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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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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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Time-efficiency assessment of guided toric IOL cataract surgery: a pilot study. J Cataract Refract Surg 2021; 47:1535-1541. [PMID: 34074992 DOI: 10.1097/j.jcrs.0000000000000688] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 04/26/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the time spent on toric intraocular lens (IOL) implantation during cataract surgery using a manual-marking versus a digital image-guided system (the Verion) for toric IOL alignment. SETTINGS All procedures were performed at the Instituto Oftalmológico Quirónsalud ophthalmology clinic (A Coruña, Spain). DESIGN We designed an experimental and longitudinal (1-month follow-up) study. METHODS A total of 98 eyes of 65 participants (68.2 ± 12.2 years) were divided into two groups: 49 eyes operated with toric IOL alignment using a manual-marking technique (manual group) and another 49 eyes operated using image-guided marking (Verion group). The primary variable for comparison between both groups was cataract surgery time. Other outcomes such as toric IOL misalignment, spherical equivalent (SE), astigmatism, uncorrected distance visual acuity (UDVA), and corrected distance visual acuity (CDVA) were also measured. RESULTS The total cataract surgery time was 2:09 minutes shorter (p < 0.001) with the Verion system (12:12 ± 2:20) compared to the surgical procedure performed using manual marking (15:27 ± 3:04). One month after surgery, there were no statistical differences in terms of toric IOL misalignment between the Verion (3.38° ± 2.95°) and the manual group (4.66° ± 3.95°). No statistical differences were observed between groups for refractive and visual outcomes either (p ≥ 0.05). CONCLUSIONS The cataract surgery time was reduced when the procedure was assisted using the Verion system to align the IOL compared to manual marking, maintaining the same efficacy in terms of toric IOL misalignment, residual refraction, and visual acuity.
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Piñero DP, Molina-Martín A, Camps VJ, de Fez D, Caballero MT. Validation of corneal topographic and aberrometric measurements obtained by color light-emitting diode reflection topography in healthy eyes. Graefes Arch Clin Exp Ophthalmol 2019; 257:2437-2447. [PMID: 31482276 DOI: 10.1007/s00417-019-04453-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/12/2019] [Accepted: 08/27/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate the intrasession repeatability of anterior corneal topographic and aberrometric measurements provided by a color-LED topographer as well as their interchangeability with those provided by a Scheimpflug-based system in healthy eyes. METHODS Thirty-five healthy eyes of 35 patients (age, 16-66 years) were enrolled. A complete eye examination was performed in all cases including a complete corneal analysis with the Scheimpflug-based system Pentacam (Oculus Optikgeräte) (one measurement) and the Cassini system (i-Optics) (three consecutive measurements). Intrasession repeatability of the Cassini measurements was assessed with the within-subject standard deviation (Sw) and the intraclass correlation coefficient (ICC). The Bland-Altman analysis was used to evaluate the agreement between both devices. RESULTS Mean Sw for keratometric readings was 0.02 mm (ICC ≥ 0.992), ranging between 0.16 and 0.05 D (ICC 0.930-0.978) for anterior and total astigmatic measurements. Mean Sw for asphericity and corneal diameter were 0.06 (ICC 0.926) and 0.03 mm (IC 0.997), respectively. Aberrometric parameters showed ICCs ≥ 0.816, except for Z42 (ICC 0.741) and Z44 (ICC 0.544). When comparing devices, statistically significant differences were found for most of topographic and aberrometric data (p ≤ 0.044). Likewise, ranges of agreement between devices were clinically relevant (keratometry > 0.06 mm; total astigmatic components > 0.69 D; asphericity 0.35; second-, third-, and fourth-order Zernike terms, more than 0.20, 0.13, and 0.01 μm, respectively). CONCLUSIONS Consistent anterior corneal topographic, total corneal astigmatic, and aberrometric measurements are obtained with color-LED topography in healthy eyes, which are not interchangeable with those provided by the Scheimpflug-based topography.
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Affiliation(s)
- David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n, 03690, San Vicente del Raspeig, Alicante, Spain.
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain.
| | - Ainhoa Molina-Martín
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n, 03690, San Vicente del Raspeig, Alicante, Spain
| | - Vicent J Camps
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n, 03690, San Vicente del Raspeig, Alicante, Spain
| | - Dolores de Fez
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n, 03690, San Vicente del Raspeig, Alicante, Spain
| | - María Teresa Caballero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n, 03690, San Vicente del Raspeig, Alicante, Spain
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Fukumitsu H, Camps VJ, Piñero DP. Intrasession Repeatability of Biometric Measurements Obtained with a Low-Coherence Interferometry System in Pseudophakic Eyes. Curr Eye Res 2019; 45:221-226. [PMID: 31438734 DOI: 10.1080/02713683.2019.1659976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To evaluate the intrasession repeatability of the biometric measurements obtained with a low-coherence reflectometry optical biometer in pseudophakic eyes implanted with two different types of intraocular lens (IOL).Methods: Prospective, single-center, comparative study including 69 eyes of 69 patients with ages ranging from 51 to 92 years. Previous uncomplicated cataract surgery had been performed in all patients 1 to 2 months before measurements, with implantation of the Acrysof SN60WF IOL in 35 eyes (35 patients, group 1) and the IOL Akreos MI60 in 34 eyes (34 patients, group 2). A complete postoperative ophthalmological examination was performed including three consecutive measurements with the "Aladdin" system from (Topcon, Japan). Intrasession repeatability of axial length (AXL), anterior chamber depth (ACD) and IOL thickness (IOLT) were assessed with the within-subject standard deviation (Sw), intraobserver precision (1.96 × Sw), coefficient of variation (CV) and intraclass correlation coefficient (ICC). Results: The Sw for AXL measurements was 0.03 and 0.05 mm in groups 1 and 2, respectively, with ICC of 1.000 and 0.999 (CV: 0.14% and 0.22%) (p ≤ 0.031). Concerning pseudophakic ACD, the Sw was 0.03 and 0.09 mm in groups 1 and 2, respectively, with ICC of 0.992 and 0.956 (CV: 0.55% and 1.75%) (p ≤ 0.021). The variability of IOLT measurements was high in both groups, with Sw of 0.12 and 0.29 mm for groups 1 and 2 (p = .008), respectively, and ICC of 0.065 and 0.770 (CV: 20.84% and 62.39%).Conclusions: The optical biometer "Aladdin" (Topcon, Japan) provides consistent measurements of AXL and ACD in pseudophakic eyes. However, there is a limitation in the consistency of IOLT measurements that should be investigated further.
