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      Agreement between Two Swept-Source Optical Coherence Tomography Biometers and a Partial Coherence Interferometer

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          Abstract

          Purpose

          To evaluate the level of agreement between ANTERION (Heidelberg Engineering, Heidelberg, Germany), OA-2000 (Tomey, Nagoya, Japan), and IOLMaster 500 (Carl Zeiss AG, Jena, Germany).

          Methods

          Fifty-one eyes of 51 patients were included in the study. Flat keratometry (K) and steep K, vector component of astigmatism (Jackson cross-cylinder at 0° and 90° [ J 0 ] and Jackson cross-cylinder at 45° and 135° [ J 45 ]), anterior chamber depth, and axial length were compared using the three devices. Repeated measures analysis of variance was conducted to compare the mean values of the biometrics. Pearson correlation test was conducted to analyze the correlations of the measured values, and a Bland-Altman plot was used to assess the agreement between the three devices. The predicted intraocular lens power of each device was compared to the others using the SRK/T, Haigis, Barrett Universal II, and Kane formulas.

          Results

          All K values measured using ANTERION were flatter than those of other instruments. However, good agreement was observed for flat K (ANTERION - OA-2000; 95% limits of agreement [LoA], 0.86 diopters [D]) and steep K (ANTERION - OA-2000; 95% LoA, 0.93 D) and OA-2000 - IOLMaster 500 (95% LoA, 0.93 D). J 0 and J 45 vector components of astigmatism were not statistically different; however, the agreements were poor between the devices (95% LoA ≥1.97 D). Anterior chamber depth values of ANTERION and OA-2000 were interchangeable (95% LoA, 0.15 mm). The axial length showed a high agreement (95% LoA ≤0.17 mm) among the three devices. The predicted intraocular lens powers of the three devices were not interchangeable regardless of formulas (95% LoA ≥1.04 D).

          Conclusions

          Significant differences in ocular biometrics were observed between ANTERION and the other two devices. This study demonstrated that only axial length showed good agreement among devices.

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          Most cited references35

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          Power vectors: an application of Fourier analysis to the description and statistical analysis of refractive error.

          The description of sphero-cylinder lenses is approached from the viewpoint of Fourier analysis of the power profile. It is shown that the familiar sine-squared law leads naturally to a Fourier series representation with exactly three Fourier coefficients, representing the natural parameters of a thin lens. The constant term corresponds to the mean spherical equivalent (MSE) power, whereas the amplitude and phase of the harmonic correspond to the power and axis of a Jackson cross-cylinder (JCC) lens, respectively. Expressing the Fourier series in rectangular form leads to the representation of an arbitrary sphero-cylinder lens as the sum of a spherical lens and two cross-cylinders, one at axis 0 degree and the other at axis 45 degrees. The power of these three component lenses may be interpreted as (x,y,z) coordinates of a vector representation of the power profile. Advantages of this power vector representation of a sphero-cylinder lens for numerical and graphical analysis of optometric data are described for problems involving lens combinations, comparison of different lenses, and the statistical distribution of refractive errors.
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            The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group.

            To develop the Lens Opacities Classification System III (LOCS III) to overcome the limitations inherent in lens classification using LOCS II. These limitations include unequal intervals between standards, only one standard for color grading, use of integer grading, and wide 95% tolerance limits. The LOCS III contains an expanded set of standards that were selected from the Longitudinal Study of Cataract slide library at the Center for Clinical Cataract Research, Boston, Mass. It consists of six slit-lamp images for grading nuclear color (NC) and nuclear opalescence (NO), five retroillumination images for grading cortical cataract (C), and five retroillumination images for grading posterior subcapsular (P) cataract. Cataract severity is graded on a decimal scale, and the standards have regularly spaced intervals on a decimal scale. The 95% tolerance limits are reduced from 2.0 for each class with LOCS II to 0.7 for nuclear opalescence, 0.7 for nuclear color, 0.5 for cortical cataract, and 1.0 for posterior subcapsular cataract with the LOCS III, with excellent interobserver agreement. The LOCS III is an improved LOCS system for grading slit-lamp and retroillumination images of age-related cataract.
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              Sources of error in intraocular lens power calculation.

              To identify and quantify sources of error in the refractive outcome of cataract surgery. AMO Groningen BV, Groningen, The Netherlands. Means and standard deviations (SDs) of parameters that influence refractive outcomes were taken or derived from the published literature to the extent available. To evaluate their influence on refraction, thick-lens ray tracing that allowed for asphericity was used. The numerical partial derivative of each parameter with respect to spectacle refraction was calculated. The product of the partial derivative and the SD for a parameter equates to its SD, expressed as spectacle diopters, which squared is the variance. The error contribution of a parameter is its variance relative to the sum of the variances of all parameters. Preoperative estimation of postoperative intraocular lens (IOL) position, postoperative refraction determination, and preoperative axial length (AL) measurement were the largest contributors of error (35%, 27%, and 17%, respectively), with a mean absolute error (MAE) of 0.6 diopter (D) for an eye of average dimensions. Pupil size variation in the population accounted for 8% of the error, and variability in IOL power, 1%. Improvement in refractive outcome requires better methods for predicting the postoperative IOL position. Measuring AL by partial coherence interferometry may be of benefit. Autorefraction increases precision in outcome measurement. Reducing these 3 major error sources with means available today reduces the MAE to 0.4 D. Using IOLs that compensate for the spherical aberration of the cornea would eliminate the influence of pupil size. Further improvement would require measuring the asphericity of the anterior surface and radius of the posterior surface of the cornea.
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                Author and article information

                Journal
                Korean J Ophthalmol
                Korean J Ophthalmol
                Korean Journal of Ophthalmology : KJO
                Korean Ophthalmological Society
                1011-8942
                2092-9382
                August 2022
                15 June 2022
                : 36
                : 4
                : 326-337
                Affiliations
                [1 ]Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
                [2 ]Department of Ophthalmology, Ewha Womans University Seoul Hospital, Ewha Womans University School of Medicine, Seoul, Korea
                Author notes
                Corresponding Author: Kyung Eun Han, MD, PhD. Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea. Tel: 82-2-2650-5154, Fax: 82-2654-4334, E mail: hanke@ 123456ewha.ac.kr

                This study was presented at the 125th meeting of Korean Ophthalmological Society.

                Article
                kjo-2022-0017
                10.3341/kjo.2022.0017
                9388892
                35766049
                94c7f03d-a47c-4e0d-8f7b-4d47adceb889
                © 2022 The Korean Ophthalmological Society

                This is an Open Access journal distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 February 2022
                : 31 March 2022
                : 26 April 2022
                Categories
                Original Article

                Ophthalmology & Optometry
                biometry,partial coherence interferometer,swept-source optical coherence tomography

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