Journal of refractive surgery最新文献_第10页

Enhancing the Automated Detection of Implantable Collamer Lens Vault Using Generative Adversarial Networks and Synthetic Data on Optical Coherence Tomography 利用生成式对抗网络和光学相干断层扫描合成数据加强植入式胶束透镜穹窿的自动检测

IF 2.4 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery

Pub Date : 2024-04-01 DOI: 10.3928/1081597x-20240214-01

Jad F. Assaf, MD, Hady Yazbeck, MD, Dan Z. Reinstein, MD, MA(Cantab), FRCOphth, Timothy J. Archer, MA(Oxon), DipCompSci(Cantab), PhD, Juan Arbelaez, MD, Yara Bteich, MD, Maria Clara Arbelaez, MD, Anthony Abou Mrad, MD, Shady T. Awwad, MD

Purpose:

To investigate the efficacy of incorporating Generative Adversarial Network (GAN) and synthetic images in enhancing the performance of a convolutional neural network (CNN) for automated estimation of Implantable Collamer Lens (ICL) vault using anterior segment optical coherence tomography (AS-OCT).

Methods:

This study was a retrospective evaluation using synthetic data and real patient images in a deep learning framework. Synthetic ICL AS-OCT scans were generated using GANs and a secondary image editing algorithm, creating approximately 100,000 synthetic images. These were used alongside real patient scans to train a CNN for estimating ICL vault distance. The model's performance was evaluated using statistical metrics such as mean absolute percentage error (MAPE), mean absolute error (MAE), root mean squared error (RMSE), and coefficient of determination (R²) for the estimation of ICL vault distance.

Results:

The study analyzed 4,557 AS-OCT B-scans from 138 eyes of 103 patients for training. An independent, retrospectively collected dataset of 2,454 AS-OCT images from 88 eyes of 56 patients, used prospectively for evaluation, served as the test set. When trained solely on real images, the CNN achieved a MAPE of 15.31%, MAE of 44.68 µm, and RMSE of 63.3 µm. However, with the inclusion of GAN-generated and algorithmically edited synthetic images, the performance significantly improved, achieving a MAPE of 8.09%, MAE of 24.83 µm, and RMSE of 32.26 µm. The R² value was +0.98, indicating a strong positive correlation between actual and predicted ICL vault distances (P < .01). No statistically significant difference was observed between measured and predicted vault values (P = .58).

Conclusions:

The integration of GAN-generated and edited synthetic images substantially enhanced ICL vault estimation, demonstrating the efficacy of GANs and synthetic data in enhancing OCT image analysis accuracy. This model not only shows potential for assisting postoperative ICL evaluations, but also for improving OCT automation when data paucity is an issue.

[J Refract Surg. 2024;40(4):e199–e207.]

目的：研究生成对抗网络（GAN）和合成图像在提高卷积神经网络（CNN）性能方面的功效，该网络用于使用前段光学相干断层扫描（AS-OCT）自动估算植入式角膜接触镜（ICL）穹窿。使用 GAN 和二次图像编辑算法生成合成 ICL AS-OCT 扫描，创建了约 100,000 张合成图像。这些图像与真实患者扫描图像一起用于训练估计 ICL 拱顶距离的 CNN。使用平均绝对百分比误差 (MAPE)、平均绝对误差 (MAE)、均方根误差 (RMSE) 和判定系数 (R2) 等统计指标对模型的性能进行了评估，以估计 ICL 拱顶距离。测试集是一个独立的、回顾性收集的数据集，包含 56 名患者 88 只眼睛的 2454 张 AS-OCT 图像，用于前瞻性评估。仅在真实图像上进行训练时，CNN 的 MAPE 为 15.31%，MAE 为 44.68 µm，RMSE 为 63.3 µm。然而，在加入 GAN 生成并经过算法编辑的合成图像后，其性能显著提高，MAPE 为 8.09%，MAE 为 24.83 µm，RMSE 为 32.26 µm。R2 值为 +0.98，表明实际和预测的 ICL 拱顶距离之间具有很强的正相关性（P < .01）。结论：GAN 生成的合成图像和编辑的合成图像的整合大大提高了 ICL 拱顶的估算，证明了 GAN 和合成数据在提高 OCT 图像分析准确性方面的功效。该模型不仅显示了辅助术后 ICL 评估的潜力，还显示了在数据匮乏的情况下改进 OCT 自动化的潜力。

