AGREEMENT OF VAULT SIZE MEASUREMENTS BETWEEN THE PENTACAM®, THE ANTERION® AND THE SPECTRALIS®

To evaluate the agreement of vault size measurements between the Pentacam®, Anterion® and Spectralis® devices.

Despite good refractive results, Implantable Collamer Lens (ICL) implantation may lead to postoperative complications. One indicator of the ICL safety is the vault size.

Cross-sectional analysis of eyes previously submitted to ICL implantation. Vault size was evaluated with the Pentacam HR®, Anterion® and Spectralis® (anterior segment module) devices. Secondarily, the anterior chamber depth (ACD) was evaluated with the Pentacam® and Anterion® devices. Images of each patient were performed in the same day, by the same technician. Vault and ACD measurements were performed by two refractive surgeons (O1 and O2). The horizontal median images were used for analysis and the measurements were obtained using the on-screen calibration system. Images were randomly divided into three groups and each group was analyzed one week apart, by each observer, with images in a randomized order. The agreement between exams was assessed with an Intraclass Correlation Coefficient (ICC). The differences between devices were evaluated using paired T tests. For correlations between devices the Pearson and Spearman correlations were used.

Fifty-five eyes of 30 patients were included. The ICC for absolute agreement was excellent between Anterion® and Spectralis® (O1: 0.972; O2: 0.977) and good between Pentacam® and Anterion® (O1: 0.831; O2: 0.849) and Pentacam® and Spectralis® (O1: 0.825; O2: 0.836). The Intraclass Correlation Coefficient (ICC) for absolute agreement and consistency of vault measurements was good to excellent. The vault measurements obtained with Pentacam® were inferior to those obtained with Anterion® and Spectralis® (p<0.001). There were no differences between Anterion® and Spectralis® (p>0.697). The differences in vault measurements between the Anterion® and Pentacam® devices correlated positively with the increase in vault size in the Anterion® (R(53)>0.629, p<0.001) and the differences between Spectralis® and Pentacam® correlated with an increase in vault size in the Spectralis® (R(53)>0.569, p<0.001). The difference in vault measurements between Anterion® and Pentacam® correlated positively with the increment in pupillary diameter in the Anterion® (R(53)>0.365, p<0.006) and the difference between the Spectralis® and the Pentacam® correlated with the increase in pupillary diameter in the Spectralis® (r(67)>0.329, p<0.014). For ACD, the ICC for absolute agreement and for consistency between Pentacam® and Anterion® was good (ICC >0.790). Pentacam® provided inferior ACD sizes, compared to Anterion® (p<0.001).

While the Anterion® and the Spectralis® may be used interchangeably, Pentacam® provided inferior values to those obtained with the other devices. The differences in vault size between devices are influenced by vault size and pupillary diameter measured with the Spectralis® and the Anterion®.