Comparison of Biometric Measurements and Refractive Results between Applanation Ultrasonography and Three Different Interferometries

Ji Sun Moon; Jeong Ah Shin; Gi Hyun Bae; Sung Kun Chung

doi:10.3341/jkos.2015.56.11.1720

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Moon, Shin, Bae, and Chung: Comparison of Biometric Measurements and Refractive Results between Applanation Ultrasonography and Three Different Interferometries

Original Article

J Korean Ophthalmol Soc 2015;56(11):1720-1727.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.11.1720

Comparison of Biometric Measurements and Refractive Results between Applanation Ultrasonography and Three Different Interferometries

Ji Sun Moon, M.D¹, Jeong Ah Shin, M.D², Gi Hyun Bae, M.D¹, Sung Kun Chung, M.D, PhD^2,

¹Department of Ophthalmology, Sahmyook Medical Center^¹, Seoul, Korea

²Department of Ophthalmology and Visual Science, St. Paul’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Sung Kun Chung, MD, PhD Department of Ophthalmology, St. Paul’s Hospital, College of Medicine, The Catholic University of Korea, #180 Wangsan-ro, Dongdaemun-gu, Seoul 02559, Korea Tel: 82-2-958-2151, Fax: 82-2-960-2150 E-mail: eyedoc@catholic.ac.kr

Received 19 June 20152 July 2015 Accepted 4 September 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare ocular biometry and refractive results measured using conventional applanation ultrasonography and 3 different optical interferometries, Lenstar LS900^®, AL-Scan^® and OA-2000^®.

Methods

The biometries of 31 cataractous eyes were measured using ultrasonography, Lenstar LS900^®, AL-Scan^® or OA-2000^®. The axial length, anterior chamber depth and keratometry were measured. The SRK/T formula was used to calculate intraocular lens power. Two months after cataract surgery, the refractive outcome was determined and results from the 4 differ-ent biometry methods were compared.

Results

Axial lengths were 23.39 ± 0.95 mm, 23.42 ± 0.98 mm, 23.43 ± 0.98 mm and 23.44 ± 0.98 mm measured using ultra-sonography, Lenstar LS900^®, AL-Scan^® and OA-2000^®, respectively with no statistically significant differences observed ( p = 0.996). The anterior chamber depth and keratometry were 3.14 ± 0.41 mm, 3.10 ± 0.38 mm and 3.13 ± 0.39 mm ( p = 0.936) and 44.41 ± 1.52 D, 44.54 ± 1.57 D and 44.44 ± 1.52 D ( p = 0.937) for Lenstar LS900^®, AL-Scan^® and OA-2000^® respectively. There were no statistically significant differences between the 3 optical devices. The mean absolute error of the 4 different devices were not statistically significant ( p = 0.722).

Conclusions

The ocular biometric measurements and prediction of postoperative refraction using ultrasonography, Lenstar LS900^®, AL-Scan^® or OA-2000^® showed no significant differences.

Keywords: Axial length, OA-2000^®, Optical low coherence reflectometry, Partial coherence interferometer, Refractive error

References

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Figure 1.

Bland-Altman plots showing the agreement between axial length (mm) obtained by 4 different divicies. (A) A-scan and Lenstar LS900®, (B) A-scan and AL-Scan®, (C) A-scan and OA-2000®, (D) Lenstar LS900® and AL-Scan®, (E) Lenstar LS900® and OA-2000®, (F) AL-Scan® and OA-2000®. 95% limits of agreement for axial length difference are -0.23~0.17 mm, -0.26~0.17 mm, -0.25~0.14 mm, -0.10~0.06 mm, -0.08~0.03 mm and -0.10~0.80 mm.

Figure 2.

Bland-Altman plots showing the agreement between anterior chamber depth (mm) obtained by 3 different optical divicies. (A) Lenstar LS900® and AL-Scan®, (B) Lenstar LS900® and OA-2000®, (C) AL-Scan® and OA-2000®. 95% limits of agreement for anterior chamber depth difference are -0.17~0.24 mm, -0.20~0.21 mm and -0.22~0.16 mm.

