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Wendelstein JA, Yeo TK, Hinterberger S, Seiler TG, Dick HB, Savini G, Langenbucher A, Taneri S. The Influence of Lens Position, Vault Prediction, and Posterior Cornea on Phakic Posterior Chamber Intraocular Lens Power. Am J Ophthalmol 2024; 261:7-18. [PMID: 38218514 DOI: 10.1016/j.ajo.2024.01.008] [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: 10/31/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND Achieving precise refractive outcomes in phakic posterior chamber intraocular lens (pIOL) implantation is crucial for patient satisfaction. This study investigates factors affecting pIOL power calculations, focusing on myopic eyes, and evaluates the potential benefits of advanced predictive models. DESIGN Retrospective, single-center, algorithm improvement study. METHODS Various variations with different effective lens position (ELP) algorithms were analyzed. The algorithms included a fixed constant model, and a multiple linear regression model and were tested with and without incorporation of the posterior corneal curvature (Rcp). Furthermore, the impact of inserting the postoperative vault, the space between the pIOL and the crystalline lens, into the ELP algorithm was examined, and a simple vault prediction model was assessed. RESULTS Integrating Rcp and the measured vault into pIOL calculations did not significantly improve accuracy. Transitioning from constant model approaches to ELP concepts based on linear regression models significantly improved pIOL power calculations. Linear regression models outperformed constant models, enhancing refractive outcomes for both ICL and IPCL pIOL platforms. CONCLUSIONS This study underscores the utility of implementing ELP concepts based on linear regression models into pIOL power calculation. Linear regression based ELP models offered substantial advantages for achieving desired refractive outcomes, especially in lower to medium power pIOL models. For pIOL power calculations in both pIOL platforms we tested with preoperative measurements from a Scheimpflug device, we found improved results with the LION 1ICL formula and LION 1IPCL formula. Further research is needed to explore the applicability of these findings to a broader range of pIOL designs and measurement devices.
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Affiliation(s)
- Jascha A Wendelstein
- Johannes Kepler University Linz, Medical Faculty (J.A.W., S.H.), Linz, Austria; Department for Ophthalmology and Optometry (J.A.W., S.H.), Kepler University Hospital GmbH, Linz, Austria; Institut für Refraktive und Ophthalmo-Chirurgie (IROC) (J.A.W., T.G.S.), Zurich, Switzerland; Institute of Experimental Ophthalmology, Saarland University (J.A.W., A.L.), Homburg, Germany.
| | - Tun Kuan Yeo
- Tan Tock Seng Hospital (T.K.Y.), Singapore, Singapore
| | - Sarah Hinterberger
- Johannes Kepler University Linz, Medical Faculty (J.A.W., S.H.), Linz, Austria; Department for Ophthalmology and Optometry (J.A.W., S.H.), Kepler University Hospital GmbH, Linz, Austria
| | - Theo G Seiler
- Institut für Refraktive und Ophthalmo-Chirurgie (IROC) (J.A.W., T.G.S.), Zurich, Switzerland; Universitätsklinik für Augenheilkunde, Inselspital Bern (T.G.S.), Bern, Switzerland; Klinik für Augenheilkunde, Universitätsklinikum Düsseldorf (T.G.S.), Duesseldorf, Germany
| | - H Burkhard Dick
- Department of Ophthalmology, University of Bochum (H.B.D., S.T.), Bochum, Germany
| | | | - Achim Langenbucher
- Institute of Experimental Ophthalmology, Saarland University (J.A.W., A.L.), Homburg, Germany
| | - Suphi Taneri
- Department of Ophthalmology, University of Bochum (H.B.D., S.T.), Bochum, Germany; Zentrum für Refraktive Chirurgie (S.T.), Muenster, Germany
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Alió JL, José-Martínez M, Martínez-Abad A, Rodríguez AE, Versaci F, Hjortdal J, Murta JN, Plaza-Puche AB, Cantó-Cerdán M, Piñero DP. Clinical Evaluation of a New Spectral-Domain Optical Coherence Tomography-Based Biometer. Diagnostics (Basel) 2024; 14:560. [PMID: 38473032 DOI: 10.3390/diagnostics14050560] [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: 12/18/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
The VEMoS-AXL system is a new optical biometer based on spectral domain optical coherence tomography (SD-OCT) that has been tested in terms of intrasession repeatability and compared with a swept-source optical coherence tomography biometer (SS-OCT), which is recognized as the gold standard for the performance of an agreement analysis. A biometric analysis was performed three consecutive times in 120 healthy eyes of 120 patients aged between 18 and 40 years with the SD-OCT system, and afterwards, a single measurement was obtained with the SS-OCT system. Within-subject standard deviations were 0.004 mm, 4.394 µm, and 0.017 mm for axial length (AL), central corneal thickness (CCT), and anterior chamber depth (ACD) measures obtained with the SD-OCT biometer, respectively. The agreement between devices was good for AL (limits of agreement, LoA: -0.04 to 0.03 mm) and CCT (LoA: -4.36 to 14.38 µm), whereas differences between devices were clinically relevant for ACD (LoA: 0.03 to 0.21 mm). In conclusion, the VEMoS-AXL system provides consistent measures of anatomical parameters, being most of them interchangeable with those provided by the SS-OCT-based gold standard.
