Comparision of Corneal Refractive Power Measured with Opitcal Low-coherence Reflectometry, Autokeratometer, and Topography in Children

Jae Gyun Jeung; Gi Hyun Bae

doi:10.3341/jkos.2016.57.10.1535

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Jeung and Bae: Comparision of Corneal Refractive Power Measured with Opitcal Low-coherence Reflectometry, Autokeratometer, and Topography in Children

Original Article

J Korean Ophthalmol Soc 2016;57(10):1535-1541.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.10.1535

Comparision of Corneal Refractive Power Measured with Opitcal Low-coherence Reflectometry, Autokeratometer, and Topography in Children

Jae Gyun Jeung, MD, Gi Hyun Bae, MD

Department of Ophthalmology, Sahmyook Medical Center, Seoul, Korea

Address reprint requests to Gi Hyun Bae, MD Department of Ophthalmology, Sahmyook Medical Center, #82 Mangu-ro, Dongdaemun-gu, Seoul 02500, Korea Tel: 82-2-2210-3556, Fax: 82-2-2212-2673 E-mail: eddc99@gmail.com

Received 18 February 2016 Accepted 20 September 2016

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 the keratometry obtained from optical low-coherence reflectometry (Lenstar LS900^®), autokeratometer (KR-8100^®), and topography (Medmont E300^®) in children.

Methods

A retrospective study was performed in 316 eyes of 160 subjects. Subjects were divided into 3 groups according to age. Group 1 was younger than 10 years, group 2 was older than 10 years and younger than 18 years, and group 3 was older than 18 years. Subjects were tested using the Lenstar LS900^®, KR-8100^®, and Medmont E300^®. Comparisons were made for steep K, flat K, mean K, and astigmatism among three groups. Agreement among the 3 devices was examined using the Bland-Altman method.

Results

The keratometry measured by Medmont E300^® was highest, followed by that of Lenstar LS900^® and KR-8100^® in all 3 groups. Almost all keratometry was significantly different among the 3 devices except for the flat K measured by LS900^® and KR-8100^® in all 3 groups and flat K measured by KR-8100^® and Medmont E300^® in Group 3 (p < 0.05). With regard to mean K, the agreement between Lenstar LS900^® and KR-8100^® was better than that between the other two pairs in both Groups 1 and 2, while agreement between Lenstar LS900^® and Medmont E300^® was better in Group 3. The agreement between KR-8100^® and Medmont E300^® was worse than that between the other two pairs in Groups 1 and 3, while the agreement between Lenstar LS900^® and Medmont E300^® was worse in Group 2.

Conclusions

There were significant differences in keratometry among the 3 devices in all 3 groups. In children, Medmont E300^® showed relatively less agreement compared with the other two devices. In adults, however, the agreement between 2 devices showed variable results. Consideration of the keratometry measurement from Lenstar LS900^®, KR-8100^®, and Medmont E300^® might be helpful to estimate accurate corneal keratometry in children.

Keywords: Autokeratometer, Children, Keratometry, Lenstar, Topography

References

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Figure 1.

Bland-Altman plots for mean keratometry obtained using Lenstar LS900^®, Autokeratometer (KR-8100^®), and Topography (Medmont E300^®) in 3 groups. (A) Agreements of mean keratometery in group 1. (B) Agreements of mean keratometery in group 2.(C) Agreements of mean keratometery in group 3. SD = standard deviation.

Table 1.

