ASSESSMENT OF ANTERION, MS-39, PENTACAM, AND SIRIUS IN CORNEAL DIAGNOSTICS PRIOR TO REFRACTIVE SURGERY

This study aimed to compare corneal evaluations using two Scheimpflug camera devices (Oculus Pentacam and CSO Sirius) and two spectral domain anterior segment optical coherence tomography devices (Heidelberg Engineering Anterion and CSO MS-39) during preoperative corneal screening prior to refractive surgery.

This retrospective study was performed at the Department of Ophthalmology, St. John of God Hospital, Regensburg, Germany.

One hundred ten eyes from consecutive patients undergoing refractive surgery were examined between February 2022 and February 2024.  Patients exhibiting abnormal slit-lamp biomicroscopy, with distance corrected visual acuity (DCVA) less than 20/25, those with a history of prior eye surgery, or those receiving topical treatments other than artificial tears were excluded from the study.  All participants underwent screening using the Pentacam AXL (Oculus Optikgeräte), Sirius (CSO), Anterion (Heidelberg Engineering), and MS-39 (CSO) devices.

This retrospective case series included 110 patients who underwent refractive surgery.  Simulated keratometry (Sim-K), posterior keratometry (PK), central corneal thickness (CCT), keratometric astigmatism magnitude (KAM), corneal diameter, anterior chamber depth (ACD), and total corneal power (TCP) were analysed using various instruments.  A repeated measures ANOVA was employed to compare the mean values of the measurements.

Simulated keratometry (Sim-K), central corneal thickness (CCT), keratometric astigmatism magnitude (KAM), and total corneal power (TCP) demonstrated strong concordance (ICC > 95%, ANOVA p > 0.05).  Posterior keratometry (PK) showed no significant differences; however, the low Cronbach’s alpha and ICC suggest limited agreement.  Corneal diameter displayed a moderate to poor intraclass correlation coefficient (ICC) (p < 0.001).  The assessment of anterior chamber depth (ACD) using the Anterion yielded the highest values; however, these results did not reach statistical significance (p > 0.05).

Both Scheimpflug camera devices and AS-OCT are effective tools for assessing the cornea prior to refractive surgery.  A significant correlation was observed among Sim-K, CCT, CD, and TCP; however, discrepancies were noted in posterior keratometry, astigmatism magnitude, and ACD.  The findings emphasise the need to consider device-specific factors in evaluating corneal and anterior segment measures during refractive surgery assessments.