Reproducibility of intraocular lens decentration and tilt measurement using a clinical Purkinje meter

• Published in: Journal of cataract and refractive surgery Vol. 36; no. 9; pp. 1529 - 1535
• Main Authors: Nishi, Yutaro, MD, Hirnschall, Nino, MD, Crnej, Alja, MD, FEBO, Gangwani, Vinod, MRCOphth, FRCS, Tabernero, Juan, PhD, Artal, Pablo, PhD, Findl, Oliver, MD, MBA
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.2010; Elsevier
• Subjects: Aged; Aged, 80 and over; Astigmatism - diagnosis; Biological and medical sciences; Contrast Sensitivity - physiology; Diagnostic Techniques, Ophthalmological; Female; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Male; Medical sciences; Middle Aged; Observer Variation; Ophthalmology; Phacoemulsification; Photography - instrumentation; Prosthesis Failure; Pseudophakia - etiology; Refraction, Ocular - physiology; Reproducibility of Results; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Visual Acuity - physiology; Measurement; Treatment; Reproducibility; Surgery; Tilt; Ophthalmology; Intraocular lens
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2010.03.043

Purpose To determine the reproducibility of intraocular lens (IOL) decentration and tilt measurements with a new Purkinje meter instrument. Setting Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. Methods After pupil dilation, images of pseudophakic eyes with a plate-style IOL (Akreos Adapt) were obtained using a recently developed Purkinje meter. Intraocular lens decentration and tilt were evaluated by analyzing the captured images using a semiobjective method by marking the reflexes in the images and automatic calculation using a dedicated software program. In study 1, examiner 1 examined the eyes first followed by examiner 2. Ten minutes later, examiner 1 performed a second measurement, after which the intraexaminer and interexaminer reproducibility were determined. In study 2, a Purkinje meter was used to measure pseudophakic eyes with slitlamp finding of clinical IOL decentration, IOL tilt, or both. The results were compared with retroillumination photographs and slitlamp findings. Results In study 1, there was high intraexaminer reproducibility for decentration ( r = 0.95) and tilt ( r = 0.85) and high interexaminer reproducibility for decentration ( r = 0.84) and tilt ( r = 0.75). In study 2, even in extreme cases of decentration and/or tilt, the Purkinje meter measurements were possible and appeared to correlate well with slitlamp findings. Conclusions Acquisition of images in pseudophakic eyes with the Purkinje meter was simple and rapid. The method was highly reliable for 1 examiner and between 2 examiners. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.