Non-diffractive, toric, extended depth-of-focus intraocular lenses in eyes with low corneal astigmatism.

BACKGROUND: To assess clinical outcomes after implanting toric, extended-depth-of-focus intraocular lenses (IOLs) to correct low corneal astigmatism in eyes with cataracts. METHODS: 47 eyes were implanted with the AcrySof IQ Vivity Toric DFT215 IOL. Main outcome measures were refractive error, monocular uncorrected and corrected distance (UDVA/CDVA), uncorrected and distance-corrected intermediate (UIVA/DCIVA), and uncorrected near and distance-corrected near (UNVA/DCNVA) visual acuities, monocular defocus curve, rotational stability, and IOLSAT and QUVID questionnaires. Patients were assessed at 3 months postsurgery. RESULTS: All eyes had a postoperative spherical equivalent (SE) within ± 0.50 D and 97.87% (n = 46) had a refractive cylinder ≤ 0.50 D. The mean SE and refractive cylinder were - 0.10 ± 0.17 D and - 0.16 ± 0.24 D, respectively. The CDVA was ≥ 20/25 and ≥ 20/32 in 95.74% (n = 45) and 97.87% (n = 46) of eyes, respectively. The DCIVA was ≥ 20/32 in 85.11% (n = 40) of eyes and the DCNVA was ≥ 20/40 in 74.47% (n = 35). The mean values of CDVA, DCIVA, and DCNVA were - 0.02 ± 0.08, 0.14 ± 0.09, and 0.23 ± 0.12 logMAR, respectively. The defocus curve revealed good visual acuity at far and intermediate distances with a depth-of-focus of about 1.75 D. IOL rotation was 0.74 ± 1.13 degrees and all eyes had a rotation of less than 5 degrees. Patients reported either good or very good postoperative vision without eyeglasses under bright-light-conditions at distance (87.80%, 36/41) and intermediate distance (92.68%, 38/41). Between about 63.83%-72.34% (30-34) of patients reported no starburst, halos, or glare, or if experienced, were not bothersome. CONCLUSIONS: The Vivity toric IOL implanted in eyes with low-astigmatism provides accurate refractive outcomes, good visual acuity at different distances and excellent rotational stability. Trial Registration The study was registered with the German Clinical Trials Register (DRKS00030579).

Visual and Refractive Outcomes of a Trifocal Toric Intraocular Lens Implanted in Eyes With High Corneal Astigmatism.

PURPOSE: To analyze the refractive and visual outcomes following cataract surgery and implantation of a trifocal toric intraocular lens (IOL) in eyes with high degrees of corneal astigmatism. METHODS: A total of 29 eyes from 21 patients who underwent implantation of a trifocal toric IOL (FineVision PODFT; PhysIOL) were evaluated in this study. Phacoemulsification with femto-second laser and intraoperative aberrometry were performed in all cases. All IOLs used exhibited a cylinder power of 3.75 diopters (D) or greater. The main outcome measures were refractive error and corrected distance visual acuity (CDVA) and uncorrected distance visual acuity (UDVA) values. Eyes were evaluated during a follow-up period of 5 years. RESULTS: A total of 96.30%, 100%, 95.83%, and 89.47% of eyes were within ±1.00 D at 1, 2, 3, and 5 years postoperatively, respectively. Furthermore, 92.31%, 86.36%, 82.61%, and 84.21% of eyes showed a refractive cylinder value of ±1.00 D at 1, 2, 3, and 5 years postoperatively, respectively. During the entire follow-up period, between 81.48% and 91.30% of eyes showed a CDVA of 20/25 or better. The mean monocular Snellen decimal CDVA values were 0.90 ± 0.12, 0.90 ± 0.11, 0.91 ± 0.11, and 0.90 ± 0.12 at 1, 2, 3, and 5 years postoperatively, respectively. No significant rotation was reported in any eye during follow-up. CONCLUSIONS: The current study suggests that use of this trifocal toric IOL in eyes with high amounts of corneal astigmatism provides accurate refractive outcomes with good distance visual acuity. [J Refract Surg. 2023;39(4):229-234.].

