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Purpose: To calculate the keratometric (K) reading in corneas modified by myopic keratorefractive surgery using the total corneal refractive power (TCRP) of the Pentacam rotating Scheimpflug camera., Setting: University hospitals and private clinics, South Korea, Design: Evaluation of diagnostic test or technology., Methods: The study comprised healthy eyes, eyes having myopic keratorefractive surgery, and eyes having cataract surgery after myopic keratorefractive surgery. The conversion equation from the TCRP in the central 4.0 mm zone (TCRP4) to a K reading was derived in normal corneas. This equation was rechecked and its application range extended in corneas modified by myopic keratorefractive surgery. Then, the predictability of the TCRP method, combining the K reading derived from the TCRP4 and the Holladay 2 formula, was evaluated in a case series of cataract surgery patients who had previous myopic keratorefractive surgery., Results: The K reading derived from the TCRP4 was obtained by adding 0.7 diopter (D). This conversion factor was applicable after myopic keratorefractive surgery because changes in TCRP4 were equal to changes in refraction in the 4.0 mm zone. The TCRP method predicted intraocular lens power within ± 0.5 D in 83% and within ± 1.0 D in 94% of eyes having cataract surgery after myopic keratorefractive surgery., Conclusion: The TCRP4 of the rotating Scheimpflug camera was successfully converted into the equivalent K reading, and the TCRP method showed good predictability in corneas modified by myopic keratorefractive surgery., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: The aim of this study was to predict the mean corneal power change preoperatively for simultaneous pterygium excision and cataract extraction., Methods: This study was performed in 2 stages. First, 66 eyes undergoing pterygium excision were recruited, and the subjects were divided into 2 groups based on a pterygium length of 2.0 mm (group 1: <2.0 mm, group 2: ≥2.0 mm). Keratometric values (K) were measured before, 1 month after, and 3 months after surgery. Multiple regression analyses were used to predict the postoperative mean K using preoperative K and morphological factors that significantly affect corneal power change. In the second stage, the regression equation was applied to 50 eyes (23 with pterygium <2.0 mm and 27 with pterygium ≥2.0 mm) in several clinics. Prediction accuracy was graded based on the difference between the calculated mean K and the postoperative mean K., Results: In group 1, the mean Ks did not change significantly after the surgery, and therefore, the predicted mean K was not statistically different from the preoperative mean K. In group 2, the horizontal and mean Ks steepened significantly, and the regression analysis predicted the mean K within the range of 0.5 diopter difference in 22 of 31 eyes, showing a better approximation compared with the preoperative mean K (P < 0.001). The prediction accuracy was verified similarly in other clinics, and the regression analysis was useful for pterygium exceeding a length of 2.0 mm., Conclusions: Pterygium exceeding a length of 2.0 mm induced a significant corneal power change after surgery. The mean K predicted from the regression analysis could be used as an approximation for a simultaneous pterygium and cataract surgery.

Objective: To compare the reliability and the agreement in measuring central corneal thickness (CCT) using the following technologies: RTVue Fourier-domain optical coherence tomography (Optovue, Inc., Fremont, CA), Pentacam (Oculus, Inc., Wetzlar, Germany), and ultrasonic pachymetry (USP; Pocket-II; Quantel Medical, Inc., Bozeman, MT)., Design: Evaluation of diagnostic test., Participants: One hundred four eyes of 52 healthy subjects (mean age ± standard deviation, 28.6 ± 4.8 years)., Methods: One eye from each subject was assigned randomly for a repeatability test in which a single operator performed 3 successive measurements. The other eye underwent an interoperator reproducibility test by 3 operators. Two centering methods of RTVue and 3 types of CCT from Pentacam were investigated. For USP, 1 drop of topical anesthetic was administered, and measurement was initiated 90 seconds later. Agreement among the instruments was evaluated using Bland-Altman plots., Main Outcome Measures: Various types of CCT were compared: central zone average and minimum thickness of RTVue centering on the vertex and the pupil; corneal thickness at the pupil center, apex, and thinnest location from Pentacam; and mean CCT of 5 repeated measurements of USP. The reliability of measurement was assessed using the repeatability or reproducibility coefficient (Rco), the coefficient of variation, and the intraclass correlation coefficient. The limit of agreement was used to analyze concordance., Results: The Rco of RTVue was 4 to 5 μm, which was comparable with that of USP and better than that of Pentacam (10-11 μm). The Rco was not dependent on centering methods (RTVue) or types of CCT (Pentacam). The location of minimum thickness found by RTVue was less reliable than that of the Pentacam. The central zone average of RTVue was approximately 7 μm larger than the pupil center or apex thickness of Pentacam and approximately 13 μm larger than the CCT measurement of USP. Those discrepancies could be as high as 20 and 23 μm, respectively. The minimum thickness measured by the RTVue was similar to that of Pentacam., Conclusions: The RTVue is a rapid and reliable noncontact means of measuring CCT; however, the characteristics of CCT measured by RTVue must be understood when comparing the CCT obtained by the Pentacam or USP., Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article., (Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)