Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Does Corneal Collagen Cross-Linking Effect the Repeatability and Reliability of Scheimpflug Imaging in Keratoconus?
Korneal Kollajen Çapraz Bağlama Keratokonus Hastalarında Scheimpflug Görüntülemenin Tekrarlanabilirlik ve Güvenilirliğini Etkiler mi?
Ayşe ÇİÇEKa, Mustafa ATAŞa, Mahmut Erkam ARSLANa, Hayrettin ÇOBANOĞLUa, Esra VURALa, Bedirhan ALABAYa
aKayseri Training and Research Hospital, Department of Opthalmology, Kayseri, TURKEY
Turkiye Klinikleri J Med Sci. 2020;40(2):141-7
doi: 10.5336/medsci.2019-72509
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of this study was to assess the repeatability and reliability of measurements obtained with Pentacam in keratoconic and cross-linked keratoconic eyes. Material and Methods: The subjects eligible for the study were composed of two groups: Keratoconus group and Collagen-cross-linking (CXL) group. All subjects underwent three consecutive corneal topography measurements using the Scheimpflug camera (Pentacam, Oculus, Germany). The time between each scan was, typically, about 1-2 min. The repeatability limits of the 3 repeated measurements were calculated. Reliability was assessed by an intraclass correlation coefficient (ICC). Results: This study comprised 36 eyes of 18 keratoconus patients and 28 eyes of 14 keratoconus patients cross-linking applied. All ICC values in both groups are more than 0.95. The repeatability limits are higher in CXL group than keratoconus group for all parameters except Q value, root mean square (RMS) of total and horizontal coma. The repeatability limits of K1, K2, Kmax and the thinnest corneal thickness (TCT) were 0.58 D, 0.64 D, 1.77 D and 14.3 μm in keratoconus group, respectively. The repeatability limits of K1, K2, Kmax and TCT were 1.39 D, 1.13 D, 2.06 D and 15.3 μm in CXL group, respectively. Conclusion: The higher repeatability limits of K1, K2 and Kmax in CXL group were interesting. These results show the need for studies with larger numbers evaluating the repeatability of Pentacam in keratoconus patients after cross-linking.

Keywords: Keratoconus; Pentacam; cross-linking; reliability; repeatability
ÖZET
 Amaç: Bu çalışmanın amacı Pentacam ölçümlerinin çapraz bağlanma uygulanmış ve uygulanmamış keratokonus hastalarında tekrarlanabilirlik ve güvenilirliğini değerlendirmektir. Gereç ve Yöntemler: Çalışmaya dahil edilen kişiler iki gruptan oluştu: Keratokonus grubu, Kollajen çapraz bağlama (KÇB) grubu. Çalışmaya dahil edilen tüm kişilere Scheimpflug kamera sistemi (Pentacam, Oculus, Almanya) ile ardışık üç kere korneal topografi ölçümü yapıldı. Her ölçüm arasında 1-2 dakika süre beklendi. Üç ölçümün tekrarlanabilirlik limiti ölçümlerin %95'inin içinde olduğu varsayılan 1,96* √2Sw olarak hesaplandı. Güvenilirlik sınıf içi korelasyon katsayısı (SKK) ile değerlendirildi. Bulgular: Bu çalışma 18 keratokonus hastasının 36 gözünü ve 14 KÇB uygulanmış keratokonus hastasının 28 gözünü kapsamaktadır. Tüm ölçümler için SKK değerleri üç grupta da 0,95'in üzerindeydi. Q, total ve horizontal komanın root mean square (RMS) değerleri haricinde tüm ölçümlerin tekrarlanabilirlik limitleri KÇL grubunda keratokonus grubundan yüksekti. K1, K2, Kmax ve en ince kornea kalınlığı (EİKK) ölçümlerinin tekrarlanabilirlik limitleri keratokonus grubunda sırasıyla 0,58 D, 0.64 D, 1.77 D ve 14,3 μm idi. K1, K2, Kmax ve EİKK ölçümlerinin tekrarlanabilirlik limitleri KÇB grubunda sırasıyla 1,39 D, 1,13 D, 2,06 D ve 15,3 μm idi. Sonuç: KÇB grubunda daha yüksek tekrarlanabilirlik limitleri ile birlikte bütün gruplarda Pentakam ölçümlerinde çok iyi düzeyde güvenilirlik gözlendi. KÇB grubunda K1, K2 ve Kmax ölçümlerinin daha yüksek tekrarlanabilirlik limitleri dikkat çekiciydi. Bu sonuçlar KÇB sonrası keratokonus hastalarında Pentacam ölçümlerinin tekrarlanabilirliğini değerlendiren daha çok hasta sayılı çalışmalara ihtiyaç olduğunu göstermiştir.

Anahtar Kelimeler: Keratokonus; Pentacam; çapraz bağlama; güvenilirlik; tekrarlanabilirlik
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