Comparison of Multicolored Spot Reflection Topographer and Scheimpflug-Placido System in Corneal Power and Astigmatism Measurements With Normal and Post-refractive Patients

Keratometry Agreement Between Two Swept-Source OCT Devices in Healthy and Post-refractive Surgery Eyes

PURPOSE

To evaluate the keratometry agreement between two swept-source devices for healthy and post-refractive surgery eyes and compare them.

METHODS

One hundred volunteers between 20 and 55 years of age were recruited for this study including both healthy and post-refractive surgery eyes. Three consecutive measurements of simulated keratometry (Sim K), posterior keratometry (PK), and total keratometry (TK) were obtained with the IOLMaster 700 and Anterion. The agreement was assessed through the Bland-Altman method. Limits of agreement (LoA) were calculated as mean difference ±1.96·SD and it represents the 95% of the differences between devices.

RESULTS

For both groups, Sim K measurements exhibited a mean difference close to 0 and within a range of ±0.30 and ±0.36 diopters (D) for the control and post-refractive surgery groups, respectively. Meanwhile, the IOLMaster 700 provided flatter PK values (0.30 D on average) for both groups. In general, the post-refractive surgery group exhibited slightly greater mean differences and wider 95% LoA than the control group for Sim K and PK. Steeper TK values were obtained by the IOLMaster in both groups (control = 0.50 D and post-refractive surgery = 0.75 D). TK differences between devices were significantly greater in the post-refractive surgery group (ranging from 0.38 to 1.14 D) compared to the control group (ranging from 0.15 to 0.85 D).

CONCLUSIONS

The IOLMaster 700 and Anterion are not interchangeable for TK measurements and eyes that had corneal refractive surgery even decreased the agreement between devices. Differences between devices for Sim K and PK measurements should be clinically judged, particularly in eyes with previous corneal surgery. [J Refract Surg. 2023;39(5):347-353.].

Repeatability and reproducibility of corneal higher-order aberrations measurements after small incision lenticule extraction using the Scheimpflug-Placido topographer

Background

To evaluate the precision of corneal higher-order aberrations measurements after small incision lenticule extraction (SMILE) using the Sirius Scheimpflug-Placido topographer (CSO, Italy).

Methods

Seventy-five eyes from 75 postoperative subjects were included in this prospective study. Three consecutive corneal aberrometric measurements were obtained with the Scheimpflug-Placido topographer by two experienced operators to assess intra- and inter-observer reproducibility. The within-subject standard deviation (S_w), test-retest repeatability (TRT) and the intraclass correlation coefficient (ICC) were calculated.

Results

For intraobserver repeatability of anterior and total corneal aberrations, all ICCs were more than 0.922, except for trefoil (0.722 to 0.768). The ICCs of total root mean square (RMS), coma Z (3, ± 1), and spherical aberration Z (4, 0) were over 0.810 while higher-order RMS, trefoil Z (3, ± 3), and astigmatism II Z (4, ± 2) were below 0.634 for posterior corneal surface aberrations. All S_w values for all types of aberrations were equal to or below 0.07 μm. Regarding interobserver reproducibility, all TRT values were no more than 0.12 μm, 0.05 μm, and 0.11 μm for anterior, posterior, and total corneal aberrations, respectively. The ICC values ranged from 0.875 to 0.989, from 0.686 to 0.976 and over 0.834 for anterior, posterior, and total corneal aberrations, respectively.

Conclusions

The repeatability of measurements of anterior and total corneal aberrations with the Sirius system in corneas after SMILE surgery was high, except for trefoil. There was some variability in posterior corneal aberrometric measurements. High reproducibility of corneal aberrometric measurements was observed between measurements of both examiners, except for trefoil, with poor to moderate reproducibility.

Repeatability and comparability of the Galilei-G4 and Cassini in measuring corneal power and astigmatism in normal and post-refractive surgery eyes

To assess the repeatability and comparability of the Galilei G4 versus the Cassini topographer in post-refractive eyes and in normal eyes, including older patients representative of an initial cataract evaluation. Simulated keratometric (simK), total corneal and posterior corneal power and astigmatism were evaluated in both post-refractive and normal eyes. Repeatability was measured by calculating within-subject standard deviation (Sw), coefficient of variation (CoV), and intraclass correlation coefficient (ICC). Vector analyses and Bland-Altman plots were employed to assess agreement between devices. We studied 32 subjects with a history of refractive surgery and 32 subjects without a history of refractive surgery undergoing cataract surgery. The mean age was 55 ± 18.5 years and the age range was 21.5-91.5 years. In non-refractive and post-refractive eyes, the ICC was > 0.9 (P < 0.001) for all corneal powers and for simK and total corneal astigmatism for both analyzers. The ICC for posterior corneal astigmatism magnitude using the Galilei was 0.62 and 0.67 and for the Cassini 0.55 and 0.38 in normal and post-refractive eyes, respectively. In both post-refractive and normal eyes, the Galilei G4 and Cassini analyzers have high repeatability in simK, total, and posterior corneal power and low repeatability for posterior corneal astigmatism.

García Á, Piñero DP. Comparison of Standard and Total Keratometry Astigmatism Measured with three Different Technologies

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.