Axial length measurement failure rates using optical biometry based on swept-source OCT in cataractous eyes.

INTRODUCTION: Ocular dimensions measurement is extremely important in cataract procedures and refractive surgery. The use of optical techniques for axial measurements has been developed in recent years. AREAS COVERED: The purpose was to summarize the outcomes reported when swept-source optical coherence tomography (SS-OCT) optical biometry failed during axial length measurement. A peer-reviewed literature search was carried out to identify publications reporting clinical outcomes for cataractous eyes measured with SS-OCT optical biometers available on the market. A comprehensive analysis of the available data was performed, focusing on parameters such as the sample of eyes evaluated, failure rates, and specifically, the cataract type when the measurement was not possible. 27 studies were included in this review. In general, SS-OCT biometers lead to only small failure rates when measuring axial length (but in some cases up to 38.49%). In the few cases where the measurement was not possible, the cataract type of the eyes was mainly mature white or grade ≥ IV. SS-OCT optical biometers show good outcomes when measuring axial length in eyes with advanced cataracts. EXPERT OPINION: We believe that the use of SS-OCT technology may be considered the gold standard for measuring axial length in any type of cataract.

Refractive and Visual Outcomes of a Monofocal Non-Constant Aberration Aspheric Intraocular Lens.

Purpose: To evaluate the refractive and visual outcomes following cataract surgery and implantation of a new monofocal non-constant aberration aspheric intraocular lens (IOL). Methods: Ninety eyes of 86 patients who underwent implantation the CT LUCIA 621P IOL (Carl Zeiss Meditec AG) were retrospectively analyzed in this study. Main outcome measures were refractive error and monocular corrected distance visual acuity (CDVA) and monocular uncorrected distance visual acuity (UDVA) values. Patients were evaluated at 1-month post-surgery and intra- and post-operative complications were recorded. Results: Eighty percent of the eyes showed a CDVA of 20/25 or better before surgery. The postoperative mean values of monocular distance Snellen decimal UDVA and CDVA were 0.64±0.22 and 0.89±0.13, respectively. All eyes showed the same or better difference between UDVA and CDVA. In relation to the postoperative spherical equivalent, the highest percentage of eyes, 31.11%, was for the range between -0.50 and -0.14D followed by 22.22% for the ±0.13D range. Ninety percent of the eyes were within ±1.00 D and 73.33% of eyes within ±0.50 D. The mean postoperative spherical equivalent was -0.18±0.55D. 37.78% and 76.67% of the eyes showed a value ≤0.50 D and ≤1.00D, respectively, being the mean postoperative refractive cylinder -0.81±0.50D. No adverse events were reported in whole sample intra and postoperatively. Conclusion: The present study shows that cataract surgery with an monofocal non-constant aberration aspheric IOL implantation resulted in good visual performance and refractive outcomes. This lens may be considered as a valid choice for patients in a standard-routine cataract surgery practice.

Acquisition Time for Swept-Source Optical Biometry Plus Corneal Power Measurement During Cataract Evaluation.

Purpose: To compare the acquisition time necessary to obtain the optical biometry plus corneal power measurement using the IOLMaster 700 with central topography with that found using the standard IOLMaster 700 in combination with two corneal topographers, when acquiring biometry measurements during cataract evaluation. Methods: This prospective, observational, controlled study included 96 eyes of 96 cataract patients. Acquisition times were registered for different conditions: time required for one complete measurement with IOLMaster 700 with central topography, time required for one complete measurement with standard IOLMaster 700 (without central topography), time required for one complete measurement with standard IOLMaster 700 plus time required for one complete measurement with Cassini, and time required for one complete measurement with standard IOLMaster 700 plus time required for one complete measurement with Pentacam HR. In addition, the agreement between keratometry (K), total keratometry (TK) and equivalent K reading (EKR) parameters using the three devices was performed. Results: The post hoc Tukey's test revealed that there were statistically significant differences for all pairwise comparisons (p < 0.001) except for the acquisition times of the IOLMaster with central topography and the standard IOLMaster 700 (p = 0.501). The acquisition time by the IOLMaster 700 with central topography takes approximately three less times than the use of a corneal topographer combined with a biometer. The agreement of K1, K2, TK1, TK2, EKR1 and EKR2 measurements between the three devices revealed statistically significant differences for all possible comparisons (p < 0.001) except for the comparison between the IOLMaster 700 and the Cassini for all parameters (p > 0.05). Conclusion: We consider that this is an efficient procedure that improves clinical flow. We also conclude that K readings obtained with the three devices cannot be used interchangeably since there are clinically relevant differences that may affect cataract surgery outcomes.