Demographics and anterior segment parameters obtained using the Lenstar LS900^®

	Group 1	Group 2	Group 3	p-value
Gender (male:female)	26:36	29:37	16:15	0.672^*
Age (years)	7.53 ± 1.30	12.26 ± 1.86	32.81 ± 13.36	<0.001^†
	(4∼9)	(10∼17)	(19∼58)
Refractive error (SE, D)	–2.29 ± 1.91	–3.36 ± 2.67	–3.26 ± 3.61	0.020^†
	(−6.38∼5.25)	(−14.50∼2.38)	(−14.88∼0.38)
Axial length (mm)	24.17 ± 1.08	25.02 ± 1.15	24.97 ± 1.60	<0.001^†
	(20.67∼27.03)	(22.25∼27.75)	(22.58∼29.23)
Anterior chamber depth (mm)	3.15 ± 0.22	3.24 ± 0.23	3.06 ± 0.38	0.001^†
	(2.55∼3.51)	(2.66∼3.83)	(1.54∼3.72)
Central corneal thickness (μ m)	548.10 ± 35.86	553.48 ± 31.54	540.92 ± 34.85	0.059^†
	(471∼640)	(480∼614)	(448∼640)
Lens thickness (mm)	3.43 ± 0.19	3.38 ± 0.16	3.75 ± 0.44	<0.001^†
	(3.0∼4.1)	(2.9∼3.7)	(3.2∼5.1)
White-to-white (mm)	12.14 ± 0.44	12.06 ± 0.41	12.04 ± 0.45	0.289^†
	(11.09∼13.46)	(11.15∼13.40)	(11.04∼12.99)
Pupil diameter (mm)	6.05 ± 0.75	5.67 ± 0.75	5.72 ± 0.84	<0.001^†
	(2.71∼7.94)	(3.01∼7.40)	(3.34∼7.50)

Values are presented as mean ± SD (range) unless otherwise indicated.

SE = spherical equivalent; D = dioptier.

^* Pearson chi-square test

^† Kruskal-Wallis test.

Table 2.

Comparisons of the keratometirc readings (D) obtained with Lenstar LS900^®, Autokeratometer (KR-8100^®), and Topography (Medmont E300^®) in 3 groups

		Group 1(n = 124)	Group 2(n = 129)	Group 3(n = 63)	p-value^*
Flat K	Lenstar	42.88 ± 1.41	42.76 ± 1.20	42.86 ± 1.74	0.45
		(38.04∼45.67)	(40.14∼45.79)	(38.50∼45.17)
	Autokeratometer	42.89 ± 1.45	42.76 ± 1.22	42.83 ± 1.77	0.53
		(38.00∼46.00)	(40∼46)	(38∼45)
	Topography	42.99 ± 1.41	42.84 ± 1.21	42.90 ± 1.71	0.51
		(38.10∼45.80)	(40.20∼46.10)	(38.50∼45.30)
Steep K	Lenstar	44.31 ± 1.47	44.20 ± 1.54	44.34 ± 1.88	0.44
		(39.55∼47.47)	(40.89∼48.70)	(40.40∼49.20)
	Autokeratometer	44.19 ± 1.49	44.09 ± 1.47	44.25 ± 1.88	0.43
		(39.50∼47.50)	(40.75∼48.50)	(40.50∼49.00)
	Topography	44.57 ± 1.48	44.54 ± 1.54	44.67 ± 1.80	0.57
		(39.60∼47.70)	(41.30∼48.70)	(40.90∼49.40)
Mean K	Lenstar	43.60 ± 1.38	43.48 ± 1.32	43.60 ± 1.75	0.39
		(38.80∼46.44)	(40.60∼46.91)	(39.74∼47.10)
	Autokeratometer	43.54 ± 1.42	43.42 ± 1.30	43.54 ± 1.45	0.47
		(38.75∼46.38)	(40.50∼47.13)	(39.38∼47.00)
	Topography	43.78 ± 1.40	43.69 ± 1.32	43.78 ± 1.69	0.55
		(38.90∼46.70)	(40.90∼47.30)	(39.90∼47.10)
Astigmatism	Lenstar	1.43 ± 0.81	1.44 ± 0.81	1.51 ± 0.92	0.81
		(0.05∼4.49)	(0.23∼4.49)	(0.06∼4.20)
	Autokeratometer	1.30 ± 0.73	1.33 ± 0.76	1.42 ± 0.83	0.56
		(0.25∼3.75)	(0.00∼4.00)	(0.25∼4.00)
	Topography	1.58 ± 0.77	1.70 ± 0.82	1.74 ± 0.95	0.41
		(0.40∼4.60)	(0.40∼4.60)	(0.40∼4.50)

Values are presented as mean ± SD (range) unless otherwise indicated.

^* Krunskal Wallis test.

Table 3.

