Comparison of Ocular Biometry Measurements Using A-Scan Ultrasound and Two Types of Partial Coherence Interferometers

Dae Young Ha; Kang Won Lee; Ji Won Jung

doi:10.3341/jkos.2016.57.5.757

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Ha, Lee, and Jung: Comparison of Ocular Biometry Measurements Using A-Scan Ultrasound and Two Types of Partial Coherence Interferometers

Original Article

J Korean Ophthalmol Soc 2015;57(5):757-762.

Published online: 7 September 2015

DOI: https://doi.org/10.3341/jkos.2016.57.5.757

Comparison of Ocular Biometry Measurements Using A-Scan Ultrasound and Two Types of Partial Coherence Interferometers

Dae Young Ha, MD, Kang Won Lee, MD, Ji Won Jung, MD

Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea

Address reprint requests to Ji Won Jung, MD Department of Ophthalmology, Inha University Hospital, #27 Inhang-ro, Jung-gu, Incheon 22332, Korea Tel: 82-32-890-2400, Fax: 82-32-890-2417 E-mail: panch325@hanmail.net

Received 26 November 201512 February 2016 Accepted 12 April 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 perm its unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the measurement results of 3 ocular biometry devices, A-scan ultrasound and two types of partial coherence interferometers in normal and cataractous eyes.

Methods

This study included 42 normal eyes and 40 cataractous eye. Axial length and anterior chamber were measured using three ocular biometry measurements, ultrasonography (HiScan®, Optikon 2000, Rome, Italy), IOL Master® (Carl Zeiss, Jena, Germany), and AL-scan® (Nidek, Gamagori, Japan), and mean corneal curvature and corneal diameter were measured using two partial coherence interferometers. The results were compared in each group.

Results

Significant differences in measurements existed among the 3 ocular biometry devices (A-scan ultrasound, IOL Master® and AL-scan®) in normal eyes (p < 0.001) and cataractous eyes (p = 0.034). However, the measurements were not significantly different between the 2 partial coherence interferometers (IOL Master® and AL-scan®) in both groups. We confirmed lower agreement among the 3 ocular biometry devices in cataractous eyes compared with normal eyes in terms of a larger range of 95% agreement and error in cataractous eyes.

Conclusions

Significant differences in measurements were observed when using the 3 ocular biometry devices in both normal and cataractous eyes. Because of low agreements between ocular biometry devices in cataractous eyes, complementing the measurements between ocular biometry devices is necessary when measuring cataractous eyes.

Keywords: AL-scan®, Axial length, Biometry, IOL Master®, Partial coherence interferometers

References

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Figure 1.

Bland-Altman plots of axial length (mm) showing the agreement among the three devices in normal and cataractous eyes. (A) IOL Master® and A-scan in normal eyes. (B) AL scan and A-scan in normal eyes. (C) IOL Master® and AL scan in normal eyes. (D) IOL Master® and A-scan in cataractous eyes. (E) AL scan and A-scan in cataractous eyes. (F) IOL Master® and AL scan in cataractous eyes showing the 95% limits of agreement for axial length difference: -0.19 ~ 0.20 mm, -0.19 ~ 0.20 mm, -0.04 ~ 0.04 mm, -0.40 ~ 0.43 mm, -0.45 ~ 0.49 mm and -0.24 ~ 0.23 mm, respectively.

Table 1.

Characteristics of normal and cataractous eyes

	Normal eyes	Cataractous eyes	p-value^‡
No. of eyes	42	40
Sex (male:female)	28:14	23:17
Age (years)	36.9 ± 5.6 (21-70)	59.3 ± 10.9 (17-89)
BCVA (decimal)	1.0 ± 0.0	0.4 ± 0.25
Spherical equivalent (D)^∗	-0.27 ± 0.44 (-2.12~1.25)	0.15 ± 0.47 (-2.50~1.37)	0.262
Mean keratometric value (D)^∗	44.05 ± 1.24 (41.13~46.62)	44.00 ± 1.46 (41.12~46.50)	0.121
Axial length (mm)^†	23.93 ± 0.61 (22.34~24.87)	23.41 ± 0.55 (22.38~24.78)	0.052

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

BCVA = best corrected visual acuity.

^∗ Measurement using Autokeratometer;

^† Measurement using A-scan ultrasound biometry;

^‡ Using an unpaired t-test.

Table 2.

Comparison of biometric measurements when using the 3 biometry devices in normal and cataractous eyes

	A-scan ultrasound biometry	IOL Master^®	AL-scan^®	p-value^∗	p-value^†
	A-scan ultrasound biometry	IOL Master^®	AL-scan^®	p-value^∗	IOL Master^® and A-scan	AL-scan^® and A-scan	IOL Master^® and AL-scan^®
Normal eyes
AL (mm)	23.93 ± 0.61	23.99 ± 0.63	24.01 ± 0.63	<0.001	<0.001	<0.001	0.059
ACD (mm)	3.32 ± 0.38	3.29 ± 0.31	3.39 ± 0.37	0.051	0.105	0.141	0.842
Km (D)	44.05 ± 1.24^‡	43.84 ± 1.26	43.97 ± 1.27	0.284	0.276	0.279	0.686
WTW (mm)		12.13 ± 0.48	11.78 ± 0.35	<0.001
Cataractous eyes
AL (mm)	23.41 ± 0.55	23.63 ± 0.72	23.68 ± 0.75	0.034	0.049	0.034	0.393
ACD (mm)	3.34 ± 0.21	3.45 ± 0.34	3.60 ± 0.48	0.015	0.506	0.027	0.003
Km (D)	44.05 ± 1.24^‡	43.84 ± 1.26	43.97 ± 1.27	0.163	0.124	0.635	0.051
WTW (mm)		12.01 ± 0.64	11.57 ± 0.30	0.002

Values are presented as mean ± SD unless otherwise indicated.

AL = axial length; ACD = anterior chamber depth; Km = mean keratometry; WTW = white to white.

^∗ Using repeated-measures analysis of variance (ANOVA) incorporating, where necessary, a Greenhouse-Geisser correction for non-sphericity;

^† Post-hoc analysis using paired t-test;

^‡ Measurement using Autokeratometer.

Table 3.

Comparison of prediction error among the 3 biometry devices

	A-scan ultrasound biometry	IOL Master^®	AL-scan^®	p-value^∗
Mean PE	0.13 ± 0.53	-0.14 ± 0.50	0.00 ± 0.60	0.505
Absolute PE	0.37 ± 0.39	0.41 ± 0.39	0.45 ± 0.36	0.844

Values are presented as mean ± SD unless otherwise indicated.

PE = prediction error.

^∗ Using analysis of variance (ANOVA).

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