Lens-vault analysis and its correlation with other biometric parameters using swept-source OCT

Purpose: To measure lens vault (LV) and to assess its correlation with various ocular parameters in healthy eyes, using for all measurements the same high-resolution swept-source optical coherence tomographer (SS-OCT).Methods: We prospectively recruited 67 Caucasian healthy patients whose mean age was 41.9 ± 12.4 years; only their right eye was included in the study. Data were all recorded with the ANTERION SS-OCT and comprised, for each patient, 5 consecutive measurements of LV, anterior chamber depth (ACD), lens thickness (LT), axial length (AL), white-to-white (WTW) distance, central corneal thickness (CCT), anterior chamber volume (ACV) and spur-to-spur (STS) distance.Results: Mean LV was 0.26 ± 0.23 mm (ranging from -0.24 to 0.78 mm). Data analysis revealed a statistically significant negative correlation between LV and ACD (R=-0.80, p < 0.001), AL (R = -0.36, p = 0.002), and ACV (R = -0.68, p < 0.001), and a positive correlation between LV and LT (R = 0.67, p < 0.001), and age (R = 0.53, p < 0.001). In contrast, no statistically significant correlation was found between LV and WTW (R=-0.17, p = 0.15), CCT (R = 0.11, p = 0.36) or STS (R=-0.10, p = 0.41).Conclusions: Taking into account our findings about intra-parameter correlation levels, we believe that LV should be measured and analyzed together with other ocular parameters in clinical routine practice both for diagnosis and for some refractive surgeries. (AU)

Lens-vault analysis and its correlation with other biometric parameters using swept-source OCT.

PURPOSE: To measure lens vault (LV) and to assess its correlation with various ocular parameters in healthy eyes, using for all measurements the same high-resolution swept-source optical coherence tomographer (SS-OCT). METHODS: We prospectively recruited 67 Caucasian healthy patients whose mean age was 41.9 ±â€¯12.4 years; only their right eye was included in the study. Data were all recorded with the ANTERION SS-OCT and comprised, for each patient, 5 consecutive measurements of LV, anterior chamber depth (ACD), lens thickness (LT), axial length (AL), white-to-white (WTW) distance, central corneal thickness (CCT), anterior chamber volume (ACV) and spur-to-spur (STS) distance. RESULTS: Mean LV was 0.26 ± 0.23 mm (ranging from -0.24 to 0.78 mm). Data analysis revealed a statistically significant negative correlation between LV and ACD (R=-0.80, p < 0.001), AL (R = -0.36, p = 0.002), and ACV (R = -0.68, p < 0.001), and a positive correlation between LV and LT (R = 0.67, p < 0.001), and age (R = 0.53, p < 0.001). In contrast, no statistically significant correlation was found between LV and WTW (R=-0.17, p = 0.15), CCT (R = 0.11, p = 0.36) or STS (R=-0.10, p = 0.41). CONCLUSIONS: Taking into account our findings about intra-parameter correlation levels, we believe that LV should be measured and analyzed together with other ocular parameters in clinical routine practice both for diagnosis and for some refractive surgeries.

Transitional conic toric intraocular lens evaluation after femtosecond laser-assisted cataract surgery using intraoperative aberrometry.

