Comparison of refractive outcomes using conventional keratometry or total keratometry for IOL power calculation in cataract surgery

Srivannaboon, Sabong; Chirapapaisan, Chareenun

doi:10.1007/s00417-019-04443-7

Cited by 67 publications

(61 citation statements)

References 22 publications

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“…This is in line with the study by Fisus et al [8] that the mean absolute difference was 0.04 D when comparing ANTE RION and IOLMaster 700. Regarding total keratometry, a better refractive outcome was achieved using total keratometry compared to conventional anterior keratometry in the calculation of IOLs for cataract surgery by IOLMaster 700 [14][15][16]. In addition, it is expected that more patients will undergo cataract surgery who have previously undergone refractive surgery; therefore, it will become more important to accurately measure total corneal power [15,17].…”

Section: Discussionmentioning

confidence: 99%

Comparison of ocular biometric measurements in patients with cataract using three swept-source optical coherence tomography devices

Choi

et al. 2021

BMC Ophthalmol

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Background Precise measurement of ocular biometry is critical for determining intraocular lens power. Newly developed swept-source optical coherence tomography (SS-OCT) - based ocular biometric devices, ANTERION and CASIA2 provide ocular biometric measurements as IOLMaster 700. This study aimed to assess agreement between three devices. Methods This retrospective comparative study includes patients with cataract who underwent ocular biometric measurements with three devices, ANTERION, CASIA2, and IOLMaster 700, at Seoul National University Hospital, in April 2020. Anterior keratometry, total keratometry, central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were the main parameters for the comparison. To assess the agreement between the devices, intraclass coefficient (ICC) and Bland-Altman analysis with 95% limits of agreement (LoA) were used. Results A total of 47 eyes of 29 patients were measured with three devices. Average anterior keratometry showed excellent agreement (ICC ≥ 0.989), and the mean difference was less than 0.1 D. However, the ICC of the total average keratometry ranged from 0.808 to 0.952, and the difference was more than 0.43 D. The AL measured by ANTERION and IOLMaster 700 showed excellent agreement (ICC = 0.999), and the mean difference was 0.005 mm. The ANTERION and IOLMaster 700 did not obtain AL in six (12.8%) and three (6.4%) cases, respectively (P = 0.001 by Fisher’s exact test). The CCT, ACD, and LT also showed excellent agreement (ICC > 0.9). Conclusions The new SS-OCT-based devices, ANTERION, and CASIA2 showed a good agreement with IOLMaster 700 in measuring ocular biometry except for the total keratometry. The AL of ANTERION and IOLMaster 700 showed excellent agreement.

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Section: Discussionmentioning

confidence: 99%

Comparison of ocular biometric measurements in patients with cataract using three swept-source optical coherence tomography devices

Choi

et al. 2021

BMC Ophthalmol

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“…Recently, a new biometry device known as the IOLMaster 700 (Carl Zeiss Meditec, Jena, Germany), based on the principle of swept-source optical coherence tomography (SS-OCT), has been developed. IOLMaster 700 enables the assessment of the posterior corneal surface by combining data from the anterior corneal surface obtained via telecentric keratometry with pachymetry data obtained via SS-OCT 4 – 7 . Subsequently, total keratometry (TK) values are calculated using data from both the anterior and posterior cornea and measurements of corneal thickness, which are combined using the thick lens formula 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have reported better refractive outcomes for conventional monofocal IOL implantation when accurate posterior corneal data are used to calculate TK values, whereas few other studies did not show any benefits of TK over K 2 , 4 , 8 – 10 . A recent study also compared refractive outcomes of cataract surgery with diffractive multifocal IOLs using K and TK, and K groups showed better IOL power prediction accuracy than TK groups across most of the formulas (Haigis, Holladay2, Barrett Universal II), except for the SRK/T 11 .…”

Section: Introductionmentioning

confidence: 99%

Prediction accuracy of conventional and total keratometry for intraocular lens power calculation in femtosecond laser-assisted cataract surgery

