PURPOSE
A novel diagnostic device combining Scheimpflug and anterior segment optical coherence tomography promises increased accuracy in corneal diagnostics. The aim of this study was to analyze the epithelial thickness measurement repeatability in healthy and keratoconus eyes and define severity-dependent thresholds.
METHODS
This prospective, cross-sectional, observational, monocentric study included a total of 217 eyes of 217 subjects divided into a keratoconus group (166 eyes of 166 subjects) and a healthy control group (51 eyes of 51 subjects). Keratoconus diagnosis and stage was established using multimodal imaging. Three measurements were performed with the novel combined Scheimpflug and optical coherence tomography device (Pentacam Cornea optical coherence tomography) on the same day. Repeatability coefficients (RCs) with two-sided 95% confidence intervals (CIs) were calculated for epithelial parameters. The repeatability was compared between groups and according to keratoconus severity and crosslinking status.
RESULTS
The median repeatability of the epithelial thickness was slightly better in the healthy group (RC = 3.3) compared with the keratoconus group (RC = 3.9; P < 0.001) when the tear film was excluded. The overall median repeatability with (RC = 3.7) and without tear film (RC = 3.8) did not differ significantly (P > 0.05). Repeatability worsened significantly in severe keratoconus stages (P < 0.01), whereas crosslinking status had only a marginal effect.
CONCLUSIONS
The hybrid tomographic device demonstrated high intrasubject repeatability for epithelial thickness assessment in healthy and keratoconus eyes, supporting its technical feasibility for clinical use. Further studies are needed to analyze the benefit of incorporating epithelium into established keratoconus scores using the hybrid system.
V. A. Augustin, Maximilian Friedrich, Julia Keim et al.· Cornea· 0 citations
This study aimed to evaluate the early postoperative refractive stabilization pattern and time course associated with a novel hydrophobic C-loop monofocal intraocular lens (IOL) following phacoemulsification cataract surgery. This retrospective study evaluated patients who underwent uneventful phacoemulsification and implantation of a single-piece hydrophobic C-loop monofocal IOL. Manifest refraction spherical equivalent (MRSE) and refractive error (RE) were assessed on postoperative day 1, at 1 week, and at 1 month. Primary outcomes included longitudinal changes in MRSE and RE to evaluate refractive stabilization over time. Secondary outcomes included prediction error and the proportion of eyes achieving target refraction accuracy. The study included 43 eyes of 43 patients with a mean age of 69.9 ± 6.3 years, including 24 females (55.8%). A statistically significant myopic shift was observed during the first postoperative month; the mean MRSE progressively shifted from 0.08 ± 0.50 D on day 1 to −0.09 ± 0.40 D at 1 week, and stabilized at −0.19 ± 0.42 D at 1 month (P < .001). Correspondingly, the mean RE shifted from 0.25 ± 0.52 D on day 1 to 0.08 ± 0.41 D at 1 week, and −0.02 ± 0.43 D at 1 month (P < .001). Regarding refractive accuracy, the proportion of eyes within ± 0.50 D of the target refraction significantly improved from 51.2% on day 1 to 76.7% at 1 week and 74.4% at 1 month (P < .001). The mean absolute error also decreased significantly from 0.49 ± 0.30 D on day 1 to 0.36 ± 0.24 D at 1 month (P < .001). No intraoperative or postoperative complications were observed. This novel hydrophobic C-loop monofocal IOL exhibits a predictable and progressive early refractive pattern characterized by an initial myopic shift within the first postoperative week, followed by stabilization up to 1 month. These findings support the clinical feasibility of functional refraction and spectacle prescription as early as 1 week following uncomplicated cataract surgery.
DongKeun Na, Hyeck-Soo Son, H. Tchah et al.· Medicine· 0 citations
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