PURPOSE: To assess refractive and visual outcomes following phacoemulsification with femtosecond laser-assisted cataract surgery (FLACS) using intraoperative aberrometry and implantation of a toric intraocular lens (IOL) in eyes with different degrees of astigmatism. METHODS: One hundred two eyes of 70 patients who underwent implantation of the transitional toric 565 Precizon IOL (Ophtec BV) were enrolled. FLACS, capsular tension ring insertion, and intraoperative aberrometry were performed. Main outcome measures were refractive error, uncorrected- and corrected distance snellen decimal visual acuity values (UDVA and CDVA, respectively), and IOL rotation. Specifically, a vector analysis was carried out with J0 and J45 evaluation. Eyes were evaluated 1-year after surgery. RESULTS: Overall, 94.12% (96 eyes) and 100% (102 eyes) of the eyes showed a spherical equivalent (SE) within ± 0.50D and ± 1.00D, respectively. The mean SE and refractive cylinder were - 0.06 ± 0.29D and - 0.23 ± 0.37D, respectively. Vector analysis revealed that 100% of the eyes were within ± 0.50D for the J0 and J45 cylindrical components. The mean toric axis rotation was 1.10 ± 1.71° (from 0° to 5°), 77% (79 eyes), and 100% (102 eyes) of the eyes showed UDVA and CDVA of 20/25, respectively. The postoperative mean values of monocular UDVA and CDVA were 0.88 ± 0.17 and 0.96 ± 0.07 (about 20/20), respectively. No patient required IOL realignment during the postoperative follow-up. CONCLUSIONS: The present study suggests that the use of the Precizon IOL after FLACS, using intraoperative aberrometry in patients with different amounts of astigmatism, provides good visual acuity, accurate refractive outcomes, and excellent rotational stability.

Agreement of predicted intraocular lens power using swept-source optical coherence tomography and partial coherence interferometry.

PURPOSE: To analyze the agreement of the predicted intraocular lens (IOL) power obtained with ANTERION, IOLMaster 700 and Pentacam AXL biometers. METHODS: We calculated the monofocal and trifocal IOL power using the SRK/T, Haigis, Barrett Universal II and Hoffer Q formulas for 106 eyes. IOL power agreement between devices was evaluated using the Bland-Altman method. RESULTS: We found significant differences between biometers comparisons (p < 0.001). ANTERION and IOLMaster 700 did not produce significant IOL power differences (p > 0.05), with the same outcomes for medium- and long-eyes. No significant differences were found using the SRK/T, Haigis, or Hoffer Q formulas for short-eyes (p > 0.1). However, Barrett Universal II formula produced significant differences (p < 0.05) and these differences lay between the ANTERION and Pentacam AXL. ANTERION versus IOLMaster 700 comparison showed limits of agreement (LoA) varying from 1.1071D in SRK/T monofocal medium-eyes to 1.6828D in Hoffer Q trifocal all-eyes. The largest LoA (about 3.0D) was found for short-eyes when comparing the Pentacam AXL with the other two devices. CONCLUSIONS: These devices provided statistically significant but clinically insignificant mean differences in predicted IOL power. However, wide LoA values suggest that for specific eyes these outcomes could be clinically significant.

In vivo optical quality of posterior-chamber phakic implantable collamer lenses with a central port.

BACKGROUND: The aim of this review is to summarize the optical quality results in patients following the implantation of the V4c implantable collamer lens with a central port (ICL, STAAR Surgical Inc.). MAIN TEXT: A literature search in several databases was carried out to identify those publications, both prospective, retrospective and/or comparative with other refractive surgery procedures, reporting optical outcomes of patients who were implanted with the V4c ICL model. A total of 17 clinical studies published between 2012 and 2021 were included in this review. A detailed analysis of the available data was performed including number of eyes, follow-up and preoperative spherical equivalent. Specifically, the review focused on several optical parameters including higher-order aberrations (HOAs), modulation transfer function (MTF) cut-off frequency and Strehl ratio. This review encompassed a total of 817 eyes measured using different optical devices based on Hartmann-Shack, retinal image quality measurement and ray-tracing technologies at different follow-ups. CONCLUSIONS: The outcomes found in this review lead us to conclude that the ICL V4c model provides good optical quality, by means of different metrics, when implanted.

