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• W4292183630 abstract "We read with great interest the article by Hienert et al. concerning the possibility to make intraoperative aphakic eye axial length (AL) measurements using IOLMaster 700, a biometer that uses swept-source optical coherence tomography (SS-OCT) technology.1 This is a very interesting study because this technique could replace the need to execute ultrasound (US) biometry in cases of dense cataract, which are more difficult to perform and need more skill. However, we aslo make some comments here that could help us to understand their findings. The authors stated that intraoperative SS-OCT measurements were performed at 3 different timepoints: in the phakic, aphakic, and pseudophakic states. The authors forgot to mention if, for these purposes, the machine was set in a different way, namely phakic, aphakic, and pseudophakic modes, even if we could assume it. The authors found a mean AL difference of −0.13 mm between the phakic and aphakic measurements, and they suggested that this difference could have been related either to a slight error in fixation during the measurement or to slight corneal swelling, caused by the phacoemulsification. In our opinion, a different reason could explain this finding. According to data presented in Table 1, the aphakic measurements were smaller than the preoperative ones, but in the case of corneal swelling an AL increase should have been expected. Moreover, these findings are similar to those in a previously published paper by De Bernardo et al.2 In this study, a comparable AL decrease (−0.10 mm) was found between measurements obtained before and after cataract surgery.2 This finding seems to be related to the group refractive index, which in the preoperative measurements could introduce mistakes, while in the postoperative ones should be more precise due to the intraocular lens refractive index. A different problem is present in cases of corneal refractive surgery where the decrease seems to be real.2 The authors stated that they measured the intraoperative pseudophakic AL, but no data have been reported in the paper.1 It is a pity because this could have given us a very important information on the reliability of such a measurement, comparing the intraoperative and postoperative pseudophakic measurements. Finally, the authors stated that US measurements have been shown to be inferior to optical biometry and will result in poorer refractive outcomes, supporting this statement with 3 studies.1 Unfortunately, one of these papers evaluated US-AL through the contact technique that today is discouraged because of repeatability and accuracy problems.3,4 The second study is limited to the pediatric population, and the third study did not specify which lens constants were used with the SRK/T formula: If ULIB constants without any modifications were used for both optical and echographic measurements, instead of US constants, the results could not be comparable.5" @default.
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• W4292183630 date "2022-10-01" @default.
• W4292183630 modified "2023-10-14" @default.
• W4292183630 title "Comment on: Evaluation of intraoperative aphakic eye axial length measurements using swept-source OCT" @default.
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• W4292183630 doi "https://doi.org/10.1097/j.jcrs.0000000000001034" @default.
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