Axial Length Measurement Failure Rates with the IOLMaster and Lenstar LS 900 in Eyes with Cataract

Colm McAlinden,Shishi Lin,Ayong Yu,Yifan Feng,Qinmei Wang,Konrad Pesudovs,Fangjun Bao,Xin Yang,Jinhai Huang,Chen-Wei Pan

doi:10.1371/journal.pone.0128929

Abstract

PurposeTo evaluate axial length (AL) measurement failure rate with the IOLMaster (Carl Zeiss AG, Germany) and Lenstar LS 900 (Haag-Streit AG, Switzerland) in eyes with cataract.MethodsTwo hundred and ninety-six eyes of 170 patients with cataract were enrolled. Cataract type and severity were graded using the Lens Opacities Classification System III (LOCS III) and AL measurements were attempted with IOLMaster (version 5.4) and Lenstar LS 900 (version 1.1). Chi-squared analysis was used to assess if the difference in AL measurement acquisition rate was statistically significant between the two devices. The association of the different cataract types and severity with the AL measurement acquisition rate was evaluated with logistic regression analysis.ResultsAL measurements were obtained in 184 eyes (62.16%) using the IOLMaster and 191 eyes (64.53%) using the Lenstar, which corresponds to a failure rate of 37.84% and 35.47% respectively. Chi-square analysis indicated no significant difference between the Lenstar and IOLMaster for AL measurement failure rate (x2 = 0.356, P = 0.550). Logistic regression analysis indicated no association between acquisition rates and cortical or nuclear cataracts with either device. There was a statistically significant association between acquisition rates and increasing severity of posterior subcapsular cataracts with the IOLMaster (β = -1.491, P<0.001) and Lenstar LS 900 (β = -1.507, P<0.001).ConclusionThe IOLMaster and Lenstar LS 900 have similar AL measurement failure rates (35–38%) for Chinese public hospital cataract patients. Increasing severity of posterior subcapsular cataracts was problematic for both devices.

Highlights

Cataract surgery is one of the most commonly performed operations around the world.[1,2] Axial length (AL) measurement is a fundamental parameter in determining the most suitable intraocular lens (IOL) at the time of cataract surgery with inaccuracies in measurement resulting in a significant effect on the post-operative refractive result.[3,4] The IOLMaster (Carl Zeiss Meditec) which employs partial coherence interferometry (PCI), is a popular device used to measure AL
AL measurements were obtained in 184 eyes (62.16%) using the IOLMaster and 191 eyes (64.53%) using the Lenstar, which corresponds to a failure rate of 37.84% and 35.47% respectively
Chi-square analysis indicated no significant difference between the Lenstar and IOLMaster for AL measurement failure rate (x2 = 0.356, P = 0.550)

Summary

Introduction

Cataract surgery is one of the most commonly performed operations around the world.[1,2] Axial length (AL) measurement is a fundamental parameter in determining the most suitable intraocular lens (IOL) at the time of cataract surgery with inaccuracies in measurement resulting in a significant effect on the post-operative refractive result.[3,4] The IOLMaster (Carl Zeiss Meditec) which employs partial coherence interferometry (PCI), is a popular device used to measure AL. The more recently developed Lenstar LS 900 biometer (Haag-Streit AG) is a non-invasive and non-contact device but is based on optical low coherence reflectometry (OLCR).[10] It detects the reflected light wave from the surface of the anterior cornea to the retinal pigment epithelium. It is able to obtain nine parameters in a single measurement: corneal thickness, keratometry, white-to-white (WTW) distance, anterior chamber depth, pupillometry, lens thickness, retinal thickness at the point of fixation, AL, and visual axis decentration.[11] Few studies have assessed the performance of this device, in terms of its performance in different types and severity of cataract

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