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引用次数: 0

Changes in Corneal Epithelial Thickness in Different Areas After Femtosecond Laser–Assisted LASIK in Patients With High Astigmatism 高度散光患者接受飞秒激光辅助 LASIK 手术后不同区域角膜上皮厚度的变化

IF 2.4 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery

Pub Date : 2024-04-01 DOI: 10.3928/1081597x-20240311-04

Anqi Li, MD, Zhichao Liu, MD, Meng Lin, MD, Qianwen Gong, MD, PhD, Linzhi Wei, MD, Fan Lu, MD, OD, Liang Hu, MD, OD

Purpose:

To explore changes in corneal epithelial thickness (CET) after femtosecond laser–assisted laser in situ keratomileusis in patients with high astigmatism.

Methods:

CET was measured at every intersection of the concentric circles and specific axes using AngioVue optical coherence tomography (Angio-OCT) preoperatively and 1 month postoperatively. The average thickness of corneal central, paracentral, and peripheral regions was the mean of the points within the central 2, 2 to 5, and 5 to 7 mm areas, respectively. Correlation analysis was performed to investigate the association between CET along different axes and other preoperative and postoperative parameters.

Results:

Forty-two eyes of 28 patients were included. CET along the astigmatic (K1) and perpendicular (K2) axes in the central and paracentral areas increased (P < .001), whereas that along the K2 axis decreased in the peripheral area 1 month postoperatively (P = .001). The amount of CET change in the peripheral area between the K1 and K2 axes was significantly different (P < .001). In the central area, the change in CET along the K2 axis was positively correlated with ablation depth (r = 0.315, P = .042) and negatively with refractive power after surgery (r = −0.347, P = .024). In the peripheral area, the changes in CET along both K1 and K2 axes were negatively correlated with ablation depth (r = −0.431, P = .004; r = −0.387, P = .011, respectively).

Conclusions:

Epithelial modeling differed between the different astigmatism axes after refractive surgery. The compensatory response of the corneal epithelium is more pronounced along the steeper axis.

[J Refract Surg. 2024;40(4):e239–e244.]

目的：探讨飞秒激光辅助激光原位角膜磨镶术后高度散光患者角膜上皮厚度（CET）的变化。方法：术前和术后1个月，使用AngioVue光学相干断层扫描（Angio-OCT）测量同心圆和特定轴的每个交点的CET。角膜中央、中央旁和周边区域的平均厚度分别为中央 2 毫米、2 至 5 毫米和 5 至 7 毫米区域内各点的平均值。结果：共纳入了 28 名患者的 42 只眼睛。术后 1 个月，中央区和旁中心区沿散光轴（K1）和垂直轴（K2）的 CET 增加（P < .001），而周边区沿 K2 轴的 CET 减少（P = .001）。外周区域 K1 轴和 K2 轴之间的 CET 变化量存在显著差异（P = .001）。在中心区域，沿 K2 轴的 CET 变化与消融深度呈正相关（r = 0.315，P = .042），与术后屈光力呈负相关（r = -0.347，P = .024）。结论：屈光手术后，不同散光轴的角膜上皮模型不同。角膜上皮的代偿反应在较陡的轴上更为明显。

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引用次数: 0

Visual Quality Assessment After FS-LASIK Using Customized Aspheric Ablation Profile for Age-Related Accommodation Deficiency Compensation 使用定制非球面消融轮廓进行 FS-LASIK 术后视觉质量评估，以补偿与年龄相关的适应性缺陷

IF 2.4 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery

Pub Date : 2024-04-01 DOI: 10.3928/1081597x-20240311-05

Ruiyu Zhang, MD, Yifei Yuan, MD, Yu Zhang, MD, Yueguo Chen, MD

Purpose:

To evaluate clinical outcomes and visual quality 12 months after femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK) performed with the Custom-Q algorithm for correction of myopia with or without astigmatism and compensate for age-related accommodation deficiency.

Methods:

Patients who had Custom-Q FS-LASIK for myopia and myopic astigmatism with age-related accommodation deficiency were included in this retrospective study. Distance, intermediate, and near visual acuities, objective and subjective refractions, Q-factor, corneal higher order aberrations (HOAs), accommodation function, defocus curve, contrast sensitivity, and a subjective questionnaire assessing visual quality were evaluated 12 months postoperatively.