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Affiliation(s)
- Jorge L Alió
- Research and Development Department, Vissum Grupo Miranza, 03016 Alicante, Spain
- School of Medicine, Miguel Hernandez University, 03202 Alicante, Spain
| | - Marina José-Martínez
- Research and Development Department, Vissum Grupo Miranza, 03016 Alicante, Spain
| | | | | | | | - Jesper Hjortdal
- Department of Opthalmology, Aarhus University Hospital, 8000 Aarhus, Denmark
| | - Joaquim Neto Murta
- Department of Opthalmology, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ana B Plaza-Puche
- Research and Development Department, Vissum Grupo Miranza, 03016 Alicante, Spain
| | - Mario Cantó-Cerdán
- Research and Development Department, Vissum Grupo Miranza, 03016 Alicante, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain
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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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Dong J, Yao J, Chang S, Kanclerz P, Khoramnia R, Wang X. Evaluation of Ocular Diameter Parameters Using Swept-Source Optical Coherence Tomography. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050899. [PMID: 37241130 DOI: 10.3390/medicina59050899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/12/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
Purpose: To investigate the iridocorneal angle-to-angle (ATA), sclera spur-to-sclera spur (STS), and white-to-white (WTW) ocular diameters and their potential influence on anterior chamber intraocular lens (ACIOL) and implantable collamer lens (ICL) sizing in Chinese subjects by using a swept-source optical coherence tomography system (SS-OCT). Design: A retrospective, observational, cross-sectional study. Methods: In 60 right eyes (60 subjects), the ATA, STS, and WTW were measured in six axes (0°-180°, 30°-210°, 60°-240°, 90°-270°, 120°-300°, and 150°-330°) using SS-OCT. The ACIOL and ICL sizes were calculated based on horizontal and vertical axes anterior segment data. A paired sample t-test was used to test the differences in each parameter across the six axes, the potential difference between each pair of parameters in a given axis, and the artificial lens size difference between the horizontal and vertical directions. Pearson's correlation analysis was used to determine the potential correlation between age and AL, WTW, STS, and ATA distances. Results: ATA and STS were the longest on the vertical and shortest on the horizontal axis, while WTW was similar on both axes. These three parameters differed only in the vertical axis (F = 4.910, p = 0.008). ATA and STS were by 0.23 ± 0.08 mm (p = 0.005) and 0.21 ± 0.08 mm wider (p = 0.010) than WTW, respectively. ICL size was 0.27 ± 0.23 mm smaller when based on the horizontal than on the vertical axis parameters (p < 0.001), while ACIOL remained similar (p = 0.709). Age correlated negatively and axial length positively with all measured values. ATA, STS, and WTW correlated positively in the same axis (all p < 0.001). Conclusions: ATA and STS were longer in the vertical than in the horizontal direction, while WTW measurements remained similar. ATA and STS diameters more accurately depicted anatomic relationships for phakic IOL sizing than WTW.
