Objective To evaluate the repeatability and accuracy of corneal parameters in post-laser in situ keratomileusis (LASIK) eyes obtained by RTVue Fourier-domain optical coherence topography (FD-OCT). Methods In this prospective study, 58 right eyes of 58 persons who agreed to undergo LASIK were included. Subjective refractions were performed before LASIK and 3 months after LASIK. IOL Master was used to evaluate corneal power before LASIK. Three months after LASIK, RTVue FD-OCT was used to evaluate the anterior corneal curvature in a 3 mm central zone (Ranterior), posterior corneal curvature in a 3 mm zone (Rposterior), the ratio of posterior and anterior curvature (Rposterior/ Ranterior), central corneal thickness (CCT), total corneal power (Knet), simulated corneal power (SimK), anterior corneal power (Kanterior), and posterior corneal power (Kposterior). Km was obtained with IOL Master 3 months after the surgery. Kchm was calculated from the patient′s clinical history. Repeatability of corneal parameters was assessed using the coefficient of variation (CV), Cronbach′s alpha, and intra-class correlation coefficient (ICC). Bonferroni corrected multiple comparisons analyzed the differences between SimK, Knet, Km and Kchm. A Pearson correlation analyzed the correlations between SimK, Knet, Km and Kchm. Bland-Altman plots analyzed the agreements between SimK and Kchm, Knet and Kchm, Km and Kchm, SimK and Knet, and SimK and Km. Results The Ranterior, Rposterior, Rposterior/Ranterior, Kanterior, Kposterior, SimK, Knet and CCT were (8.560±0.292)mm, (6.525±0.159)mm, 0.763±0.024, (43.98±1.48)D, (-6.13±0.15)D, (39.47±1.33)D, (37.93±1.42)D and (451.81±33.91)μm, respectively. The CVs of all parameters were lower than 1%. Cronbach′s alpha and ICC were both higher than 0.9. SimK was (0.434±0.433)D higher than Kchm, Knet was (1.112±0.471)D lower than Kchm, Km was (0.334±0.379)D higher than Kchm, and SimK was (1.546±0.162)D higher than Kchm. All the differences were statistically significant (P<0.01). SimK was (0.100±0.287)D higher than Km but the difference was not statistically significant. There were close correlations among SimK, Knet, Km and Kchm (r≥0.944, P<0.01). The Bland-Altman analysis showed that the 95% limit of agreements between SimK and Kchm, Knet and Kchm, Km and Kchm, SimK and Knet, and SimK and Km were -0.41~1.28 D, -2.04~-1.11 D, -0.41~1.08 D, 1.23~1.86 D, -0.46~0.66 D, respectively. Conclusion The RTVue Fourier-domain OCT had high repeatability on corneal curvature and CCT measurements in post-LASIK eyes. The SimK obtained by RTVue Fourier-domain OCT and IOL Master were 0.3 to 0.4 D higher than those obtained by clinical history. Knet may be a more accurate method to assess corneal power in post-LASIK eyes, but further clinical studies are needed for the prediction of post-LASIK intraocular lens power.
Rao SN, Raviv T, Majmudar PA, et al. Role of Orbscan II in screening keratoconus suspects before refractive corneal surgery. Ophthalmology,2002,109:1642-1646.
[2]
Arce CG, Campos M, Schor P. Determining corneal power using Orbscan II videokeratography for IOL calculation after excimer laser surgery for myopia. J Cataract Refract Surg,2007,33:1348-1350.
[3]
Mandell KJ, Jurkunas UV, Pineda R. Intraocular lens calculations after corneal refractive surgery. Int Ophthamol Clin,2010,50:181-189.
[4]
Savini G, Barboni P, Profazio V, et al. Corneal power measurements with the Pentacam Scheimpflug camera after myopic excimer laser surgery. J Cataract Refract Surg,2008, 34:809-813.
[5]
Jin H, Holzer MP, Rabsilber T, et al. Intraocular lens power calculation after laser refractive surgery corrective algorithm for corneal power estimation. J Cataract Refract Surg,2010,36:87-96.
[6]
Doors M, Tanhzio NG, Eggink FA, et al. Use of anterior segment optical coherence tomography to study corneal changes after collagen cross-linking. Am J Ophthalmol,2009,148:844-851.
[7]
Priglinger SG, Neubauer AS, May CA, et al. Optical coherence tomography for the detection of laser in situ keratomileusis in donor corneas. Cornea,2003,22:46-50.
[8]
Wildner K, Muller M, Dawczynski J, et al. Comparison of the corneal thickness as measured by Visante anterior segment OCT versus ultrasound technique. Klin Monbl Augenheilkd,2007,224:832-836.
[9]
Tang M, Li Y, Avila M, et al. Measuring total corneal power before and after laser in situ keratomileusis with high-speed optical coherence tomography. J Cataract Refract Surg,2006, 32:1843-1850.
[10]
Holladay JT, Van GS, Ting AC, et al. Silicone intraocular lens power vs temperature. Am J Ophthalmol,1989,107:428-429.
[11]
Bland JM, Altman DG. Cronbach's alpha. BMJ,1997,314:572.
[12]
Chen D, Lam AK. Reliability and repeatability of the Pentacam on corneal curvatures. Clin Exp Optom,2009,92:110-118.
[13]
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet,1986,2:307-310.
[14]
Tang M, Chen A, Li Y, et al. Corneal power measurement with Fourier-domain optical coherence tomography. J Cataract Refract Surg,2010,36:2115-2122.
[15]
Kalyani SD, Alisa K, John GL. Intraocular lens power calculation after corneal refractive surgery. Current Option in Ophthalmology,2008,19:357-362.