Journal List > J Korean Ophthalmol Soc > v.60(11) > 1137319

An, Kim, and Joo: Accuracy of Predicting Refractive Outcomes Using Swept-source Optical Coherence Tomography in Nuclear Cataracts

Abstract

Purpose

To evaluate the accuracy of predicting refractive outcomes of swept-source optical coherence tomography based biometry (ARGOS; Movu Inc., Santa Clara, CA, USA) in nuclear cataracts.

Methods

A total of 107 eyes (107 nuclear cataract patients) were analyzed. Subjects were divided into three groups according to the maximum nuclear density of Pentacam HR (A, lower tertile; B, medium tertile; C, upper tertile). The keratometry and axial length measured by IOLMaster (Carl Zeiss Meditec, Jena, Germany) and ARGOS systems were compared for each group. The correlation between maximum nuclear density and axial length difference readings from the two instruments was evaluated. The mean absolute error between the predicted refraction and 2-month post-operative refraction was compared.

Results

The maximum nuclear densities were 28.31 ± 7.30, 51.37 ± 7.82, and 88.63 ± 11.23 for groups A, B, and C, respectively. The axial length measured by ARGOS was significantly longer than that obtained using IOLMaster for groups B and C (respectively, p = 0.035, p < 0.001). A significantly positive correlation was found between the maximum nuclear density and axial length difference of the two devices (p < 0.001). Mean absolute errors were not significantly different between IOLMaster and ARGOS in group A. However, in groups B and C, the mean absolute error using ARGOS (0.31 ± 0.22 D and 0.32 ± 0.20 D, respectively) was significantly lower than that of IOLMaster (0.43 ± 0.21 D and 0.50 ± 0.26 D, respectively) (Group B, p = 0.027; Group C, p = 0.001).

Conclusions

Even in dense nuclear cataracts, accurate refractive outcome prediction was possible using swept-source optical coherence tomography based biometry.

Figures and Tables

Figure 1

Relationship between maximum nuclear density and the axial length difference. The difference in axial length measurements of the two instruments is positively correlated with the maximum nuclear density.

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Figure 2

Comparisons of accuracy of predictive postoperative refraction by mean absolute error. Dots represent values outside the first and third quartiles. (A) Maximum lens density in the lower tertile, (B) maximum lens density in the medium tertile, (C) maximum lens density in the upper tertile. D = diopters.

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Table 1

Patients characteristics

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‘Group A’ means maximum lens density in the lower tertile. ‘Group B’ means maximum lens density in the medium tertile, and ‘Group C’ means maximum lens density in the upper tertile. Values are presented as mean ± standard deviation or number (%).

LOCS = Lens Opacities Classification System.

*One-way analysis of variance; Pearson chi-square test.

Table 2

Comparison of biometric data by IOLMaster and ARGOS

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‘Group A’ means maximum lens density in the lower tertile, and ‘Group B’ means maximum lens density in the medium tertile. ‘Group C’ means maximum lens density in the upper tertile. Values are presented as mean ± standard deviation (range).

D = diopter.

*Wilcoxon signed rank test; paired t-test.

Table 3

Comparison of IOL power with the SRK/T formulas between IOLMaster and ARGOS

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‘Group A’ means maximum lens density in the lower tertile, ‘Group B’ means maximum lens density in the medium tertile. ‘Group C’ means maximum lens density in the upper tertile.

IOL = intraocular lens; SRK/T = Sanders-Retzlaff-Kraff/Theoretical; MAE = mean absolute error; SD = standard deviation; D = diopters; MedAE = median absolute error; PE = prediction error.

*Wilcoxon signed rank test.

Notes

Conflicts of Interest The authors have no conflicts to disclose.

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