on intraclass correlation coefficient (ICC). Agreement was evaluated by linear regression analysis and Bland-Altman analysis by calculating the mean difference and 95% limits of agreement (LoA). RESULTS Assessment of intraoperator repeatability by means of ICC showed excellent reproducibility of measurements for both devices and all parameters examined ranging from 0.994 to 1.0. IOLMaster 700 exhibited significantly higher Kmean (p<0.001) and AL (p<0.001) values than the Pentacam AXL. Pentacam AXL showed significantly higher ACD (p<0.001) measurements than IOLMaster 700. There was no statistically significant difference of J0 (p=0.115) and J45 (p=0.255) values between Pentacam AXL and IOLMaster 700. CONCLUSIONS Both devices provide high reproducible values for all parameters investigated. J0 and J45 values are statistically and clinically interchangeable between Pentacam AXL and IOLMaster 700. All other parameters are statistically different. In clinical practice, the differences for ACD and AL are to small and the values can be used interchangeable. However, Kmean values are clinically and statistically different and cannot be used interchangeable between the two devices.
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