Optical and ultrasound measurement of axial length and anterior chamber depth for intraocular lens power calculation

Purpose: To evaluate the precision, reproducibility, and applicability of an optical method based on partial coherence interferometry for intraocular lens (IOL) power calculation. Setting: Ultrasound laboratory of a university eye hospital. Methods: A prospective comparison of measurements made by the IOLMaster optical instrument (Carl Zeiss) and Ultrascan Digital 2000 contact ultrasound A-scan (Alcon) for IOL calculations was performed. Examined were 255 eyes of 134 persons (204 phakic, 47 pseudophakic, and 4 aphakic). The mean age of the patients was 67.9 years (range 7 to 94 years). Results: The IOLMaster measurements were successful in more than 80% of cases: in 82%, 99%, and 99% for axial length (AL), anterior chamber depth (ACD), and keratometry measurements, respectively. The reproducibility of the AL and ACID measurements was very high (coefficient of variation 0.13% and 2.20%, respectively). The AL and ACD values were significantly larger with the IOLMaster (P < .001) than with the Ultrascan Digital 2000. The correlation between ultrasound and optical AL measurements was high (r = 0.985; P < .001); however, there was no correlation between ACD measurements (r = 0.079; P = .397). The corneal refractive power measurements of a Javal-type keratometer and the IOLMaster were highly correlated (r = 0.955; P < .001), with a mean difference of 0.2 diopter. Conclusions: The results show that measurements for IOL calculation are easy and precise with the optical method. It is a noncontact method, so no anesthesia is needed and there is no risk of infection. (C) 2003 ASCRS and ESCRS.