Results:

Clinical data of 43 cases were analyzed. The mean age was 42.02 ± 1.85 years (range: 40 to 48 years). At the 12-month follow-up visit, there were 43 (100%), 42 (97%), and 33 (77%) patients who achieved a binocular uncorrected distance, intermediate, and near visual acuity, respectively, better than 20/20 separately. Defocus curves revealed better distance vision in the dominant eyes, and the nondominant eyes performed better at intermediate and near vergence (P < .001). The Q-value and corneal spherical aberration coefficient were more positive in the dominant eyes than those in the nondominant eyes (P < .001). The accommodative amplitude and relative accommodation improved binocularly (P < .001). The questionnaire demonstrated high patient satisfaction with near vision, and no one reported having severe visual disturbance.

Conclusions:

For myopic patients with age-related accommodation deficiency, the Custom-Q algorithm proved to be an effective way to achieve acceptable near vision without compromising distance vision.

[J Refract Surg. 2024;40(4):e245–e252.]

目的：评估采用Custom-Q算法进行飞秒激光辅助激光原位角膜磨镶术（FS-LASIK）矫正近视（伴有或不伴有散光）并补偿年龄相关性调节功能缺陷12个月后的临床疗效和视觉质量。方法：本回顾性研究纳入了采用Custom-Q FS-LASIK治疗近视和近视散光并伴有年龄相关性调节功能缺陷的患者。结果：分析了 43 例患者的临床数据。平均年龄为（42.02 ± 1.85）岁（40 至 48 岁）。在 12 个月的随访中，分别有 43 例（100%）、42 例（97%）和 33 例（77%）患者的双眼未矫正远、中、近视力均优于 20/20。散焦曲线显示，优势眼的远视力更好，而非优势眼的中远近屈光度更好（P < .001）。显性眼的 Q 值和角膜球差系数比非显性眼的更正（P < .001）。双眼的适应性振幅和相对适应性均有所改善（P < .001）。调查问卷显示，患者对近距离视力的满意度很高，没有人报告有严重的视力障碍。结论：对于有年龄相关性适应不良的近视患者来说，Custom-Q 算法被证明是在不影响远距离视力的情况下获得可接受的近距离视力的有效方法。

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引用次数: 0

Effects of Topical 0.05% Cyclosporine A on Dry Eye Symptoms and Parameters Following Small Incision Lenticule Extraction 局部使用 0.05% 环孢素 A 对小切口扁桃体摘除术后干眼症状和参数的影响

IF 2.4 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery

Pub Date : 2024-04-01 DOI: 10.3928/1081597x-20240311-03

Xiaofeng Zhu, MD, Shanshan Li, MM, Min Wang, MD, Wenbo Yao, BAppSc(Optom), Xinhui Huang, MM, Liquan Zhao, MD

Purpose:

To evaluate the effects of topical 0.05% cyclosporine A on Ocular Surface Disease Index (OSDI) score and ocular surface parameters after small incision lenticule extraction (SMILE) for myopia.

Methods:

In this study, 151 patients who underwent SMILE were randomized into the control group (71 eyes) and the 0.05% cyclosporine A group (80 eyes). Both groups received standard treatment during the 1 month after SMILE. Over the next 3 months, The control group continued standard therapy (0.3% sodium hyaluronate) and the 0.05% cyclosporine A group received additional 0.05% cyclosporine A. OSDI total and subscale scores, non-invasive tear break-up time (NIBUT), tear lipid layer thickness (LLT), and tear meniscus height (TMH) were assessed preoperatively and postoperatively.

Results:

Compared to baseline, the OSDI scores significantly increased in both groups (P < .001). The 0.05% cyclosporine A group exhibited lower OSDI total scores after administering 0.05% cyclosporine A versus the control group (P = .026). At 1 month of follow-up, NIBUT, LLT, and TMH values significantly decreased in both groups compared to baseline (P < .05). The 0.05% cyclosporine A group exhibited higher NIBUT, LLT, and TMH versus the control group, returning to preoperative values after 2 months. Overall, the OSDI total score and NIBUT values during follow-up were not significantly different between the two groups; however, the LLT and TMH values were significantly different between the two groups (P < .001 and .041, respectively) by repeated measures analysis of variance.

Conclusions:

Topical 0.05% cyclosporine A was effective in relieving subjective dry eye symptoms and maintaining ocular surface stability in the early postoperative period of SMILE.

