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

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<sub>0</sub>] and Jackson cross-cylinder at 45° and 135° [J<sub>45</sub>]), 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 - OA2000; 95% LoA, 0.93 D) and OA-2000 - IOLMaster 500 (95% LoA, 0.93 D). J<sub>0</sub> and J<sub>45</sub> 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.

Clinical Evaluation of a New Spectral-Domain Optical Coherence Tomography-Based Biometer

“…The mean difference between biometers was 0.12 mm, with limits of agreement of 0.03 and 0.21 mm. This difference was statistically significant as well as clinically relevant, considering the trend an overestimation of ACD with the VEMoS-AXL system and that the limits of agreement were in the range of those reported in studies comparing biometers and concluding that ACD measures were not interchangeable [ 5 , 6 , 13 , 14 , 15 , 16 , 17 ]. Moon et al [ 16 ] concluded that ACD measures obtained with Anterion and IOL-Master 500 systems were not interchangeable (limits of agreement, −0.33 to 0.22 mm) as well as ACD measurements obtained with OA-2000 and IOL-Master 500 biometers (limits of agreement, −0.37 to 0.20 mm).…”

“…This difference was statistically significant as well as clinically relevant, considering the trend an overestimation of ACD with the VEMoS-AXL system and that the limits of agreement were in the range of those reported in studies comparing biometers and concluding that ACD measures were not interchangeable [ 5 , 6 , 13 , 14 , 15 , 16 , 17 ]. Moon et al [ 16 ] concluded that ACD measures obtained with Anterion and IOL-Master 500 systems were not interchangeable (limits of agreement, −0.33 to 0.22 mm) as well as ACD measurements obtained with OA-2000 and IOL-Master 500 biometers (limits of agreement, −0.37 to 0.20 mm). Cheng et al [ 17 ] compared different biometers, confirming the presence of a poor agreement of ACD measures obtained with some of them: Anterion vs. OA-2000 (−0.19 to 0.28 mm), OA-2000 vs. IOL-Master (−0.19 to 0.25 mm), Anterion vs. Lenstar (−0.04 to 0.21 mm), and OA-2000 vs. Lenstar (−0.16 to 0.23 mm).…”

“…Several studies have investigated the level of intrasession repeatability of the last generation of optical biometers, including those based on SS-OCT [ 14 , 15 , 16 , 17 , 18 ], in order to know the consistency of the anatomical measures obtained with these devices. It should be considered that such measurements are crucial in the clinical practice, especially for IOL power calculations when planning cataract surgeries.…”

“…It should be considered that a 0.1 mm error in AL is equivalent to an error of about 0.27 D in the spectacle plane assuming normal eye dimensions, a dioptric value that can be detected and measured in subjective refraction [ 19 ]. Moon et al [ 16 ] compared three different biometers (Anterion vs. IOL-Master 500 vs. OA-2000), analyzing the level of interchangeability between the anatomical measures obtained with them. These authors found limits of agreement between pairs of biometers that could be considered as clinically acceptable: −0.09 to 0.08 mm for Anterion vs. OA-2000, −0.04 to 0.09 mm for Anterion vs. IOL-Master 500, and −0.01 to 0.07 mm for OA-2000 vs. IOL-Master 500 [ 16 ].…”

“…Moon et al [ 16 ] compared three different biometers (Anterion vs. IOL-Master 500 vs. OA-2000), analyzing the level of interchangeability between the anatomical measures obtained with them. These authors found limits of agreement between pairs of biometers that could be considered as clinically acceptable: −0.09 to 0.08 mm for Anterion vs. OA-2000, −0.04 to 0.09 mm for Anterion vs. IOL-Master 500, and −0.01 to 0.07 mm for OA-2000 vs. IOL-Master 500 [ 16 ]. Monera Lucas et al [ 15 ] confirmed the interchangeability of AL measures from Anterion and Lenstar LS900 systems, obtaining limits of agreement of −0.06 and 0.04 mm.…”