Validation of Orbscan II posterior corneal curvature measurement for intraocular lens power calculation

Abstract

Aims: To validate the use of Orbscan II slit-scanning topography for measuring posterior corneal curvature, by comparing corneal power calculations using this value with the standard keratometric method of corneal power calculation.

Method: Corneal measurements were taken from both eyes of 15 normal subjects using the Javal-Schiotz keratometer and the Orbscan II topographer. Corneal power was calculated using standard keratometric indices of 1.337.5 or 1.331.5 and Javal-Schiotz keratometry. Corneal power was then recalculated using the thick-lens formula, with anterior corneal curvature from the Javal-Schiotz or Orbscan II and posterior measurements from the Orbscan II; in addition, the 3.0 mm 'Mean Power' value from the Orbscan II software was noted. Six comparisons were then made using mean-difference plots.

Results: The smallest difference and therefore the most predictable agreement was between Javal-Schiotz keratometry using a refractive index of 1.331.5 and the thick-lens formula using Javal-Schiotz anterior curvature and Orbscan II posterior curvature. The mean difference was 0.27 D with a confidence interval of 0.02-0.52 D.

Conclusions: In normal eyes, data on posterior corneal curvature from the Orbscan II can be used to calculate corneal power in close agreement with the standard keratometric method. This suggests the use of the Orbscan II in eyes that have previously undergone refractive surgery, for calculation of intraocular lens power prior to cataract surgery.