Ryu

Jun

Kim

et al. 2021

Sci Rep

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This study evaluated the accuracy of total keratometry (TK) and standard keratometry (K) for intraocular lens (IOL) power calculation in eyes treated with femtosecond laser-assisted cataract surgery. The retrospective study included a retrospective analysis of data from 62 patients (91 eyes) who underwent uneventful femtosecond laser-assisted cataract surgery with Artis PL E (Cristalens Industrie, Lannion, France) IOL implantation by a single surgeon between May 2020 and December 2020 in Severance Hospital, Seoul, South Korea. The new IOLMaster 700 biometry device (Carl Zeiss Meditec, Jena, Germany) was used to calculate TK and K. The mean absolute error (MAE), median absolute error (MedAE), and the percentages of eyes within prediction errors of ± 0.25 D, ± 0.50 D, and ± 1.00 D were calculated for all IOL formulas (SRK/T, Hoffer-Q, Haigis, Holladay 1, Holladay 2, and Barrett Universal II). There was strong agreement between K and TK (intraclass correlation coefficient = 0.99), with a mean difference of 0.04 D. For all formulas, MAE tended to be lower for TK than for K, and relatively lower MAE and MedAE values were observed for SRK/T and Holladay 1. Furthermore, for all formulas, a greater proportion of eyes fell within ± 0.25 D of the predicted postoperative spherical equivalent range in the TK group than in the K group. However, differences in MAEs, MedAEs, and percentages of eyes within the above prediction errors were not statistically significant. In conclusion, TK and K exhibit comparable performance for refractive prediction in eyes undergoing femtosecond laser-assisted cataract surgery.

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“…This so-called conventional keratometry (K) is used in IOL Master PCI devices for corneal power estimation and assumes a constant posterior to anterior corneal curvature radii ratio (PA ratio or R PA ) [1]. This assumption leads to sufficient refractive outcomes when IOL power calculation is performed in virgin eyes [2,3].…”

Section: Introductionmentioning

confidence: 99%

Assessing the validity of corneal power estimation using conventional keratometry for intraocular lens power calculation in eyes with Fuch’s dystrophy undergoing Descemet membrane endothelial keratoplasty

Diener¹,

Treder²,

Lauermann³

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Purpose The present retrospective study was designed to test the hypothesis that the postoperative posterior to preoperative anterior corneal curvature radii (PPPA) ratio in eyes with Fuch’s dystrophy undergoing Descemet membrane endothelial keratoplasty (DMEK) is significantly different to the posterior to anterior corneal curvature radii (PA) ratio in virgin eyes and therefore renders conventional keratometry (K) and the corneal power derived by it invalid for intraocular lens (IOL) power calculation. Methods Measurement of corneal parameters was performed using Scheimpflug imaging (Pentacam HR, Oculus, Germany). In 125 eyes with Fuch’s dystrophy undergoing DMEK, a fictitious keratometer index was calculated based on the PPPA ratio. The preoperative and postoperative keratometer indices and PA ratios were also determined. Results were compared to those obtained in a control group consisting of 125 eyes without corneal pathologies. Calculated mean ratios and keratometer indices were then used to convert the anterior corneal radius in each eye before DMEK to postoperative posterior and total corneal power. To assess the most appropriate ratio and keratometer index, predicted and measured powers were compared using Bland-Altman plots. Results The PPPA ratio determined in eyes with Fuch’s dystrophy undergoing DMEK was significantly different (P < 0.001) to the PA ratio in eyes without corneal pathologies. Using the mean PA ratio (0.822) and keratometer index (1.3283), calculated with the control group data to convert the anterior corneal radius before DMEK to power, leads to a significant (P < 0.001) underestimation of postoperative posterior negative corneal power (mean difference (∆ = − 0.14D ± 0.30) and overestimation of total corneal power (∆ = − 0.45D ± 1.08). The lowest prediction errors were found using the geometric mean PPPA ratio (0.806) and corresponding keratometer index (1.3273) to predict the postoperative posterior (∆ = − 0.01 ± 0.30) and total corneal powers (∆ = − 0.32D ± 1.08). Conclusions Corneal power estimation using conventional K for IOL power calculation is invalid in eyes with Fuch’s dystrophy undergoing DMEK. To avoid an overestimation of corneal power and minimize the risk of a postoperative hyperopic shift, conventional K for IOL power calculation should be adjusted in eyes with Fuch’s dystrophy undergoing cataract surgery combined with DMEK. The fictitious PPPA ratio and keratometer index may guide further IOL power calculation methods to achieve this.

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Comparison of refractive outcomes using conventional keratometry or total keratometry for IOL power calculation in cataract surgery

Cited by 67 publications

References 22 publications

Comparison of ocular biometric measurements in patients with cataract using three swept-source optical coherence tomography devices

Comparison of ocular biometric measurements in patients with cataract using three swept-source optical coherence tomography devices

Prediction accuracy of conventional and total keratometry for intraocular lens power calculation in femtosecond laser-assisted cataract surgery

Assessing the validity of corneal power estimation using conventional keratometry for intraocular lens power calculation in eyes with Fuch’s dystrophy undergoing Descemet membrane endothelial keratoplasty

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