Optical and visual quality assessment of an extended depth-of-focus intraocular lens based on spherical aberration of different sign.

PURPOSE: To assess the optical quality and the visual performance of patients implanted with an extended depth-of-focus (EDOF) intraocular lens (IOL). METHODS: Thirty-eight eyes underwent implantation of the Mini WELL Ready EDOF IOL and were evaluated at 3-months postsurgery. Higher-order aberrations (HOAs) and modular transfer function (MTF) were measured at 3- and 5-mm pupils. Binocular uncorrected-distance visual acuity (UDVA) and corrected-distance visual acuity (CDVA), uncorrected-distance intermediate visual acuity (UIVA) and corrected-distance intermediate visual acuity (CDIVA) at 80 cm, and uncorrected-distance near visual acuity (UNVA) and corrected-distance near visual acuity (CDNVA) at 40 cm were obtained. Postoperative refraction, binocular defocus curve, halometry and subjective ad hoc patients' questionnaire were also evaluated. RESULTS: HOAs were 0.171 ± 0.046 µm and 0.406 ± 0.137 µm at 3 and 5 mm, respectively. MTFs decreased as the spatial frequency increased being comparable for both pupils. 92.10% of eyes were within ± 1.00D, and the mean postoperative spherical equivalent was - 0.25 ± 0.65D. Mean UDVA, UIVA and UNVA were 0.06 ± 0.12, 0.05 ± 0.10 and 0.26 ± 0.28 logMAR, respectively. Mean CDVA, CDIVA and CDNVA were - 0.01 ± 0.08, 0.06 ± 0.11 and 0.24 ± 0.12 logMAR, respectively. Defocus curve showed a continuous range of vision, especially at intermediate distances. Mean discrimination index was 0.79 ± 0.04. Questionnaire revealed that about 79% of patients reported a high or moderately high satisfaction with the procedure, and about 95% of patients would undergo the same procedure again. CONCLUSIONS: The Mini WELL Ready EDOF IOL provided good optical and visual quality with high level of patient satisfaction and seems to be a valuable option to provide unaided vision at different distances minimizing visual disturbances.

Repeatability of whole-cornea measurements using a new swept-source optical coherence tomographer.

PURPOSE: The aim of this study was to evaluate the repeatability of several corneal parameters provided by a high-resolution swept-source optical coherence tomographer (SS-OCT). METHODS: One eye from each of 74 patients was measured five times consequently using the ANTERION SS-OCT. The following corneal parameters were analyzed: average, steep and flat keratometry (K), astigmatism for anterior, posterior and total at 3-mm, average K and astigmatism at 6-mm, anterior and posterior eccentricity, higher-order aberrations (HOA) and spherical aberration (Z40), and anterior and posterior best-fit sphere at 8-mm. The intrasubject standard deviation (Sw), coefficient of variation (CoV), coefficient of repeatability (CoR) and intraclass correlation coefficient (ICC) were calculated for each parameter to assess the repeatability. RESULTS: We have not found statistically significant differences between repeated measurements (p > 0.05). Repeatability was good considering the different metrics used. Sw values were <0.09, varying from 0.035 (posterior average K at 6-mm) to 0.0878 (anterior flat K at 3-mm). CoV values were also low and similar among the different parameters (from 0.08% to 0.21%), except for anterior, posterior and total astigmatism (from 2.25% to 8.46%). Both anterior and posterior eccentricity, and corneal aberrations (HOA and Z40) CoV values were also high. The CoR values were low for all parameters showing those related to the posterior cornea the lowest values (about 0.01). ICC values were >0.98. CONCLUSIONS: The ANTERION SS-OCT showed good repeatability when reconstructed different parameters for the whole cornea. This device produces measurements with high repeatability that could be useful for clinical research.

Posterior-chamber phakic implantable collamer lenses with a central port: a review.