Figure 3.

Bland-Altman plots showing the agreement between keratometry (D) obtained by 3 different optical divicies. (A) Lenstar LS900® and AL-Scan®, (B) Lenstar LS900® and OA-2000®, (C) AL-Scan® and OA-2000®. 95% limits of agreement for keratometry difference are -0.85~0.58 D, -0.67~0.61 D and -0.58~ 0.79 D.

Table 1.

Biometry mearsurements by A-scan, Lenstar LS900®, AL-Scan® and OA-2000®

A-scan	Lenstar LS900®	AL-Scan®	OA-2000®	p-value^*
AL (mm)	23.39 ± 0.95	23.42 ± 0.98	23.43 ± 0.98	23.44 ± 0.98	0.996
ACD (mm)	-	3.14 ± 0.41	3.10 ± 0.38	3.13 ± 0.39	0.936
Mean K (D)	-	44.41 ± 1.52	44.54 ± 1.57	44.44 ± 1.52	0.937

Values are presented as mean ± SD unless otherwise indicated.

AL = axial length; ACD = anterior chamber depth; K = keratometry.

^* p-value based on analysis of variance (ANOVA).

Table 2.

Refractive results: comparison of A-scan, Lenstar LS900®, AL-Scan® and OA-2000®

	Prediction error (diopter)			Number of eyes within (%)
	MNE	MAE	Range	±0.50 D	±1.00 D	±1.50 D	±2.00 D
A-scan	0.08 ± 0.69	0.51 ± 0.44	-1.50~1.41	18 (58)	8 (84)	5 (100)	-
Lenstar LS900®	0.39 ± 0.65	0.61 ± 0.44	-0.89~1.54	13 (42)	11 (78)	5 (94)	2 (100)
AL-Scan®	0.26 ± 0.57	0.52 ± 0.34	-0.97~1.39	18 (58)	11 (94)	2 (100)	-
OA-2000®	0.28 ± 0.66	0.59 ± 0.40	-1.10~1.35	16 (52)	9 (81)	6 (100)	-

Values are presented as mean ± SD unless otherwise indicated.

MNE = mean numerical error; MAE = mean absolute error.

Table 3.

Technical information of three optical interferometries

	Lenstar LS900®	AL-Scan®	OA-2000®
Optical interference	OLCR	PCI	OLCR
Applications	AL, ACD, CCT, LT, KM, WTW, PS, RT	AL, ACD, CCT, LT, KM, WTW, PS	AL, ACD, CCT, LT, KM, WTW, PS, topography
AL (range, mm)	14-32/0.01	14-40/0.01	14-40/0.01
US optional (mm)	-	12-40/0.01	13-45/0.01
ACD, principal	OLCR	Scheimpflug	OLCR
KM measurement	(16 points × 2 circles)	(360 points × 2 rings)	(Placido ring, 2,500 points)
	ϕ 2.3 mm/ϕ 1.65 mm	ϕ 3.3 mm/ϕ 2.4 mm	ϕ 3.0 mm/ϕ 2.5 mm
Auto tracking	No	Yes (3 D)	Yes (3 D)
IOL calculation	SRK/T, Holladay, Hoffer Q, Haigis	SRK-II, SRK/T, Holladay, Hoffer Q, Binghorst, Haigis	SRK II, SRK/T, Holladay, Hoffer Q, Haigis, Haigis optimized, Haigis standard
LASIK support	Shammas-PL	Camelling-Calossi, Shammas-PL	Shammas-PL

OLCR = optical low coherence reflectometry; PCI = partial coherence interferometry; AL = axial length; ACD = anterior chamber depth; CCT = central corneal thickness; LT = lens thickness; KM = corneal curvature; WTW = White to white; PS = pupil size; RT = retinal thickness; US = ultrasound; IOL = intraocular lens; LASIK = laser-assisted in-situ keratomileusis; SRK = Sanders/Retzlaff/Kraff; T = third-generation; PL = post-LASIK.

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