aladdin / oa 2000 / argos - movu inc. … · cv j0 aladdin -0.10 ±±±0.31 0.11 0.23 0.32 -120.74...
TRANSCRIPT
ALADDIN / OA 2000 / ARGOS
PRECISION / AGREEMENT STUDY
IOL POWER CLUB
NEW ORLEANS
2016
TIME DOMAIN
FOURIER DOMAIN: SPECTRAL
FOURIER DOMAIN: SWEPT SOURCE
- Moving mirror
in the reference arm
- Stationary mirror
in the reference arm
- Spectrometer
- Stationary mirror
in the reference arm
- Swept source laser
IOL MASTER 700
ZEISS
ARGOS
MOVU
OA 2000
TOMEY
IOL MASTER 500LENSTAR
LS900
ALADDIN
OA 1000AL SCAN
ZEISSHAAG STREIT
TOPCON
TOMEYNIDEK
CORNEA
PLACIDO DISK
TOPOGRAPHY
PLACIDO CONE
TOPOGRAPHY
VIDEO KERATOMETRY
METHODS
■ 27 eyes of 27 people: Patients attending BEGITEK Clinic for
cataract surgery / RLE
■ No eye pathology
■ 2 PRK cases (K>40)
■ Age: 68.89 ± 8.45 yo
■ Males: 10; Females: 17
■ 14 LE and 13 RE
■ Prospective and randomized:
- Eye to be explored
- Order of device
■ 1 expert explorer. Informed consent was signed
■ 3 consecutive measurements were performed with each
device
METHODS
DATA ANALYSISDATA ANALYSIS
REPEATABILITY
Sw : Wthin subject standard deviation (square root of mean variance)
Precision: 1.96Sw : Half range of 95 % of population data
Repeatability: 2.77Sw : Highest absolute difference between 95 % of pair
of observations
Coefficient of Variation: 100 Sw / Mean
METHODS
DATA ANALYSISDATA ANALYSIS
AGREEMENT
Bland Altman plots
One way ANOVA test for means comparison
■ Measurement:
1ST measurement was used for agreement analysis
METHODS
ANALYSED DATAANALYSED DATA
CORNEA:
- K flat (K 1)
- K steep (K 2)
-Axis steep
-Sim K
-Astigmatism
-K power vectors: J0, J45
(as defined by Thibos)
AXIOMETRY HWTW
- AXL
- CCT
- ACD
- LT
RESULTS
REPEATABILITY
MEAN ±±±±
SDSw Precision Repeatability CV
AXL
Aladdin23.73 ±±±±
1.44
0.02
0.04 0.06 0.09
OA2000
23.73 ±±±±
1.450.01
0.02 0.03 0.05
Argos23.71 ±±±±
1.410.01
0.01 0.02 0.03
n=27
AXIAL LENGTH
MEAN ±±±±
SDSw Precision Repeatability CV
AXL
Aladdin23.73 ±±±±
1.44
0.02
0.04 0.06 0.09
OA2000
23.73 ±±±±
1.450.01
0.02 0.03 0.05
Argos23.71 ±±±±
1.410.01
0.01 0.02 0.03
n=27
AXIAL LENGTH
MEAN ±±±±
SDSw Precision Repeatability CV
AXL
Aladdin23.39 ±±±±
1.35
0.02
0.05 0.07 0.10
OA2000
23.40 ±±±±
1.350.01
0.03 0.04 0.06
IOL
Master
700
23.40 ±±±±
1.35 0.01 0.01 0.02 0.03
n=32
San Sebastian
2015
Sw PrecisionRepeatab
ilityCV
AXL
NORMALS
IOL
Master 50.03 0.07 0.10 0.14
Lenstar 0.02 0.04 0.06 0.09
AXL
CATARACTS
IOL
Master 50.04 0.08 0.11 0.17
Lenstar 0.01 0.03 0.04 0.06
n=35
n=37
MEAN ±±±±
SDSw Precision Repeatability CV
AXL
Aladdin23.73 ±±±±
1.44
0.02
0.04 0.06 0.09
OA2000
23.73 ±±±±
1.450.01
0.02 0.03 0.05
Argos23.71 ±±±±
1.410.01
0.01 0.02 0.03
n=27
AXIAL LENGTH
Wurzburg
2011
MEAN ±±±±
SDSw Precision Repeatability CV
AXL
Aladdin23.73 ±±±±
1.44
0.02
0.04 0.06 0.09
OA2000
23.73 ±±±±