[J Refract Surg. 2024;40(4):e229–e238.]

目的：评估外用0.05%环孢素A对近视小切口人工晶体摘除术（SMILE）后眼表疾病指数（OSDI）评分和眼表参数的影响。方法：将151名接受SMILE手术的患者随机分为对照组（71只眼）和0.05%环孢素A组（80只眼）。两组患者均在SMILE术后1个月内接受标准治疗。在接下来的 3 个月中，对照组继续接受标准治疗（0.3% 透明质酸钠），而 0.05% 环孢素 A 组则接受额外的 0.05% 环孢素 A。术前和术后分别对 OSDI 总分和分量表评分、无创泪液破裂时间（NIBUT）、泪液脂质层厚度（LLT）和泪液半月板高度（TMH）进行了评估。结果：与基线相比，两组的 OSDI 评分均显著增加（P < .001）。使用0.05%环孢素A后，0.05%环孢素A组的OSDI总分低于对照组（P = .026）。随访1个月时，两组的NIBUT、LLT和TMH值与基线相比均显著下降（P <.05）。与对照组相比，0.05% 环孢素 A 组的 NIBUT、LLT 和 TMH 值更高，2 个月后恢复到术前值。总体而言，两组随访期间的OSDI总分和NIBUT值无显著差异；但通过重复测量方差分析，两组的LLT和TMH值有显著差异（P分别为.001和.041）。结论：外用0.05%环孢素A能有效缓解SMILE术后早期的主观干眼症状并维持眼表稳定。

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引用次数: 0

Differences Between Simulated Keratometry and Total Corneal Power in Eyes With Keratoconus and a Formula to Improve IOL Power Calculation Results 角膜炎患者的模拟角膜测量和总角膜力之间的差异以及改进人工晶体力计算结果的公式

IF 2.4 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery

Pub Date : 2024-04-01 DOI: 10.3928/1081597x-20240311-06

Catarina P. Coutinho, MSc, Domenico Schiano-Lomoriello, MD, Cosimo Mazzotta, MD, PhD, Marco Ferrise, MD, Kenneth J. Hoffer, MD, Filomena J. Ribeiro, MD, PhD, João Mendanha Dias, PhD, Giacomo Savini, MD

Purpose:

To compare simulated keratometry (SimK) and total corneal power (TCP) in keratoconic eyes, to determine whether the differences are systematic and predictable and to evaluate an adjusted TCP-based formula for intraocular lens (IOL) power calculation.

Methods:

In a consecutive series of keratoconic eyes, measurements of SimK, TCP, posterior keratometry, and anterior and posterior corneal asphericities (Q-values) were retrospectively collected. The difference between SimK and TCP was linearly correlated to the biometric parameters. In a separate sample of keratoconic eyes that had undergone cataract surgery, IOL power was calculated with the Barrett Universal II, Hoffer QST, Holladay 1, Kane, and SRK/T formulas using the SimK and an adjusted TCP power. The respective prediction errors were calculated.

Results:

A total of 382 keratoconic eyes (271 patients) were enrolled. An increasing overestimation of SimK by TCP was detected from stage I to III, with a significant correlation between the SimK and TCP difference and SimK in the whole sample (P < .0001, r² = 0.1322). Approximately 7% of cases presented an underestimation of SimK by TCP. IOL power calculation with the adjusted TCP improved outcomes, achieving a maximum of 80% of eyes with a prediction error within ±0.50 diopters with the Hoffer QST, Holladay 1, and Kane formulas.

Conclusions:

Overall, SimK overestimated TCP. Such a difference could not be predicted by any variable. The proposed TCP-adjustment formula (TCP_adj = TCP + 0.56 diopters) in keratoconic eyes for IOL power calculation might be valuable for improving refractive outcomes.

[J Refract Surg. 2024;40(4):e253–e259.]

