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Reproducibility of intraocular lens decentration and tilt measurement using a clinical Purkinje meter

PURPOSE: To determine the reproducibility of intraocular lens (IOL) decentration and tilt measurements with a new Purkinje meter instrument.

SETTING: Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.

METHODS: After pupil dilation, images of pseudophakic eyes with a plate-style IOL (Akreos Adapt)were obtained using a recently developed Purkinje meter. Intraocular lens decentration and tilt wereevaluated by analyzing the captured images using a semiobjective method by marking the reflexes inthe images and automatic calculation using a dedicated software program. In study 1, examiner 1examined the eyes first followed by examiner 2. Ten minutes later, examiner 1 performeda second measurement, after which the intraexaminer and interexaminer reproducibility weredetermined. In study 2, a Purkinje meter was used to measure pseudophakic eyes with slitlampfinding of clinical IOL decentration, IOL tilt, or both. The results were compared withretroillumination photographs and slitlamp findings.

RESULTS: In study 1, there was high intraexaminer reproducibility for decentration (r Z 0.95) andtilt (r Z 0.85) and high interexaminer reproducibility for decentration (r Z 0.84) and tilt (r Z 0.75).In study 2, even in extreme cases of decentration and/or tilt, the Purkinje meter measurements werepossible and appeared to correlate well with slitlamp findings.

CONCLUSIONS: Acquisition of images in pseudophakic eyes with the Purkinje meter was simpleand rapid. The method was highly reliable for 1 examiner and between 2 examiners.

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