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Affiliation(s)
- Hideki Fukumitsu
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Department of Ophthalmology, Marina Baixa Hospital, Alicante, Spain.,Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - Vicent J Camps
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
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Analysis of Intrasession Repeatability of Ocular Aberrometric Measurements and Validation of Keratometry Provided by a New Integrated System in Mild to Moderate Keratoconus. Cornea 2019; 38:1097-1104. [DOI: 10.1097/ico.0000000000002034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Piñero DP, Soto-Negro R, Ruiz-Fortes P, Pérez-Cambrodí RJ, Fukumitsu H. Interchangeability of corneal curvature and asphericity measurements provided by three different devices. Int J Ophthalmol 2019; 12:412-416. [PMID: 30918809 DOI: 10.18240/ijo.2019.03.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 12/17/2018] [Indexed: 12/22/2022] Open
Abstract
AIM To evaluate the interchangeability of keratometric and asphericity measurements provided by three measurement systems based on different optical principles. METHODS A total of 40 eyes of 40 patients with a mean age of 34.1y were included. In all cases, a corneal curvature analysis was performed with IOL-Master (IOLM), iDesign 2 (ID2), and Sirius systems (SIR). Differences between instruments for flattest (K1) and steepest (K2) keratometric readings, as well as for magnitude and axis of corneal astigmatism were analyzed. Likewise, differences in asphericity (Q) between SIR and ID2 were also evaluated. RESULTS Mean differences between devices for K1 were 0.20±0.21 (P<0.001), -0.12±0.36 (P=0.046) and -0.32±0.36 D (P<0.001) for the comparisons IOLM-SIR, IOLM-ID2 and SIR-ID2, respectively. The ranges of agreement for these comparisons between instruments were 0.41, 0.70, and 0.70 D. For K2, mean differences were 0.31±0.33 (P<0.001), -0.08±0.43 (P=0.265) and -0.39±0.38 D (P<0.001), with ranges of agreement of 0.65, 0.84, and 0.74 D. Concerning magnitude of astigmatism, ranges of agreement were in the limit of clinical relevance (0.49 D, P=0.011; 0.55 D, P=0.386; 0.43 D, P=0.05). In contrast, ranges of agreement were clinically relevant for astigmatic axis (26.68°, 33.83° and 18.37°, P≥0.121) and for Q between SIR and ID2 (0.16, P<0.001). CONCLUSION The keratometric corneal power, astigmatic axis and asphericity measurements provide by the three systems evaluated cannot be considered as interchangeable, whereas measurements of corneal astigmatism obtained with SIR and ID2 can be considered as interchangeable for clinical purposes.
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Affiliation(s)
- David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, San Vicente del Raspeig 03690, Alicante, Spain.,Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante 03014, Spain
| | - Roberto Soto-Negro
- Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante 03014, Spain
| | - Pedro Ruiz-Fortes
- Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante 03014, Spain
| | - Rafael J Pérez-Cambrodí
- Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante 03014, Spain
| | - Hideki Fukumitsu
- Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante 03014, Spain.,Department of Ophthalmology, Marina Baixa Hospital, Villajoyosa 03570, Alicante, Spain
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Panagiotopoulou EK, Ntonti P, Gkika M, Konstantinidis A, Perente I, Dardabounis D, Ioannakis K, Labiris G. Image-guided lens extraction surgery: a systematic review. Int J Ophthalmol 2019; 12:135-151. [PMID: 30662853 DOI: 10.18240/ijo.2019.01.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 10/09/2018] [Indexed: 12/29/2022] Open
Abstract
A systematic review of the recent literature regarding the current image-guided systems used for cataract surgery or refractive lens exchange was performed based on the PubMed and Google Scholar databases in March 2018. Literature review returned 21 eligible studies. These studies compared image-guided systems with other keratometric devices regarding their accuracy, repeatability and reproducibility in measurement of keratometric values, astigmatism magnitude and axis, as well as in IOL power calculation. Additionally, the image-guided systems were compared with conventional manual ink-marking techniques for the alignment of toric IOLs. In conclusion, image-guided systems seem to be an accurate and reliable technology with measurements of high repeatability and reproducibility regarding the keratometry and IOL power calculation, but not yet interchangeable with the current established and validated keratometric devices. However, they are superior over the conventional manual ink-marking techniques for toric IOL alignment.
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Affiliation(s)
| | - Panagiota Ntonti
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis 68100, Greece
| | - Maria Gkika
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis 68100, Greece
| | - Aristeidis Konstantinidis
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis 68100, Greece
| | - Irfan Perente
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis 68100, Greece
| | - Doukas Dardabounis
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis 68100, Greece
| | - Konstantinos Ioannakis
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis 68100, Greece
| | - Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis 68100, Greece
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Jeon SH, Park CH, Kim HS. Effect of the Corneal Incision Direction Using an Image-guided System on Residual Astigmatism. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.6.505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Seung Hee Jeon
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Hyun Park
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Seung Kim
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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