Tomoaki Nakamura1, Naoki Isogai2, Takashi Kojima3, Yoko Yoshida2, Yasuo Sugiyama2. 1. Nagoya Eye Clinic, Nagoya, Japan. Electronic address: nic@bc5.so-net.ne.jp. 2. Nagoya Eye Clinic, Nagoya, Japan. 3. Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Abstract
PURPOSE: To develop and evaluate the accuracy of a size-determination formula using anterior segment optical coherence tomography (AS-OCT) parameters. DESIGN: Interventional case series. METHODS: This study included 46 eyes of 23 patients with implantable collamer lens (ICL). Preoperatively, the anterior segment parameters were measured using high-frequency ultrasound biomicroscopy and AS-OCT. Three months postoperatively, the vaults were measured and the optimal ICL size was calculated using a previously published method. Stepwise multiple regression analysis was performed using the optimal ICL size as a dependent variable; the NK-formula was obtained. Thereafter, 35 eyes of 18 patients were implanted with ICL after the size was calculated using the NK-formula. Vaults measured at 3 months postoperatively were used to evaluate the accuracy of the NK-formula. RESULTS: The distance between scleral spurs (ACW) and crystalline lens rise (CLR) were selected as significant parameters for the regression model (R2 = 0.68, P < .05). There were 25 (71%), 8 (23%), and 2 (6%) eyes in the moderate, high, and low vault categories, respectively. Using the STAAR nomogram for ICL sizing, 24 eyes (69%) were fitted in the moderate vault. The mean absolute error of the predicted vault was significantly lower with the NK-formula (0.190 ± 0.129 mm) than with the STAAR nomogram (0.331 ± 0.235 mm, P = .002, paired t test). CONCLUSION: AS-OCT is useful for ICL size determination, because it calculates the anterior segment parameters using automatic analysis. The NK-formula shows higher accuracy for predicting vault than the STAAR nomogram.
PURPOSE: To develop and evaluate the accuracy of a size-determination formula using anterior segment optical coherence tomography (AS-OCT) parameters. DESIGN: Interventional case series. METHODS: This study included 46 eyes of 23 patients with implantable collamer lens (ICL). Preoperatively, the anterior segment parameters were measured using high-frequency ultrasound biomicroscopy and AS-OCT. Three months postoperatively, the vaults were measured and the optimal ICL size was calculated using a previously published method. Stepwise multiple regression analysis was performed using the optimal ICL size as a dependent variable; the NK-formula was obtained. Thereafter, 35 eyes of 18 patients were implanted with ICL after the size was calculated using the NK-formula. Vaults measured at 3 months postoperatively were used to evaluate the accuracy of the NK-formula. RESULTS: The distance between scleral spurs (ACW) and crystalline lens rise (CLR) were selected as significant parameters for the regression model (R2 = 0.68, P < .05). There were 25 (71%), 8 (23%), and 2 (6%) eyes in the moderate, high, and low vault categories, respectively. Using the STAAR nomogram for ICL sizing, 24 eyes (69%) were fitted in the moderate vault. The mean absolute error of the predicted vault was significantly lower with the NK-formula (0.190 ± 0.129 mm) than with the STAAR nomogram (0.331 ± 0.235 mm, P = .002, paired t test). CONCLUSION:AS-OCT is useful for ICL size determination, because it calculates the anterior segment parameters using automatic analysis. The NK-formula shows higher accuracy for predicting vault than the STAAR nomogram.
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