aladdin / oa 2000 / argos - movu inc. … · cv j0 aladdin -0.10 ±±±0.31 0.11 0.23 0.32 -120.74...

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