目的：比较模拟角膜屈光度（SimK）和角膜总功率（TCP）在角膜炎眼中的差异，确定差异是否系统且可预测，并评估基于TCP的调整后的眼内人工晶体（IOL）功率计算公式。方法：在一系列连续的角膜炎眼中，回顾性地收集了SimK、TCP、后角膜屈光度以及前后角膜非球面度（Q值）的测量值。SimK 和 TCP 之间的差异与生物计量参数呈线性相关。在接受过白内障手术的角膜病变眼的单独样本中，采用巴雷特通用 II、霍弗 QST、霍拉迪 1、凯恩和 SRK/T 公式，使用 SimK 和调整后的 TCP 功率计算人工晶体的功率。结果：共有 382 只角膜病变眼（271 名患者）入组。在整个样本中，SimK 和 TCP 差值与 SimK 之间存在显著相关性（P < .0001，r2 = 0.1322）。约有 7% 的病例显示 TCP 低估了 SimK。使用调整后的 TCP 计算人工晶体力量改善了结果，使用 Hoffer QST、Holladay 1 和 Kane 公式预测误差在±0.50 屈光度以内的眼最多达到 80%。结论：总的来说，SimK 高估了 TCP，这种差异是任何变量都无法预测的。在计算角膜病变眼的 IOL 功率时，所提出的 TCP 调整公式（TCPadj = TCP + 0.56 斜度）可能对改善屈光结果很有价值。

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引用次数: 0

Evaluation of the Agreement Between a New Pyramid Wavefront Sensor Aberrometer and Scheiner-Smirnov Aberrometers 评估新型金字塔波前传感器像差仪与谢纳-斯米尔诺夫像差仪之间的一致性

IF 2.4 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery

Pub Date : 2024-04-01 DOI: 10.3928/1081597x-20240311-02

Yizhou Yang, MD, Rui Ning, MD, Shuoyu Xu, MD, Jinxuan Xiahou, MD, Jiawei Li, MD, Giacomo Savini, MD, PhD, Domenico Schiano-Lomoriello, MD, Xingtao Zhou, MD, PhD, Jinhai Huang, MD, PhD

Purpose:

To assess agreement between a new aberrometer (Osiris-T; CSO) employing pyramid wavefront sensor technique and Scheiner-Smirnov aberrometer (OPD-Scan III; Nidek) on measuring ocular, corneal, and internal aberrations in healthy participants.

Methods:

The measurements were conducted three times consecutively by an experienced examiner. The total root mean square (RMS) aberrations, higher order aberration RMS, coma Z₃^±1, trefoil Z₃^±3, spherical aberration Z₄⁰_, and astigmatism II Z₄^±2 up to 7th order were exported in both 4-and 6-mm pupil zones. The parameters between the two devices were statistically compared using the paired t-test, and the differences assessed with Bland-Altman plots and 95% limits of agreement.

Results:

This prospective study included 70 right eyes of 70 healthy participants with an average age of 25.94 ± 6.59 years (range: 18 to 47 years). The mean difference in the two devices ranged from 0.01 µm for astigmatism II Z₄^±2 to 0.63 µm for total RMS in 4 mm and from 0.01 to 1.41 µm in 6-mm pupil size. The Bland-Altman analysis of ocular, corneal, and internal aberrations indicated high agreement between the two devices and the maximum absolute values for 95% limits of agreement ranged from 0.03 to 1.06 µm for 4-mm pupil diameters and 0.12 to 1.13 µm for 6-mm pupil diameters.

Conclusions:

The newly developed pyramid wavefront sensor technique aberrometer demonstrated a high agreement with a Scheiner-Smirnov aberrometer when measuring ocular, corneal, and internal aberrations in healthy participants. Thus, the two aberrometers may be considered interchangeable for clinical applications.

[J Refract Surg. 2024;40(4):e218–e228.]

目的：评估采用金字塔波前传感器技术的新型像差仪（Osiris-T；CSO）与 Scheiner-Smirnov 像差仪（OPD-Scan III；Nidek）在测量健康参与者的眼球、角膜和内部像差方面的一致性。在 4 毫米和 6 毫米瞳孔区输出总均方根（RMS）像差、高阶像差 RMS、彗差 Z3±1、三叶差 Z3±3、球差 Z40 和散光 II Z4±2 直至 7 阶。结果：这项前瞻性研究包括 70 名健康参与者的 70 只右眼，平均年龄为 25.94 ± 6.59 岁（范围：18 至 47 岁）。散光 II Z4±2 至 4 毫米总有效值的平均差异为 0.01 微米至 0.63 微米，6 毫米瞳孔的平均差异为 0.01 至 1.41 微米。对眼球、角膜和内部像差的 Bland-Altman 分析表明，这两种仪器之间的一致性很高，95% 一致性极限的最大绝对值为：4 毫米瞳孔直径 0.03 至 1.06 微米，6 毫米瞳孔直径 0.12 至 1.13 微米。因此，这两种像差仪在临床应用中可以互换。

