Axial length estimation error caused by hidden double-peak on partial coherence interferometry in an eye with epiretinal membrane: a case report

Kitaguchi, Yoshiyuki; Yano, Shinsaku; Gomi, Fumi

doi:10.2147/opth.s59309

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…Although axial length measurements using a PCI technology should not be affected by retinal thickening due to macular pathologies, in literature are reported cases of myopic spherical errors after combined phacovitrectomy for iERM related to the presence of a second biometric peak. 38,39 The main purpose of our study was to evaluate the effect of changes in retinal thickening on ultrasound immersion and optical biometry measures as well as the consequences of these changes on the postoperative refraction after combined phacovitrectomy for iERM.…”

Section: Discussionmentioning

confidence: 99%

Impact of epiretinal membrane on biometry measurements accuracy in combined phaco-vitrectomy

Piergentili,

Stefanini,

Vannozzi

et al. 2024

Preprint

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Background To assess the reproducibility of axial length measurements and the postoperative refractive error in patients undergoing combined phacovitrectomy for idiopathic epiretinal membrane removal. Methods Ten eyes of 10 patients who underwent combined phacovitrectomy were enrolled in this prospective observational case series. The main outcome was the axial length changes on ultrasound biometry. Secondary outcome measures were: changes in central macular thickness (CMT), the correlation between axial length changes on ultrasound biometry and absolute change in central macular thickness, mean predicted refractive error either with optical or ultrasound biometry, absolute refractive error in spherical equivalent (SE), axial length (AL), BCVA and intraocular pressure (IOP). Optical (IOL master 500, Carl Zeiss) and Ultrasound Immersion (Compact Touch, Quantel Medical) axial length together with central macular thickness (OCT – Optical coherence Tomography, Heidelberg) measurements were obtained preoperatively and at 3 months follow up. Intraocular lens power selection was based on Holladay I, SRK-T and Hoffer Q formulas and the preoperative mean predicted refraction calculated either with ultrasound or optical biometry was compared with mean postoperative spherical equivalent measured with automatic refractometry (Nidek, ARK1). A comprehensive assessment including BCVA, Intraocular pressure, refractive status, anterior segment biomicroscopy and fundus examination was carried out at baseline and repeated one day, one and three months postoperatively. Results Mean patient’s age was 70,7 ± 4,83. The mean logMAR BCVA preoperatively was 0,44 ± 0,17 and improved significantly to 0,75 ± 0,16 at 3 months after surgery (p = < 0.05). Ultrasound (US) immersion AL increased (p < 0.05) while CMT decreased significantly (p < 0.05). A correlation was found between US and CMT reduction thus not statistically significant (p > 0.05). Contrary the optical AL decreased postoperatively (p < 0.05). The preoperative macular thickness and the postoperative optical dioptric shift correlated (p = 0.0557) while no correlation was found between the US biometry and the postoperative dioptric shift (p > 0.05). A correlation was also recorded between either the ultrasound (rho = 0,9; p < 0.05) or optical (rho = 0,511; p > 0.05) predicted refraction and the actual refractive outcome as well as between the two techniques. The dioptric shift, was then calculated both for Ultrasound (0,21 ± 0,82 D) and Optical biometry (0,113 ± 0,34 D). Bland-Altman diagram shows the difference between the two shifts was likely to be dependent on the average shift (p < 0.05 Pitman’s test for differences in variance). Conclusions Optical biometry represents the gold standard technique for the AL measurement in combined phacovitrectomy for iERM. The Ultrasound immersion biometry seems to be less accurate and deliver a less predictable refractive outcome, either hyperopic or myopic. This method should be reserved in selected cases and the patient should be always informed about the possibility of a refractive error. Further studies with a larger population and a control group are necessary to expand our understanding in IOL selection in combined surgery and eventually confirm this preliminary results.

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Section: Discussionmentioning

confidence: 99%

Impact of epiretinal membrane on biometry measurements accuracy in combined phaco-vitrectomy

Piergentili,

Stefanini,

Vannozzi

et al. 2024

Preprint

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IOL Calculation in Vitreoretinal Pathology and Surgery

Aramberri

2024

Intraocular Lens Calculations

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Intraocular lens (IOL) power calculation is frequently performed in the context of retinal pathology and concomitant vitreoretinal surgery. The precision of the regular biometric measurements and calculation formulas can be affected unless the surgeon avoids the different sources of error. In this chapter, the biometry of the eye with retinal pathology is described exposing the most relevant causes of an incorrect measurement and the ways to avoid or correct them. Previously, vitrectomized eyes, especially filled with silicone oil, were more prone to error, and both the measurements and the refractive target have to adapt to the particularity of the eye. Phacovitrectomy has become a routine surgery with increasing demands in refractive outcomes which forces the surgeon to perform a precise calculation with the latest formulas.

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Comparison between spectral-domain optical coherence tomography-based and partial coherence interferometry-based biometry

Ahn

Kim

Yun

et al. 2023

Preprint

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We compared axial length (AL) measurements using spectral-domain optical coherence tomography (SD-OCT)-based and partial coherence interferometry (PCI)-based biometry in eyes with various chorioretinal diseases. Medical records were retrospectively analyzed in 123 eyes from 73 patients who underwent AL measurements using SD-OCT and PCI. AL values were highly consistent by both measurements (ICC = 0.996 in SD-OCT and 0.995 in PCI-based biometry). The mean difference in AL between the two instruments was − 0.09 ± 0.17 mm, which was significant (P < 0.001). There was a strong correlation between the measurements obtained using the two instruments (r = 0.982, P < 0.001). The 95% limits of agreement were − 0.43 to 0.25 mm, and the agreement of AL in the Bland–Altman analysis showed a difference. The difference in measurements was not associated with the difference in central retinal thickness (r = 0.033, P = 0.720). However, the presence of an epiretinal membrane affected the difference in measurements, unlike in other chorioretinal diseases (P = 0.014). SD-OCT-based biometry showed a good correlation with PCI-based biometry in the measurement of AL; however, the mean AL between the two instruments was significantly different. Therefore, AL measurements made using SD-OCT-based and PCI-based biometry are not interchangeable. The presence of an epiretinal membrane influenced the differences in the measurements.

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Axial length estimation error caused by hidden double-peak on partial coherence interferometry in an eye with epiretinal membrane: a case report

Cited by 3 publications

References 12 publications

Impact of epiretinal membrane on biometry measurements accuracy in combined phaco-vitrectomy

Impact of epiretinal membrane on biometry measurements accuracy in combined phaco-vitrectomy

IOL Calculation in Vitreoretinal Pathology and Surgery

Comparison between spectral-domain optical coherence tomography-based and partial coherence interferometry-based biometry

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