We aimed to summarize the outcomes reported following the implantation of the V4c implantable collamer lens with a central port (ICL, STAAR Surgical Inc) for myopia correction. A literature search in PubMed, Web of Science and Scopus was carried out to identify publications reporting clinical outcomes of patients who were implanted with the V4c ICL model and had a follow-up period of at least 6 months. A total of 35 clinical studies published between 2012 and 2020 were included in the present review. A comprehensive analysis of the available data was performed, focusing on visual and refractive outcomes at different time-points post-surgery. In addition, adverse events and other parameters such as endothelial cell density, intraocular pressure and vault measurements-which were evaluated in some of the studies-were also compared. This review encompassed a total of 2904 eyes. The outcomes reported in this review lead us to conclude that ICL V4c implantation for myopia correction is a safe and efficient procedure, with stable visual and refractive outcomes and low adverse event rates. The patient's anterior segment should be thoroughly characterized, and the ICL parameters should be carefully selected so as to achieve good outcomes and avoid complications.

Agreement of white-to-white measurements with swept-source OCT, Scheimpflug and color LED devices.

PURPOSE: To assess the interchangeability of different devices for measuring white-to-white (WTW) distance. METHODS: WTW distance was measured in 53 eyes of 53 patients using Anterion swept-source optical coherence topographer (SS-OCT), IOLMaster 700 SS-OCT, Pentacam HR Scheimpflug and Cassini color LED. Statistical analysis was done by means of the Friedman test and the post hoc Tukey test. The Bland-Altman analysis was applied to carry out pairwise comparisons with the average difference, 95% confidence interval of the average difference and limits of agreement 95% (LoA). RESULTS: WTW values obtained by the Anterion, IOLMaster 700, Pentacam HR and Cassini were: 11.84 ± 0.41 mm, 11.96 ± 0.41 mm, 11.68 ± 0.38 mm and 12.65 ± 0.52 mm, respectively. Statistically significant differences were found in all pairwise comparison (p < 0.001). The lowest mean difference was found between the Anterion and IOLMaster 700 (- 0.11 mm) and the highest between the Pentacam HR and Cassini (- 0.96 mm). The widest LoA ranges were those that compared any device with the Cassini. LoA ranges when the other three devices were compared among them were similar: Anterion versus IOLMaster 700, Anterion versus Pentacam HR and IOLMaster versus Pentacam HR (about 0.2 mm). CONCLUSIONS: Our results show that there were statistically significant differences in WTW measurement among the four devices, but under a clinical point of view, we believe that Anterion and IOLMaster 700 may be considered interchangeable and so Anterion and Pentacam HR, however, IOLMaster 700 and Pentacam HR may not and neither is Cassini with any of the other three devices.

Ocular biometry with swept-source optical coherence tomography.

This study aimed to summarize the outcomes reported when swept-source optical coherence tomography (SS-OCT) is used for ocular biometry. A literature search was performed to identify publications reporting clinical outcomes of patients measured with commercial SS-OCT. Twenty-nine studies were included in this review. A comprehensive analysis of the available data was performed, focusing on parameters used for intraocular lens (IOL) power calculation in cataract surgery, including keratometry, central corneal thickness, white-to-white distance, anterior chamber depth, lens thickness, axial length, IOL power, and pupil diameter. Different metrics for repeatability, reproducibility, and agreement between devices were analyzed. In general, SS-OCT biometers provide excellent repeatability and reproducibility outcomes; however, the differences obtained for some parameters measured in agreement studies should be carefully analyzed to validate the interchangeability between devices. The good outcomes reported lead us to conclude that optical biometers based on SS-OCT technology are likely to become the gold standard for ocular biometry.

Angle-to-angle and spur-to-spur distance analysis with high-resolution optical coherence tomography.

