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      Comparison of central corneal thickness with four noncontact devices: An agreement analysis of swept-source technology

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          Abstract

          Purpose:

          The purpose of this study was to compare the central corneal thickness (CCT) measurements of four noncontact devices in healthy eyes.

          Materials and Methods:

          In a sample of 45 healthy controls, CCT was measured using an optical biometer (IOLMaster 700) based on swept-source optical coherence tomography (SS-OCT), high-resolution rotating Scheimpflug camera system (Pentacam HR), spectral-domain OCT (SD-OCT) device with an anterior segment module (Spectralis), and noncontact pachymetry (NCP) device (Topcon TRK-2P). Agreement among the devices was analyzed using mean differences (i.e., bias) and Bland–Altman analysis with 95% limits of agreement (LoA).

          Results:

          Mean CCT measurements were 537.5 ± 47.5 μm for SS-OCT optical biometer, 532.3 ± 43.8 μm for Scheimpflug system, 521.3 ± 44.7 μm for SD-OCT device, and 518.0 ± 43.1 μm for NCP ( P < 0.001). The SD-OCT device and NCP showed the closest agreement, with a bias of 2.6 μm (95% LoA, −3.6–8.8 μm), whereas the SS-OCT optical biometer and NCP showed the least agreement, with a bias of 18.7 μm (95% LoA, −2.1–39.5 μm). Bias was 16.1 μm (95% LoA, −3.1–35.3 μm) for SS-OCT optical biometer and SD-OCT, 5.1 μm (95% LoA, −6.8–17.0 μm) for SS-OCT optical biometer and Scheimpflug system, 10.9 μm (95% LoA, −15.1–36.9 μm) for SD-OCT device and Scheimpflug system, and 13.6 μm (95% LoA, −5–32.2 μm) for Scheimpflug system and NCP.

          Conclusions:

          SS-OCT optical biometer overestimates CCT measurements compared to Scheimpflug system, SD-OCT device, and NCP. Given mean differences and range variations in CCT measurements between devices, SS-OCT optical biometer and Scheimpflug system are interchangeable as are SD-OCT and NCP.

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          Most cited references29

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          The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma.

          The Ocular Hypertension Treatment Study (OHTS) has shown that topical ocular hypotensive medication is effective in delaying or preventing the onset of primary open-angle glaucoma (POAG) in individuals with elevated intraocular pressure (ocular hypertension) and no evidence of glaucomatous damage. To describe baseline demographic and clinical factors that predict which participants in the OHTS developed POAG. Baseline demographic and clinical data were collected prior to randomization except for corneal thickness measurements, which were performed during follow-up. Proportional hazards models were used to identify factors that predicted which participants in the OHTS developed POAG. In univariate analyses, baseline factors that predicted the development of POAG included older age, race (African American), sex (male), larger vertical cup-disc ratio, larger horizontal cup-disc ratio, higher intraocular pressure, greater Humphrey visual field pattern standard deviation, heart disease, and thinner central corneal measurement. In multivariate analyses, baseline factors that predicted the development of POAG included older age, larger vertical or horizontal cup-disc ratio, higher intraocular pressure, greater pattern standard deviation, and thinner central corneal measurement. Baseline age, vertical and horizontal cup-disc ratio, pattern standard deviation, and intraocular pressure were good predictors for the onset of POAG in the OHTS. Central corneal thickness was found to be a powerful predictor for the development of POAG.
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            Risk assessment for ectasia after corneal refractive surgery.

            To analyze the epidemiologic features of ectasia after excimer laser corneal refractive surgery, to identify risk factors for its development, and to devise a screening strategy to minimize its occurrence. Retrospective comparative and case-control study. All cases of ectasia after excimer laser corneal refractive surgery published in the English language with adequate information available through December 2005, unpublished cases seeking treatment at the authors' institution from 1998 through 2005, and a contemporaneous control group who underwent uneventful LASIK and experienced a normal postoperative course. Evaluation of preoperative characteristics, including patient age, gender, spherical equivalent refraction, pachymetry, and topographic patterns; perioperative characteristics, including type of surgery performed, flap thickness, ablation depth, and residual stromal bed (RSB) thickness; and postoperative characteristics including time to onset of ectasia. Development of postoperative corneal ectasia. There were 171 ectasia cases, including 158 published cases and 13 unpublished cases evaluated at the authors' institution. Ectasia occurred after LASIK in 164 cases (95.9%) and after photorefractive keratectomy (PRK) in 7 cases (4.1%). Compared with controls, more ectasia cases had abnormal preoperative topographies (35.7% vs. 0%; P<1.0x10(-15)), were significantly younger (34.4 vs. 40.0 years; P<1.0x10(-7)), were more myopic (-8.53 vs. -5.09 diopters; P<1.0x10(-7)), had thinner corneas before surgery (521.0 vs. 546.5 microm; P<1.0x10(-7)), and had less RSB thickness (256.3 vs. 317.3 microm; P<1.0x10(-10)). Based on subgroup logistic regression analysis, abnormal topography was the most significant factor that discriminated cases from controls, followed by RSB thickness, age, and preoperative corneal thickness, in that order. A risk factor stratification scale was created, taking all recognized risk factors into account in a weighted fashion. This model had a specificity of 91% and a sensitivity of 96% in this series. A quantitative method can be used to identify eyes at risk for developing ectasia after LASIK that, if validated, represents a significant improvement over current screening strategies.
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              Is Open Access

              Clinical comparison of a new swept-source optical coherence tomography-based optical biometer and a time-domain optical coherence tomography-based optical biometer.

              To evaluate the repeatability and reproducibility of a newer swept-source optical biometer and to compare it with a standard partial coherence interferometry (PCI) biometer.
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                Author and article information

                Journal
                Indian J Ophthalmol
                Indian J Ophthalmol
                IJO
                Indian Journal of Ophthalmology
                Medknow Publications & Media Pvt Ltd (India )
                0301-4738
                1998-3689
                June 2017
                : 65
                : 6
                : 461-465
                Affiliations
                [1]Department of Ophthalmology, Mugla Sitki Kocman University Training and Research Hospital, Muğla, Turkey
                [1 ]Department of Ophthalmology, Faculty of Medicine, Mugla Sitki Kocman University, Muğla, Turkey
                Author notes
                Correspondence to: Dr. Erhan Özyol, Department of Ophthalmology, Mugla Sitki Kocman University Training and Research Hospital, Muğla, Turkey. E-mail: erhanozyol@ 123456mynet.com
                Article
                IJO-65-461
                10.4103/ijo.IJO_618_16
                5508455
                28643709
                4dedfee3-0d69-410f-9902-4cff8451d0ef
                Copyright: © 2017 Indian Journal of Ophthalmology

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 06 August 2016
                : 16 May 2017
                Categories
                Original Article

                Ophthalmology & Optometry
                anterior segment optical coherence tomography,central corneal thickness,noncontact pachymetry,scheimpflug analysis system,swept-source optical biometer

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