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Affiliation(s)
- Jing Dong
- Department of Ophthalmology, First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Jinhan Yao
- Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan 030002, China
| | - Shuimiao Chang
- Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan 030002, China
| | - Piotr Kanclerz
- Hygeia Clinic, 80-286 Gdańsk, Poland
- Helsinki Retina Research Group, University of Helsinki, 00014 Helsinki, Finland
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Xiaogang Wang
- Shanxi Eye Hospital Affiliated to Shanxi Medical University, Taiyuan 030002, China
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Muzyka-Woźniak M, Oleszko A, Stróżecki Ł, Woźniak S. The corneo-scleral junction assessed with optical coherence tomography. PLoS One 2022; 17:e0278884. [PMID: 36490278 PMCID: PMC9733874 DOI: 10.1371/journal.pone.0278884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 11/26/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To evaluate corneo-scleral junction (CSJ) using anterior segment optical coherence tomography (AS-OCT) and describe the pattern of cornea and sclera interfusion based on tissue reflectivity. METHODS This prospective observational study enrolled candidates for vision correction. Eyes with previous ocular surgery or irregular corneas were excluded. Temporal and nasal CSJ width and reflectivity patterns were assessed with AS-OCT horizontal scans. Correlations between manual and automated variables and multivariate linear regression analyses with age and spherical equivalent were performed. RESULTS 101 right eyes were analysed. Temporal CSJ was wider (median 1.62; 1.13 to 2.22 mm) compared to the nasal side (median 1.18; 0.73 to 1.80 mm) (p<.0001). The temporal CSJ width showed negative correlation with ipsilateral anterior chamber angle measurements and positive correlation with horizontal visible iris diameter (HVID). These relationships were not statistically significant for the nasal CSJ width. No significant correlations with age or refractive error were observed at both sides. The pattern of temporal CSJ reflectivity was mostly V- or U-shaped. The eyes with V-shaped temporal CSJ had significantly larger HVID than the eyes with irregular temporal CSJ. The nasal CSJ presented irregular reflectivity in 47% of cases. CONCLUSIONS The temporal CSJ was wider and had regular (V or U-shaped) reflectivity patterns, while nasal CSJ was narrower and more irregular. The CSJ width was independent of age and refractive error and could not be predicted from other parameters. The HVID measurement accuracy may benefit from CSJ analysis based on AS-OCT.
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Affiliation(s)
| | - Adam Oleszko
- Ophthalmology Clinical Centre SPEKTRUM, Wrocław, Poland
| | - Łukasz Stróżecki
- Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Wrocław, Poland
| | - Sławomir Woźniak
- Department of Human Morphology and Embriology, Department of Anatomy, Wroclaw Medical University, Wrocław, Poland
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Zhu QJ, Zhu WJ, Chen WJ, Ma L, Yuan Y. A prediction model for sulcus-to-sulcus diameter in myopic eyes: a 1466-sample retrospective study. BMC Ophthalmol 2022; 22:307. [PMID: 35842598 PMCID: PMC9287952 DOI: 10.1186/s12886-022-02535-3] [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: 02/17/2022] [Accepted: 07/13/2022] [Indexed: 11/15/2022] Open
Abstract
Background To establish and verify the accuracy and reliability of a sulcus-to-sulcus diameter (STS) prediction model. Methods In this retrospective study, the prediction formula was established with the data from 1466 eyes from 733 subjects from July 2020 to April 2021 and verified with the data from 278 eyes from 139 subjects between May 2021 and June 2021. Each subject was measured with a Pentacam, IOLMaster 700, OPD-Scan III, and ultrasound biomicroscope. The prediction formulas were established with multiple linear regression, and intergroup correlation coefficients (ICCs) and Bland–Altman tests were used to assess the agreement between the predicted and actual STS (actual STS was measured by UBM). Results The explanatory variables relevant to the horizontal STS (STSH) were the Pentacam white-to-white diameter (WTWP; standardized partial regression coefficient [β] = 0.330; p < 0.001), the flat K value (β = -0.211; p < 0.001), and the anterior corneal diameter (ACD) (β = 0.178; p < 0.001). The corresponding multiple regression equation was : STSH (mm) = 8.061 + 0.510 × WTWP − 0.090 × Flat K value + 0.430 × ACD. The explanatory variables relevant to the vertical STS (STSV) were the WTWP (β = 0.435; p < 0.001), the steep K value (β = -0.271; p < 0.001), and the ACD (β = 0.187; p < 0.001). The corresponding multiple regression equation was : STSV (mm) = 8.540 + 0.492 × WTWP − 0.075 × Steep K value + 0.329 × ACD. The bias of the predicted to the actual STSH was − 0.021, with 95% limits of agreement (95% LoA) from − 0.499 to 0.457. The bias of the predicted to the actual STSV was 0.057, with 95% LoA from − 0.462 to 0.575. The ICC was 0.883 between the predicted and actual STSH and 0.859 between the predicted and actual STSV. Conclusions The Pentacam-measured WTW, the K value and the ACD are important for predicting the STS diameter. The prediction model has good accuracy and reliability. Trial registration Not applicable.
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Affiliation(s)
- Qiu-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - Wei-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - Wen-Jing Chen
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - Lie Ma
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China
| | - You Yuan
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, 215021, Jiangsu, Suzhou, China.
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