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引用次数: 0

Introspection 自省

IF 2.4 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery

Pub Date : 2024-04-01 DOI: 10.3928/1081597x-20240227-01

Adrian Muñoz-Espouy

Introduction

Figure

This artwork represents an aged man depicting with his glance, his attitude, and his skin the feeling of old age. It is a hard feeling that inspires our emotions even though the portrait is delicate and soft. However, the aggressiveness of aging is obvious in the painting. The degradation of the body, the spirit, and the expectations, together with memories of the past, are represented in the glance of this old man who is badly treated by age. His glance looks inside himself; he is observing his past and he feels no hopes for the future. A negative and analytical feeling with regret and sorrow is transmitted through his glance.

Adrian Muñoz-Espouy received the Miradas Award for the Emerging Artist Miradas de España, 2023.

Watercolor and graphite on paper and wood, 81 × 100 cm

导言人物这幅作品表现的是一位年迈的老人，他的眼神、神态和皮肤描绘出了年老的感觉。虽然画像细腻而柔和，但却能激发我们的情感。然而，衰老的侵略性在画中显而易见。身体、精神和期望的退化，加上对过去的回忆，都在这位被岁月摧残的老人的眼神中表现出来。他的目光直视自己的内心；他在观察自己的过去，对未来不抱任何希望。Adrian Muñoz-Espouy 获得了 2023 年西班牙 Miradas 新锐艺术家奖。

引用次数: 0

Interpolation. 插值

IF 2.4 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery

Pub Date : 2024-03-01 DOI: 10.3928/1081597X-20240202-01

Beatriz Arteaga-Pitzenbauer

引用次数: 0

Anterior Segment Biometry During Accommodation After Posterior Chamber Phakic Implantable Collamer Lens Implantation. 后房型角膜可植入型胶束透镜植入术后适应过程中的前段生物测量。

IF 2.4 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery

Pub Date : 2024-03-01 DOI: 10.3928/1081597X-20240212-01

Guang-Ming Zhang, Li-Jun Zhao, Hua-Tao Xie, Ming-Feng Wu

Purpose: To evaluate the dynamic changes in anterior segment parameters during accommodation following Implantable Collamer Lens (ICL) implantation with swept-source optical coherence tomography (SS-OCT).

Methods: Under the accommodation of 0.00 diopters (D), 3.00 D, and maximum amplitude, SS-OCT was used to examine the anterior segment parameters, including ICL vault, ICL depth (the distance between the corneal endothelium and the posterior surface of ICL), crystalline lens thickness, anterior chamber depth, and various parameters of the anterior chamber angle, comprising angle opening distance, angle recess area, trabecular iris space area, and trabecular iris angle.

Results: During accommodation, the ICL vault showed a significant decrease from baseline (536 ± 278 μm) to 3.00 D (522 ± 281 μm), followed by an increase from 3.00 D to maximum amplitude (548 ± 306 μm) (analysis of variance [ANOVA], P < .001). Four eyes (2.61%) exhibited a decrease in ICL vault to less than 100 μm (47 ± 32 μm) at maximum accommodation. The ICL depth decreased significantly as accommodation increased (ANOVA, P < .001). Crystalline lens thickness increased, whereas anterior chamber depth decreased during accommodation (ANOVA, P < .001). The anterior chamber angle widened during 3.00 D of accommodation but narrowed at maximum accommodation, leading to significant changes in the angle opening distance, angle recess area, trabecular iris space area, and trabecular iris angle during accommodation (ANOVA, P < .001 for all).

Conclusions: The anterior segment, including ICL vault and anterior chamber angle, undergo significant dynamic changes during accommodation. These accommodative changes may require careful monitoring for the surgery design of ICL implantation. [J Refract Surg. 2024;40(3):e164-e172.].

