Journal of cataract and refractive surgery · 2024
Comparison of keratometry and total corneal power, as measured by an SS-OCT-based optical biometer, for intraocular lens power calculation in Asian eyes.
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Savini Giacomo, Taroni Leonardo, Jeon Sohee, Koh Kyungmin, Yang Hyun Seung, Abulafia Adi, Lupardi Enrico, Hoffer Kenneth J, Moramarco Antonio, Schiano-Lomoriello Domenico
Аннотация
PURPOSE: To investigate whether standard keratometry (K) or total corneal power (TCP) leads to more accurate refractive outcomes for intraocular lens (IOL) power calculation.
SETTING: Public hospital.
DESIGN: Retrospective evaluation of a diagnostic test instrument.
METHODS: Preoperatively, all patients underwent optical biometry with Anterion, a swept-source optical coherence tomography device providing both K and TCP. The same IOL model was implanted in all cases. The whole sample was divided into a training dataset, used to optimize the formula constants, and a testing dataset, used to investigate the spherical equivalent prediction error (SEQ-PE) of 8 IOL power formulas. Trueness, precision, and accuracy were evaluated by means of the robust 2-sample t test. Cochran Q test was performed to assess whether the percentage of eyes with an SEQ-PE within each threshold was significantly different; in such an event, the McNemar test was then applied.
RESULTS: Both the training and testing datasets included 317 eyes. No significant differences were detected for trueness because of constant optimization. Precision and accuracy were better when K was entered, although a statistically significant difference was observed only with the EVO (precision: P = .02 and accuracy: P = .03) and Haigis ( P < .01 for both precision and accuracy) formulas. No significant differences were observed for the percentage of eyes with an absolute SEQ-PE within any threshold.
CONCLUSIONS: With most formulas, IOL power calculation is not more accurate when TCP is used instead of K.
SETTING: Public hospital.
DESIGN: Retrospective evaluation of a diagnostic test instrument.
METHODS: Preoperatively, all patients underwent optical biometry with Anterion, a swept-source optical coherence tomography device providing both K and TCP. The same IOL model was implanted in all cases. The whole sample was divided into a training dataset, used to optimize the formula constants, and a testing dataset, used to investigate the spherical equivalent prediction error (SEQ-PE) of 8 IOL power formulas. Trueness, precision, and accuracy were evaluated by means of the robust 2-sample t test. Cochran Q test was performed to assess whether the percentage of eyes with an SEQ-PE within each threshold was significantly different; in such an event, the McNemar test was then applied.
RESULTS: Both the training and testing datasets included 317 eyes. No significant differences were detected for trueness because of constant optimization. Precision and accuracy were better when K was entered, although a statistically significant difference was observed only with the EVO (precision: P = .02 and accuracy: P = .03) and Haigis ( P < .01 for both precision and accuracy) formulas. No significant differences were observed for the percentage of eyes with an absolute SEQ-PE within any threshold.
CONCLUSIONS: With most formulas, IOL power calculation is not more accurate when TCP is used instead of K.