Comparison of central topographic maps from a swept-source OCT biometer and a Placido disk-dual Scheimpflug tomographer.

PURPOSE: To compare central topography (CT) from IOLMaster 700 with predicate topographic (PT) maps from a Placido disk-dual Scheimpflug tomographer in detection of irregularities that would influence the decision-making for implanting premium intraocular lenses (IOLs) (toric, multifocal, or extended depth-of-focus).

SETTING

Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.

DESIGN

Prospective comparative case series.

METHODS

Eyes with various corneal conditions were randomly selected: regular/irregular corneas, previous corneal refractive surgery, and keratoconus or pellucid marginal degeneration. Three observers compared the CT and PT maps and answered a questionnaire for each eye. The questionnaire focused on (1) overall shape similarity between CT and PT and (2) decision-making for premium IOL implantation based on CT and PT. Answers to the questionnaire and agreement in answers among observers were evaluated.

RESULTS

The study included 105 eyes. Comparing CT and PT, similar shape was observed in 68.6% to 89.5% of cases, and comparable map symmetries were reported in 60.0% to 83.8%; the same decision regarding premium IOL implantation was made in 75.2% to 97.1% of cases. There were significant interobserver agreements among 3 observers for all questions, with Fleiss κ values ranging from 0.141 to 0.450 (all P < .05). Peripheral corneal steeping or flattening was the primary finding that was visible on PT but not on CT.

CONCLUSIONS

Compared with the PT, CT provided similar overall shape and comparable symmetries in most cases. The same decision was made whether to recommend a premium IOL based on CT and PT in 75% to 97% of cases.