Autores: Vanesa Blázquez, OD PhD; Montserrat Garcia-Gonzalez, MD, PhD; Jorge García-Pérez, MD, PhD ; Juan Gros-Otero, MD, PhD; Inés Contreras Martín,MD, PhD; Laureano Álvarez-Rementería Capelo, MD. Clínica Rementería Madrid
INTRODUCTION
Successfull ICL implantation is likely related to an accurate prediction of refraction and ICL vault. An appropriate ICL vault is critical for preventing major postoperative adverse effects1:
- Overestimation: angle-closure glaucoma, pigment dispersion syndrome, endothelial cell loss.
- Underestimation: anterior subcapsular cataract
Parameters to evaluate: White-to-White (WTW) 1 or Sulcus-to-Sulcus 2,3 distance and Anterior chamber depth (ACD)
ICL sizing using sulcus-to-sulcus distance seems to be more accurate than WTW methods. 4
Different methods: topography, tomography, biometry, caliper, corneal gauge. Recommended by the manufacturer: Orbscan II.
PURPOSE
To compare the agreement among the measurements obtained with Orbscan IIz, Pentacam and IOL Master during the preoperative exam performed to calculate the ICL size.
METHODS
- Retrospective, observational, non-comparative study of 21 eyes of 11 patients
- Preoperative complete ocular examination (WTW, ACD): Orbscan Iiz ,Pentacam, IOL Master
- Visian ICL V4c model
- In all cases, WTW obtained with Orbscan (gold standard) was used for the calculation of ICL size
- Central Vault and distance from the endothelium to anterior surface of ICL were measured 1 month postop with AS-OCT.
- We compared the ICL size that would have been implanted using the measurements obtained with Pentacam and IOL Master.
RESULTS
| Parameters | Mean ± SD (Range) |
| Age (yrs) | 30.16 ± 5.2 (23 to 40) |
| SE (D) | -9.67 ± 3.4 (-5.25 to -20.50) |
| Mean keratometry (D) | 45.26 ± 1.3 (43.00 to 47.45) |
| Horizontal WTW (mm) | |
| Orbscan | 11.58 ± 0.4 (10.90 to 12) |
| Pentacam | 11.63 ± 0.2 (11.01 to 12.10) |
| IOL Master | 12.14 ± 0.4 (11.50 to 12.70) |
| ACD (mm) | |
| Orbscan | 3.18 ± 0.1 (2.95 to 3.53) |
| Pentacam | 3.28 ± 0.2 (3.02 to 3.66) |
| IOL Master | 3.22 ± 0.2 (2.98 to 3.61) |
| Vault (mm) | 0.55 ± 0.2 (0.27 to 0.72) |
| Endothelium-ICL distance (mm) | 2.46 ± 0.2 (2.29 to 2.69) |
| INTRACLASS CORRELATION COEFFICIENT (ICC) | ||
| Horizontal WTW | ACD | |
| ORBSCAN-PENTACAM | 0.96 (0.83 to 0.99) | 0.85 (0.71 to 0.92) |
| ORBSCAN-IOL MASTER | 0.57 (0.41 to 0.63) | 0.87 (0.69 to 0.91) |
CONCLUSION
Measurements obtained with Orbscan II and Pentacam show a very high agreement for the calculation of ICL size.
IOL Master tends to overestimate ICL size compared to Orbscan.
BIBLIOGRAPHY
- Lee DH et al. Ophthalmology 2012; 119: 272-277.
- Oh J et al. Ophthalmology 2007;114:1685-1688.
- Kim KH et al. J Cataract Refract Surg 2008; 34:632-637.
- Reinstein DZ et al. J Refract Surg 2013; 29:30-35