1.450.01
0.02 0.03 0.05
Argos23.71 ±±±±
1.410.01
0.01 0.02 0.03
n=27
AXIAL LENGTH
Example:
23.50 mm
95 % of cases will be +/-
AXIAL LENGTH
Example:
23.50 mm
95 % of cases will be +/-
MEAN ±±±±
SDSw Precision Repeatability CV
AXL
Aladdin23.73 ±±±±
1.44
0.02
0.04 0.06 0.09
OA2000
23.73 ±±±±
1.450.01
0.02 0.03 0.05
Argos23.71 ±±±±
1.410.01
0.01 0.02 0.03
n=27
ARGOS: 23.49 – 23.51
AXIAL LENGTH
Example:
23.50 mm
95 % of cases will be +/-
OA2000: 23.48 – 23.52
ARGOS: 23.49 – 23.51
MEAN ±±±±
SDSw Precision Repeatability CV
AXL
Aladdin23.73 ±±±±
1.44
0.02
0.04 0.06 0.09
OA2000
23.73 ±±±±
1.450.01
0.02 0.03 0.05
Argos23.71 ±±±±
1.410.01
0.01 0.02 0.03
n=27
AXIAL LENGTH
Example:
23.50 mm
95 % of cases will be +/-
ALADDIN: 23.46 – 23.54
OA2000: 23.47 – 23.53
MEAN ±±±±
SDSw Precision Repeatability CV
AXL
Aladdin23.73 ±±±±
1.44
0.02
0.04 0.06 0.09
OA2000
23.73 ±±±±
1.450.01
0.02 0.03 0.05
Argos23.71 ±±±±
1.410.01
0.01 0.02 0.03
n=27
ARGOS: 23.49 – 23.51
MEAN ±±±±
SDSw Precision Repeatability CV
Sim K
Aladdin43.26 ±±±±
1.910.13 0.26 0.37 0.31
OA2000
43.13 ±±±±
1.71 0.07 0.13 0.18 0.15
Argos43.30 ±±±±
1.96 0.13 0.26 0.37 0.31
n=27
SIM K
MEAN ±±±±
SDSw Precision Repeatability CV
Sim K
Aladdin43.26 ±±±±
1.910.13 0.26 0.37 0.31
OA2000
43.13 ±±±±
1.71 0.07 0.13 0.18 0.15
Argos43.30 ±±±±
1.96 0.13 0.26 0.37 0.31
n=27
SIM K
MEAN ±±±±
SDSw Precision Repeatability CV
AXL
Aladdin43.77 ±±±±
1.780.09 0.18 0.25 0.21
OA2000
43.86 ±±±±
1.81 0.11 0.22 0.31 0.25
IOL
Master
700
43.85 ±±±±
1.79 0.10 0.20 0.28 0.23
n=34
San Sebastian
2015
MEAN ±±±±
SDSw Precision Repeatability CV
Sim K
Aladdin43.26 ±±±±
1.910.13 0.26 0.37 0.31
OA2000
43.13 ±±±±
1.71 0.07 0.13 0.18 0.15
Argos43.30 ±±±±
1.96 0.13 0.26 0.37 0.31
n=27
SIM K
n=32 SD ±±±± SD Sw Precision Repeatability CV
Sim K
IOL
Master 50.08±±±±0.09 0.12 0.23 0.32 0.26
Lenstar 0.09±±±±0.08 0.12 0.23 0.32 0.27
Wurzburg
2011
SIM K
Example:
43.50 mm
95 % of cases will be +/-
MEAN ±±±±
SDSw Precision Repeatability CV
Sim K
Aladdin43.26 ±±±±
1.910.13 0.26 0.37 0.31
OA2000
43.13 ±±±±
1.71 0.07 0.13 0.18 0.15
Argos43.30 ±±±±
1.96 0.13 0.26 0.37 0.31
n=27
SIM K
Example:
43.50 mm
95 % of cases will be +/-
MEAN ±±±±
SDSw Precision Repeatability CV
Sim K
Aladdin43.26 ±±±±
1.910.13 0.26 0.37 0.31
OA2000
43.13 ±±±±
1.71 0.07 0.13 0.18 0.15
Argos43.30 ±±±±
1.96 0.13 0.26 0.37 0.31
n=27
Argos: 43.26 – 43.76
Aladdin: 43.26 – 43.76
SIM K
Example:
43.50 mm
95 % of cases will be +/-
MEAN ±±±±
SDSw Precision Repeatability CV
Sim K
Aladdin43.26 ±±±±
1.910.13 0.26 0.37 0.31
OA2000
43.13 ±±±±
1.71 0.07 0.13 0.18 0.15
Argos43.30 ±±±±
1.96 0.13 0.26 0.37 0.31
n=27
Argos: 43.26 – 43.76
OA2000: 43.37 – 43.63
Aladdin: 43.26 – 43.76
How does this AXL and K variability
contribute to the whole IOL
calculation process variability?
