Agreement between Two Swept-Source Optical Coherence Tomography Biometers and a Partial Coherence Interferometer

Abstract

Purpose: To evaluate the level of agreement between ANTERION (Heidelberg Engineering, Heidelberg, Germany), OA-2000 (Tomey, Nagoya, Japan), and IOLMaster 500 (Carl Zeiss AG, Jena, Germany).

Methods: Fifty-one eyes of 51 patients were included in the study. Flat keratometry (K) and steep K, vector component of astigmatism (Jackson cross-cylinder at 0° and 90° [J0] and Jackson cross-cylinder at 45° and 135° [J45]), anterior chamber depth, and axial length were compared using the three devices. Repeated measures analysis of variance was conducted to compare the mean values of the biometrics. Pearson correlation test was conducted to analyze the correlations of the measured values, and a Bland-Altman plot was used to assess the agreement between the three devices. The predicted intraocular lens power of each device was compared to the others using the SRK/T, Haigis, Barrett Universal II, and Kane formulas.

Results: All K values measured using ANTERION were flatter than those of other instruments. However, good agreement was observed for flat K (ANTERION - OA-2000; 95% limits of agreement [LoA], 0.86 diopters [D]) and steep K (ANTERION - OA2000; 95% LoA, 0.93 D) and OA-2000 - IOLMaster 500 (95% LoA, 0.93 D). J0 and J45 vector components of astigmatism were not statistically different; however, the agreements were poor between the devices (95% LoA ≥1.97 D). Anterior chamber depth values of ANTERION and OA-2000 were interchangeable (95% LoA, 0.15 mm). The axial length showed a high agreement (95% LoA ≤0.17 mm) among the three devices. The predicted intraocular lens powers of the three devices were not interchangeable regardless of formulas (95% LoA ≥1.04 D).

Conclusions: Significant differences in ocular biometrics were observed between ANTERION and the other two devices. This study demonstrated that only axial length showed good agreement among devices.

Keywords: Biometry; Partial coherence interferometer; Swept-source optical coherence tomography.

Fig. 1

Bland-Altman plots of (A–C) flat keratometry (K) and (D–F) steep K between ANTERION (Heidelberg Engineering, Heidelberg, Germany), OA-2000 (Tomey, Nagoya, Japan), and IOLMaster 500 (Carl Zeiss AG, Jena, Germany). The mean (middle continuous line) and the lower and upper limits of agreement (±1.96 standard deviation, top and bottom dotted lines) are depicted. D = diopters.

Fig. 2

Bland-Altman plots of vector component of astigmatism (A–C) Jackson cross-cylinder at 0° and 90° (J₀) and (D–F) Jackson cross-cylinder at 45° and 135° (J₄₅) between ANTERION (Heidelberg Engineering, Heidelberg, Germany), OA-2000 (Tomey, Nagoya, Japan), and IOLMaster 500 (Carl Zeiss AG, Jena, Germany). The mean (middle continuous line) and the lower and upper limits of agreement (±1.96 standard deviation, top and bottom dotted lines) are depicted. D = diopters.

Fig. 3

Bland-Altman plots of anterior chamber depth (ACD) between (A) ANTERION (Heidelberg Engineering, Heidelberg, Germany) and OA-2000 (Tomey, Nagoya, Japan), (B) ANTERION and IOLMaster 500 (Carl Zeiss AG, Jena, Germany), and (C) OA-2000 and IOLMaster 500. The mean (middle continuous line), the lower and upper limits of agreement (±1.96 standard deviation, top and bottom dotted lines) are depicted.

Fig. 4

Bland-Altman plots of axial length (AL) between (A) ANTERION (Heidelberg Engineering, Heidelberg, Germany) and OA-2000 (Tomey, Nagoya, Japan), (B) ANTERION and IOLMaster 500 (Carl Zeiss AG, Jena, Germany), and (C) OA-2000 and IOLMaster 500. The mean (middle continuous line), the lower and upper limits of agreement (±1.96 standard deviation, top and bottom dotted lines) are depicted.