目的：利用扫源光学相干断层扫描（SS-OCT）评估植入式角膜塑形镜（ICL）植入术后调节过程中眼前节参数的动态变化：在0.00屈光度（D）、3.00屈光度和最大振幅的调节下，使用SS-OCT检查前节参数，包括ICL穹窿、ICL深度（角膜内皮与ICL后表面之间的距离）、晶状体厚度、前房深度以及前房角的各种参数，包括角膜开口距离、角膜凹陷面积、小梁虹膜空间面积和小梁虹膜角：在适应过程中，ICL穹隆从基线（536 ± 278 μm）显著下降到 3.00 D（522 ± 281 μm），然后从 3.00 D 上升到最大振幅（548 ± 306 μm）（方差分析 [ANOVA]，P < .001）。有四只眼睛（2.61%）显示，在最大调节时，ICL穹隆减小到小于 100 μm（47 ± 32 μm）。随着调节的增加，ICL 深度明显减少（方差分析，P < .001）。晶状体厚度增加，而前房深度在调节过程中减少（方差分析，P < .001）。前房角在 3.00 D 的调节过程中变宽，但在最大调节时变窄，导致调节过程中开角距离、角凹面积、小梁虹膜空间面积和小梁虹膜角发生显著变化（方差分析，P < .001）：前段（包括 ICL 穹窿和前房角）在适应过程中会发生显著的动态变化。结论：ICL穹隆和前房角等前节在适应过程中会发生明显的动态变化，在设计ICL植入手术时需要仔细监测这些适应性变化。[J Refract Surg. 2024;40（3）：e164-e172]。

{"title":"Anterior Segment Biometry During Accommodation After Posterior Chamber Phakic Implantable Collamer Lens Implantation.","authors":"Guang-Ming Zhang, Li-Jun Zhao, Hua-Tao Xie, Ming-Feng Wu","doi":"10.3928/1081597X-20240212-01","DOIUrl":"10.3928/1081597X-20240212-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the dynamic changes in anterior segment parameters during accommodation following Implantable Collamer Lens (ICL) implantation with swept-source optical coherence tomography (SS-OCT).</p><p><strong>Methods: </strong>Under the accommodation of 0.00 diopters (D), 3.00 D, and maximum amplitude, SS-OCT was used to examine the anterior segment parameters, including ICL vault, ICL depth (the distance between the corneal endothelium and the posterior surface of ICL), crystalline lens thickness, anterior chamber depth, and various parameters of the anterior chamber angle, comprising angle opening distance, angle recess area, trabecular iris space area, and trabecular iris angle.</p><p><strong>Results: </strong>During accommodation, the ICL vault showed a significant decrease from baseline (536 ± 278 μm) to 3.00 D (522 ± 281 μm), followed by an increase from 3.00 D to maximum amplitude (548 ± 306 μm) (analysis of variance [ANOVA], <i>P</i> < .001). Four eyes (2.61%) exhibited a decrease in ICL vault to less than 100 μm (47 ± 32 μm) at maximum accommodation. The ICL depth decreased significantly as accommodation increased (ANOVA, <i>P</i> < .001). Crystalline lens thickness increased, whereas anterior chamber depth decreased during accommodation (ANOVA, <i>P</i> < .001). The anterior chamber angle widened during 3.00 D of accommodation but narrowed at maximum accommodation, leading to significant changes in the angle opening distance, angle recess area, trabecular iris space area, and trabecular iris angle during accommodation (ANOVA, <i>P</i> < .001 for all).</p><p><strong>Conclusions: </strong>The anterior segment, including ICL vault and anterior chamber angle, undergo significant dynamic changes during accommodation. These accommodative changes may require careful monitoring for the surgery design of ICL implantation. [<b><i>J Refract Surg</i></b>. <b>2024;40(3):e164-e172.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 3","pages":"e164-e172"},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interchangeability in Automated Corneal Diameter Measurements Across Different Biometric Devices: A Systematic Review of Agreement Studies. 不同生物测量设备自动角膜直径测量的互换性：一致性研究的系统性回顾。

IF 2.9 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery

Pub Date : 2024-03-01 DOI: 10.3928/1081597X-20240212-02

Maria Muzyka-Woźniak, Slawomir Woźniak, Grzegorz Łabuz

Purpose: To provide an up-to-date review of the agreement in automated white-to-white (WTW) measurement between the latest topographic and biometric devices.

Methods: In this systematic review, PubMed, Web of Science, and Scopus databases were searched for articles published between 2017 and 2023, focusing on WTW agreement studies on adult, virgin eyes, with or without cataract and no other ocular comorbidities. Studies evaluating WTW measurements performed with autokeratometers, manual calipers, or manual image analysis were excluded. When available, the following metrics for the agreement of WTW measurements between pairs of devices were included: mean difference ± standard deviation, 95% limits of agreement (LoA), LoA width, 95% confidence interval (95 CI%), and intraclass correlation coefficient (ICC).

