Comparison of reliability and repeatability of corneal curvature assessment with six keratometers

Abstract

Background Keratometric methodology varies between instruments and the differences may have a clinical impact. We investigated the agreement and reproducibility of six keratometers. Methods Keratometry was performed on 100 subjects at two separate sessions with IOLMaster 500, Pentacam, OPD scanner, Medmont E300, Javal‐Schiøtz and TMS‐5. A second observer assessed 30 subjects to determine inter‐observer variability. A single individual was assessed on 10 separate sessions to determine intra‐observer variability. Data were analysed using coefficient of variation (CV) and intra‐class correlation coefficient (ICCC) for intra‐observer variation. Inter‐observer concordance was evaluated by the ICCC. Bland–Altman plots, Pearson's correlation coefficient and repeated measures analysis of variance were used to assess agreement of data produced by the instruments. Results OPD scanner and Javal‐Schiøtz mean spherical equivalent (MSE) results were systematically different (p < 0.001) from other instruments (flatter and steeper, respectively). J0/J45 were similar for all instruments (p < 0.05). Bland–Altman comparison plots indicated that Pentacam and IOLMaster demonstrated greatest level of agreement (ICC results MSE = 0.992, J0 = 0.934 and J45 = 0.890). Agreement (ICC) between observers for MSE ranged from 0.955 to 0.995 for all instruments; lower levels of agreement were found for J0/J45 (0.289 to 0.901). IOLMaster showed greatest correlation and Medmont the lowest. All instruments showed high intra‐observer repeatability of MSE (CV 0.1 to 0.3 per cent). The J0/J45 readings showed greater variability (CV range 8.8 to 57.6 per cent). Conclusion When considering MSE alone IOLMaster, Pentacam, OPD scan and Medmont may be considered interchangeable; however, assessment of astigmatism shows greater variability between instruments, sessions and observers.

Multivariate Regression Analysis to Predict Postoperative Refractive Astigmatism in Cataract Surgery

“…e reproducibility of the keratometric values was confirmed in the previous studies [7][8][9]. Corneal thickness was also measured using the TMS-5.…”

Comparison of anterior segment parameters and axial length measurements performed on a Scheimpflug device with biometry function and a reference optical biometer

“…Another group recently found a difference of -0.033 mm (equal to 0.19 D), also regarding the steep meridian [8]. Studies based on the former version of Pentacam or Pentacam HR also indicated differences in keratometric measurements [19][20][21][22][23][24]. Karunaratne found statistically significant differences between the mean keratometric values of the IOL Master and Pentacam equivalent keratometry readings at 2-, 3-and 4.5-mm zone measurements.…”

Corneal Evaluation in Healthy Brazilian Children Using a Scheimpflug Topography System

“…A previous study showed that the thickness profile provided by the Pentacam and the BAD software can detect early keratoconus with a sensitivity and specificity of 98% [9]. The details provided by the Pentacam are reliable because the equipment has a high level of reliability and repeatability for keratometric and pachymetric readings [21,22]. The measurement of corneal thickness is essential in the diagnosis and evaluation of multiple ocular and corneal diseases, for establishing surgical indication, and for monitoring certain pathologies.…”