BACKGROUND: To measure angle-to-angle (ATA) and spur-to-spur (STS) distances along six meridians using high-resolution swept-source optical coherence tomography (SS-OCT) and to compare those values with horizontal white-to-white (WTW) distance. METHODS: 68 eyes from 68 patients were quantitatively assessed with the Anterion SS-OCT (Heidelberg Engineering, Heidelberg, Germany). ATA and STS distances were measured with the SS-OCT's B-Scan in six cross-sectional images corresponding to the vertical (6-12 o'clock), 1-7 o'clock, 2-8 o'clock, horizontal (3-9 o'clock), 4-10 o'clock and 5-11 o'clock meridians. WTW was measured horizontally with the device's infrared camera. A Pearson correlation analysis was carried out to compare ATA and STS distances with WTW. RESULTS: The largest values were found for the vertical meridian and the shortest for the 2-8 o'clock meridian, both for ATA and STS distances. No statistically significant differences were found between WTW, ATA and STS along the horizontal meridian (p > 0.1). However, ATA and STS showed statistically significant differences elsewhere, except for the horizontal and the 2-8 o'clock meridians (p > 0.05). Moreover, we found that ATA and STS varied significantly depending on the meridian being assessed, except for ATA at 4-10 versus 3-9 o'clock and for STS at 4-10 versus 3-9 o'clock and at 3-9 versus 2-8 o'clock (p > 0.1). R2 values ranged from 0.49 to 0.75 for ATA and STS at the different meridians, showing the best correlation at 3-9 o'clock meridian (0.64 and 0.75, respectively) and the worst at 6-12 o'clock meridian (R2 = 0.49 for both ATA and STS). CONCLUSIONS: ATA and STS distances vary radially, thus showing that the anterior chamber is vertically oval. Therefore, it is advisable to measure these two distances along the meridian to be used.

Assessment of anterior segment measurements using a high-resolution imaging device.

PURPOSE: To assess the repeatability of several anterior segment parameters obtained with swept-source optical coherence tomography (SS-OCT). METHODS: We measured 5-times consequently several parameters in 69 eyes using the ANTERION SS-OCT. White-to-white (WTW), angle-to-angle (ATA), spur-to-spur (STS), and lens vault distances were measured in the horizontal- and vertical-meridian. Anterior-chamber-angle (ACA), scleral-spur-angle (SSA), angle-opening-distance (AOD), and trabecular-iris-space-area (TISA) were measured at 500 and 750 µm for the superior-, nasal-,inferior-, and temporal-quadrants. Intrasubject standard deviation (Sw),coefficient of variation (CoV), coefficient of repeatability (CoR), and intraclass-correlation-coefficient (ICC) were calculated for each parameter. Bland-Altman analysis was done. RESULTS: We have not found statistically significant differences between repeated measurements (p > 0.05). Repeatability was good for the different parameters evaluated. Sw values in distances and areas were low and ranged from 0.01 to 0.07. CoR values showed a similar pattern being larger for those metrics measuring angles. The same happened with CoV values, being very small for WTW,ATA, and STS distances (0.16-0.57%). ICC values for all parameters analyzed were > 0.97. Bland-Altman plots evidenced the narrow limits of agreement for all parameters. CONCLUSIONS: The ANTERION SS-OCT demonstrated high repeatability measuring different distances, angles, and areas of the anterior segment of the eye.

Ocular biometric repeatability using a new high-resolution swept-source optical coherence tomographer.

PURPOSE: To assess the repeatability of ocular biometric parameters using a high-resolution imaging device. METHODS: 74 healthy right eyes were included in this study. Five-repeated measurements were taken with ANTERION high-resolution swept-source optical coherence tomographer (SS-OCT) to measure: corneal thickness (central and at 2, 4 and 6-mm diameters), aqueous depth (AD), lens thickness (LT), anterior chamber volume (ACV), axial length (AL), and pupil (diameter and position). The intrasubject standard deviation (Sw), coefficient of repeatability (CoR) and intraclass correlation coefficient (ICC) were calculated. Bland-Altman method was applied to analyze the difference between the first and the last measurement. The average and the difference between both measurements were calculated for all parameters. RESULTS: We have not found statistically significant differences between repeated measurements (p > 0.05). The mean difference for corneal thickness was between -0.08 and 0.28 µm. For AD and LT was 0.004 and -0.004 µm, respectively. ACV mean difference was -0.03 mm3 and for AL was 0.001 mm. Pupil diameter and position mean differences ranged between -0.008 and 0.009 mm. Overall, most ocular parameters had a Sw <1 and a CoR <2 in their respective units, and an ICC >0.92. CONCLUSIONS: The ANTERION high-resolution SS-OCT device provides good repeatability for different ocular biometric measurements.

