Direct Measurement of the Ciliary Sulcus Diameter Using Optical Coherence Tomography-Inter-Rater Variability

• Published in: Sensors (Basel, Switzerland) Switzerland), 2024-10, Vol.24 (21), p.6950
• Main Authors: Eppig, Timo, Seer, Manuel, Martinez-Abad, Antonio, Galvis, Virgilio, Schütz, Saskia, Tello, Alejandro, Rombach, Michiel C, Alió, Jorge L
• Format: Article
• Language: English
• Subjects: Aged; Cataract; Cataract Extraction; Cataracts; Ciliary Body - diagnostic imaging; Cornea; Female; Haptics; Humans; intraocular lens; Intraocular lenses; Lenses, Intraocular; Male; Measurement; Methods; Middle Aged; Nomograms; Observer Variation; ocular dimensions; optical coherence tomography; Proprietary; Reproducibility of Results; Surgery; Tomography; Tomography, Optical Coherence - methods; Ultrasonic imaging
• ISSN: 1424-8220; 1424-8220
• DOI: 10.3390/s24216950

The determination of sulcus-to-sulcus measurements has been challenging due to the limitations of current approaches. Ultrasound methods are highly operator-dependent and require extensive training, while traditional optical devices cannot visualize structures posterior to the iris. However, modern optical anterior segment coherence tomography (AS-OCT) devices are changing this paradigm by identifying some anatomical landmarks posterior to the iris. This study evaluates the reproducibility of optical sulcus measurements in the context of sizing a novel accommodative intraocular lens (IOL). Preoperative OCT scans of patients scheduled for cataract surgery were analyzed regarding the dimensions of the ciliary sulcus using a custom scan method with a clinically available anterior segment optical coherence tomographer. Measurements were compared between two different readers, and various derived parameters were compared. The measurements by both readers were highly correlated (R > 0.96), and their agreement was excellent (mean difference 0.02 mm with 95% limits of agreement from -0.11 to 0.15 mm). In contrast, the sulcus diameter measurement did not agree well with automatically calculated values, such as the anterior chamber width or white-to-white. This leads to the conclusion that modern swept-source AS-OCT measurements of the ciliary sulcus dimensions are feasible, reproducible, and may be a clinically useful tool.