Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Reliability of Optical Devices in Terms of Measurements of Corneal Parameters in Cross Linked Keratoconic Eyes: Cross-Sectional Study
Çapraz Bağlama Yapılmış Keratokonik Gözlerde Optik Cihazların Kornea Parametrelerinin Ölçümleri Açısından Güvenilirliği: Kesitsel Çalışma
Ersin MUHAFİZa, Erdinç BOZKURTb, Şerif NİZAMOĞULLARIa
aDepartment of Ophthalmology, Kafkas University Faculty of Medicine, Kars, Türkiye
bClinic of Ophthalmology, Ümraniye Training and Research Hospital, İstanbul, Türkiye
Turkiye Klinikleri J Ophthalmol. 2022;31(3):109-18
doi: 10.5336/ophthal.2021-85528
Article Language: EN
Full Text
ABSTRACT
 Objective: To determine the reliability and agreement of different optical devices in terms of keratometry and pachymetry measurements in cross-linked (CXL) keratoconic eyes. Material and Methods: Thirty-eight CXL-treated keratoconic eyes were evaluated. Three repeated measurements were performed with Topcon KR-1 autorefractokeratometry, Sirius topography, Nidek AL-scan optical biometry and RTVue anterior segment optical coherence tomography (AS-OCT). The devices were compared in terms of pachymetry and keratometric values. Limits of agreement (LoA) between the devices were detected using Bland-Altman analysis. Intra-examiner reliability was obtained using the intraclass correlation coefficient (ICC). Results: While the mean central corneal thickness (CCT) and minimum corneal thickness (MCT) measured in AS-OCT were 456.37±41.52 μm and 431.89±43.37 μm, respectively, these values were 432.40±48.97 μm and 415.67±47.69 μm in topography (p0.97). When devices were compared in terms of the keratometric values and corneal astigmatism measurements, there was a significant difference among devices except between autorefractokeratometry and optical biometry (p0.99). Conclusion: Pachymetry and keratometry can be performed independently in each device with excellent reliability in CXL-treated keratoconic eyes. However, we consider that measurements made with different devices cannot be used interchangeably in these eyes.

Keywords: Crosslinking; keratoconus; pachymetry; keratometry; reliability
ÖZET
 Amaç: Çapraz bağlama yapılmış [cross-linked (CXL)] keratokonik gözlerde, farklı optik cihazların keratometri ve pakimetri ölçümleri açısından güvenirliğini ve uyumluluğunu belirlemek. Gereç ve Yöntemler: CXL ile tedavi edilen keratokonuslu 38 göz değerlendirildi. Topcon KR-1 otorefraktokeratometri, Sirius topografi, Nidek AL-scan optik biyometri ve RTVue ön segment optik koherens tomografi (ÖS-OKT) ile üçer ardışık ölçüm yapıldı. Cihazlar pakimetri ve keratometrik değerler açısından karşılaştırıldı. Cihazlar arasındaki uyum sınırları [limits of agreement (LoA)], Bland-Altman analizi kullanılarak tespit edildi. Sınıf içi güvenirlilik, sınıf içi korelasyon katsayısı [intraclass correlation coefficient (ICC)] kullanılarak elde edildi. Bulgular: ÖS-OKT'de ölçülen ortalama santral kornea kalınlığı (SKK) ve minimum kornea kalınlığı (MKK) sırasıyla 456,37±41,52 μm ve 431,89±43,37 μm iken, topografide bu değerler 432,40±48,97 μm ve 415,67±47,69 μm idi (p0,97). Cihazlar, keratometrik değerler ve korneal astigmatizma ölçümleri açısından karşılaştırıldığında, otorefraktokeratometri ve optik biyometri dışında cihazlar arasında anlamlı fark vardı (tümü için; p0,99). Sonuç: Pakimetri ve keratometri, CXL ile tedavi edilen keratokonik gözlerde mükemmel güvenirlilikle her cihazda bağımsız olarak gerçekleştirilebilir. Ancak farklı cihazlarla yapılan ölçümlerin, bu gözlerde birbirinin yerine kullanılamayacağını düşünmekteyiz.

Anahtar Kelimeler: Çapraz bağlama; keratokonus; pakimetri; keratometri; güvenirlik
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