Results: Forty-one studies, covering comparisons for 19 devices, were included. Altogether, 81 paired comparisons were performed for 4,595 eyes of 4,002 individuals. The mean difference in WTW measurements between devices ranged from 0.01 mm up to 0.96 mm, with varying CI. The 95% LoA width ranged from 0.31 to 2.45 mm (median: 0.65 mm). The majority of pairwise comparisons reported LoA wider than 0.5 mm, a clinically significant value for phakic intraocular lens sizing.

Conclusions: Nearly all analyzed studies demonstrated the lack of interchangeability of the WTW parameter. The corneal diameter, assessed by means of grayscale en-face image analysis, tended to demonstrate the lowest agreement among devices compared to other measured biometric parameters. [J Refract Surg. 2024;40(3):e182-e194.].

目的：对最新地形图和生物识别设备之间自动白对白（WTW）测量的一致性进行最新综述：在这篇系统性综述中，我们在 PubMed、Web of Science 和 Scopus 数据库中搜索了 2017 年至 2023 年间发表的文章，重点关注对有或无白内障、无其他眼部合并症的成年处女眼进行的 WTW 一致性研究。排除了评估使用自动角膜曲率计、手动卡尺或手动图像分析进行的WTW测量的研究。如果有可用数据，则纳入以下指标来衡量成对设备之间 WTW 测量的一致性：平均差 ± 标准偏差、95% 一致性限值 (LoA)、LoA 宽度、95% 置信区间 (95 CI%) 和类内相关系数 (ICC)：结果：共纳入 41 项研究，对 19 种设备进行了比较。共对 4,002 人的 4,595 只眼睛进行了 81 次配对比较。不同设备之间 WTW 测量值的平均差异从 0.01 毫米到 0.96 毫米不等，CI 值各异。95% LoA 宽度范围为 0.31 至 2.45 毫米（中位数：0.65 毫米）。大多数配对比较报告的 LoA 宽度超过了 0.5 毫米，这对于角膜内人工晶体的选型具有重要的临床意义：结论：几乎所有分析研究都表明 WTW 参数缺乏互换性。与其他测量的生物测量参数相比，通过灰度面内图像分析评估的角膜直径在不同设备之间的一致性最低。[J Refract Surg. 2024;40（3）：e182-e194]。

{"title":"Interchangeability in Automated Corneal Diameter Measurements Across Different Biometric Devices: A Systematic Review of Agreement Studies.","authors":"Maria Muzyka-Woźniak, Slawomir Woźniak, Grzegorz Łabuz","doi":"10.3928/1081597X-20240212-02","DOIUrl":"10.3928/1081597X-20240212-02","url":null,"abstract":"<p><strong>Purpose: </strong>To provide an up-to-date review of the agreement in automated white-to-white (WTW) measurement between the latest topographic and biometric devices.</p><p><strong>Methods: </strong>In this systematic review, PubMed, Web of Science, and Scopus databases were searched for articles published between 2017 and 2023, focusing on WTW agreement studies on adult, virgin eyes, with or without cataract and no other ocular comorbidities. Studies evaluating WTW measurements performed with autokeratometers, manual calipers, or manual image analysis were excluded. When available, the following metrics for the agreement of WTW measurements between pairs of devices were included: mean difference ± standard deviation, 95% limits of agreement (LoA), LoA width, 95% confidence interval (95 CI%), and intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Forty-one studies, covering comparisons for 19 devices, were included. Altogether, 81 paired comparisons were performed for 4,595 eyes of 4,002 individuals. The mean difference in WTW measurements between devices ranged from 0.01 mm up to 0.96 mm, with varying CI. The 95% LoA width ranged from 0.31 to 2.45 mm (median: 0.65 mm). The majority of pairwise comparisons reported LoA wider than 0.5 mm, a clinically significant value for phakic intraocular lens sizing.</p><p><strong>Conclusions: </strong>Nearly all analyzed studies demonstrated the lack of interchangeability of the WTW parameter. The corneal diameter, assessed by means of grayscale en-face image analysis, tended to demonstrate the lowest agreement among devices compared to other measured biometric parameters. <b>[<i>J Refract Surg</i>. 2024;40(3):e182-e194.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 3","pages":"e182-e194"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0