Calculation of variability in refraction
prediction using Gaussian error propagation
analysis
ALADDIN
OA 2000
ARGOSSoftware by W. Haigis
MEAN ±±±±
SDSw Precision Repeatability CV
ACD
Aladdin3.17 ±±±±
0.380.02 0.04 0.06 0.70
OA2000
3.17 ±±±±
0.36 0.08 0.16 0.23 2.62
Argos3.11 ±±±±
0.39 0.01 0.03 0.04 0.50
n=27
ACD
MEAN ±±±±
SDSw Precision Repeatability CV
ACD
Aladdin3.17 ±±±±
0.380.02 0.04 0.06 0.70
OA2000
3.17 ±±±±
0.36 0.08 0.16 0.23 2.62
Argos3.11 ±±±±
0.39 0.01 0.03 0.04 0.50
n=27
ACD
MEAN ±±±±
SDSw Precision Repeatability CV
ACD
Aladdin3.14 ±±±±
0.400.06 0.12 0.17 1.95
OA2000
3.09 ±±±±
0.41 0.14 0.28 0.40 4.64
IOL
Master
700
3.01 ±±±±
0.40 0.05 0.10 0.14 1.72
n=34
San Sebastian
2015
MEAN ±±±±
SDSw Precision Repeatability CV
LT
Aladdin4.39 ±±±±
0.780.03 0.06 0.09 0.72
OA2000
4.58 ±±±±
0.32 0.08 0.16 0.23 1.88
Argos4.69 ±±±±
0.30 0.04 0.08 0.11 0.85
n=27
LT
MEAN ±±±±
SDSw Precision Repeatability CV
LT
Aladdin4.39 ±±±±
0.780.03 0.06 0.09 0.72
OA2000
4.58 ±±±±
0.32 0.08 0.16 0.23 1.88
Argos4.69 ±±±±
0.30 0.04 0.08 0.11 0.85
n=27
LT
MEAN ±±±±
SDSw Precision Repeatability CV
LT
Aladdin4.54 ±±±±
0.390.07 0.14 0.20 1.58
OA2000
4.60 ±±±±
0.39 0.15 0.29 0.42 3.27
IOL
Master
700
4.58 ±±±±
0.38 0.03 0.07 0.10 0.77
n=34
San Sebastian
2015
ASTIGMATISMn=27
MEAN ±±±± SD Sw PrecisionRepeatabilit
yCV
CYL
MAGNITUDE
Aladdin 0.74 ±±±± 0.43 0.17 0.34 0.49 23.63
OA20000.71 ±±±± 0.39
0.14 0.28 0.39 20.09
Argos 0.82 ±±±± 0.490.31 0.60 0.85 37.49
MEAN ±±±± SD Sw PrecisionRepeatabilit
yCV
J0
Aladdin -0.10 ±±±± 0.31 0.11 0.23 0.32 -120.74
OA2000-0.06 ±±±± 0.29
0.09 0.19 0.26 -148.24
Argos -0.06 ±±±± 0.280.16 0.31 0.44 -268.37
MEAN ±±±± SD Sw PrecisionRepeatabilit
yCV
J45
Aladdin -0.07 ±±±± 0.27 0.10 0.20 0.28 -156.64
OA2000-0.03 ±±±± 0.27
0.04 0.08 0.12 -128.21
Argos -0.10 ±±±± 0.360.13 0.25 0.36 -129.03
MEAN ±±±±
SDSw Precision Repeatability CV
CCT
Aladdin
OA2000
538.51 ±±±±
34.43 4.18 8.20 11.59 0.77
Argos539.59 ±±±±
38.2 7.20 14.10 19.93 1.33
n=27
CCT
MEAN ±±±±
SDSw Precision Repeatability CV
CCT
Aladdin
OA2000
538.51 ±±±±
34.43 4.18 8.20 11.59 0.77
Argos539.59 ±±±±
38.2 7.20 14.10 19.93 1.33
n=27
CCT
MEAN ±±±±
SDSw Precision Repeatability CV
CCT
Aladdin
OA2000
533.90 ±±±±
32.14 4.03 7.90 11.17 0.75
IOL
Master
700
545.36 ±±±±
33.34 1.91 3.75 5.3 0.35
n=34
San Sebastian
2015
MEAN ±±±±
SDSw Precision Repeatability CV
CCT
Aladdin
OA2000
538.51 ±±±±
34.43 4.18 8.20 11.59 0.77
Argos539.59 ±±±±
38.2 7.20 14.10 19.93 1.33
n=27
CCT
Galilei G2 vs Pentacam HR
IPC meeting 2011 Wurzburg
RESULTS
AGREEMENT
AXIAL LENGTH
Bootstrap: 1000 samples; simple sampling; 95% conf. interv.
SIM K
Bootstrap: 1000 samples; simple sampling; 95% conf. interv.
ACD
Bootstrap: 1000 samples; simple sampling; 95% conf. interv.
ALA: 3.41
ARGOS: 2.7
ALA: 3.41
OA2000: 2.71
OA2000: 3.28
ARGOS: 2.98
ACD discrepancy case: Aladdin / Argos-OA2000
LT
Bootstrap: 1000 samples; simple sampling; 95% conf. interv.
ALA: 4.73
ARGOS: 5.3
ALA: 4.73
OA2000: 5.45
CCT
Bootstrap: 1000 samples; simple sampling; 95% conf. interv.
OA2000: 534
ALADDIN: 565
OA2000: 534
ALADDIN: 567
ASTIGMATISM
CONCLUSIONS
Good repeatibility of all measured variables
B scanners (Argos and OA2000) seem perform better
than A scanners in AXL
LT is the least precise for all of them
Agreement is very good: Interchangeable (minimum or
no IOL constant difference)
Impact of precision differences on IOL calculation is
neglectible