The mean differences, SD, CI and limits of agreement (LoA) between the keratometric readings (D) obtained with Lenstar LS900^®, Autokeratometer (KR-8100^®), and Topography (Medmont E300^®) in 3 groups

		Group 1 (n = 124)	p-value^*	Group 2 (n = 129)	p-value^*	Group 3 (n = 63)	p-value^*
		Mean difference ± SD (95% CI, width)	p-value^*	Mean difference ± SD (95% CI, width)	p-value^*	Mean difference ± SD (95% CI, width)	p-value^*
Flat K	Lens-Auto	–0.005 ± 0.19	1.0	0.002 ± 0.18	1.0	0.04 ± 0.15	1.0
		(−0.38∼0.37, 0.75)		(−0.34∼0.35, 0.69)		(−0.26∼0.33, 0.59)
	Lens-Topo	–0.11 ± 0.21	<0.001	–0.08 ± 0.22	<0.001	–0.04 ± 0.19	0.009
		(−0.51∼0.30, 0.81)		(−0.52∼0.35, 0.87)		(−0.41∼0.33, 0.74)
	Auto-Topo	–0.10 ± 0.22	<0.001	–0.08 ± 0.23	<0.001	–0.08 ± 0.22	0.270
		(−0.53∼ 0.33, 0.86)		(−0.53∼0.36, 0.88)		(−0.52∼0.37, 0.88)
Steep K	Lens-Auto	0.13 ± 0.25	<0.001	0.11 ± 0.28	<0.001	0.09 ± 0.35	0.012
		(−0.37∼0.62, 0.99)		(−0.43∼0.65, 1.08)		(−0.60∼0.78, 1.38)
	Lens-Topo	–0.25 ± 0.30	<0.001	–0.34 ± 0.36	<0.001	–0.33 ± 0.32	<0.001
		(−0.83∼0.33, 1.16)		(−1.05∼0.37, 1.41)		(−0.96∼0.31, 1.27)
	Auto-Topo	–0.38 ± 0.31	<0.001	–0.45 ± 0.32	<0.001	–0.42 ± 0.31	<0.001
		(−0.98∼ 0.22, 1.20)		(−1.07∼0.18, 1.25)		(−1.03∼0.19, 1.22)
Mean K	Lens-Auto	0.06 ± 0.19	<0.001	0.06 ± 0.18	<0.001	0.06 ± 0.20	<0.001
		(−0.31∼ 0.43, 0.74)		(−0.31∼0.42, 0.72)		(−0.33∼0.45, 0.78)
	Lens-Topo	–0.18 ± 0.20	<0.001	–0.21 ± 0.21	<0.001	–0.18 ± 0.18	<0.001
		(−0.57∼ 0.21, 0.78)		(−0.63∼0.21, 0.83)		(−0.54∼0.17, 0.71)
	Auto-Topo	–0.24 ± 0.22	<0.001	–0.27 ± 0.21	<0.001	–0.25 ± 0.22	<0.001
		(−0.67∼ 0.19, 0.86)		(−0.68∼0.15, 0.82)		(−0.69∼0.19, 0.88)
Astigmatism	Lens-Auto	0.13 ± 0.24	<0.001	0.11 ± 0.27	<0.001	0.08 ± 0.31	<0.001
		(−0.35∼ 0.61, 0.96)		(−0.42∼0.64, 1.06)		(−0.52∼0.69, 1.21)
	Lens-Topo	–0.15 ± 0.32	<0.001	–0.25 ± 0.39	<0.001	–0.23 ± 0.39	<0.001
		(−0.78∼ 0.48, 1.27)		(−1.02∼0.52, 1.54)		(−1.00∼0.54, 1.54)
	Auto-Topo	–0.28 ± 0.30	<0.001	–0.36 ± 0.34	<0.001	–0.31 ± 0.36	<0.001
		(−0.86∼ 0.30, 1.17)		(−1.04∼0.31, 1.35)		(−1.01∼0.39, 1.40)

Values are presented as mean ± SD (range, width) unless otherwise indicated.

SD = standard deviation; CI = confidence interval.

^* Wilcoxon Signed-Rank test with Bonferroni's correction.

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