A comparative study of the visual outcomes between a new trifocal and an extended depth of focus intraocular lens.

PURPOSE: To evaluate and compare the visual outcomes and ocular optical performance of the PanOptix trifocal intraocular lens (IOL) and Symfony extended range of vision IOL. METHODS: Sixty-eight eyes of 34 patients were divided into 2 groups: 20 patients with the PanOptix IOL and 14 patients with the Symfony IOL. Binocular uncorrected distance visual acuity, best-corrected distance visual acuity (BCDVA), distance-corrected intermediate visual acuity (DCIVA) at 80 and 60 cm, and distance-corrected near visual acuity (DCNVA) at 40 cm were evaluated. Additionally, preferred reading distance with best-corrected distance and visual acuity at that distance, binocular defocus curves, mesopic and photopic contrast sensitivity, photic phenomena, and monocular total higher order aberrations (HOAs) were also measured. RESULTS: The visual outcomes for PanOptix and Symfony IOL groups, respectively, were as follows: BCDVA: -0.03 ± 0.03 and -0.02 ± 0.03 logMAR; DCIVA at 80 cm: 0.06 ± 0.06 and 0.06 ± 0.04 logMAR; DCIVA at 60 cm: 0.06 ± 0.10 and 0.05 ± 0.04 logMAR; DCNVA: 0.04 ± 0.06 and 0.20 ± 0.07 logMAR (p<0.001). Similar preferred reading distances were found for both groups (37.0 ± 4.6 and 38.9 ± 5.7 cm, respectively). The visual acuities at those distances were 0.09 ± 0.08 and 0.19 ± 0.08 logMAR (p<0.001), respectively. The defocus curves showed significantly better outcomes for the PanOptix IOL from -2.0 to -4.0 D (p<0.001). No significant differences were found for contrast sensitivity, halometry, or HOAs between the groups. CONCLUSIONS: The PanOptix and Symfony IOLs showed comparable visual performance at distance and intermediate. However, the PanOptix IOL provided better near and preferred reading distance VAs and showed a more continuous range of vision than the Symfony IOL.

Comparison of a new Scheimpflug imaging combined with partial coherence interferometry biometer and a low-coherence reflectometry biometer.

PURPOSE: To evaluate the repeatability of a new biometer using Scheimpflug technology combined with partial coherence interferometry (PCI) (Pentacam AXL) and its agreement with a device based on optical low-coherence reflectometry (OLCR), the Allegro Biograph. SETTING: Oftalvist Centro Integral Ocular Jerez, Jerez de la Frontera, Spain. DESIGN: Evaluation of a diagnostic test. METHODS: The mean keratometry (K), central corneal thickness (CCT), anterior chamber depth (ACD), and axial length (AL) were measured with the 2 devices 3 times by the same examiner in 2 groups (patients with cataract and patients without cataract). The repeatability was determined using the within-subject standard deviation, test-retest repeatability, coefficient of variation, and intraclass correlation coefficient. The correlation was evaluated with the Pearson coefficient and interchangeability with the Bland-Altman plot. RESULTS: Eighty eyes (40 eyes in each group) of 80 patients were analyzed. Significant differences were found between the Scheimpflug-PCI device and the OLCR device for mean K in the normal group (P < .001) and for CCT in the normal group (P < .05) and the cataract group (P < .001). There were no differences between devices in ACD and AL in either group. The repeatability between devices was similar. Although a significant correlation between devices was found for all measurements (all P < .001), wide limits of agreement were found in both groups for all biometric parameters. CONCLUSIONS: The Scheimpflug-PCI and OLCR devices showed excellent intravisit repeatability and high correlation for mean K, CCT, ACD, and AL in healthy and cataractous eyes. No differences were found in AL; however, the 2 devices might not be interchangeable.