Vergleich der optischen Kohärenzmethode (Zeiss IOL-Master) mit zwei ultrasonographischen Biometrieverfahren zur Kunstlinsenkalkulation nach Phakoemulsifikation im klinischen Alltag

Background: The aim of this work was to investigate the accuracy of prediction of three different biometric methods for the calculation of posterior chamber intraocular lenses. Methods: In 59 consecutive patients who underwent extracapsular cataract-extraction with posterior chamber intraocular lens implantation, we compared the refractive results at the first day (D1) and 6 weeks (W6) after surgery with the calculated refraction of three biometric methods: the Carl Zeiss "IOL-Master 99" (IOLM), the Biovision "Echograph Class 1 - Type B" (BIOV) and the Allergan Humphrey "Ultrasonic Biometer Mod. 820" (AHUB). For statistical calculation box-plots, the Wilcoxon signed-rank test and linear regression analysis were used. Results: In all patients the mean of the postoperative refraction was -0.07 D (SD: 1.41) at day 1 and 0.12 D (SD: 1.18) at week 6. Compared to the postoperative refraction at week 6, the calculated refractive values were higher in all three measuring devices: IOLM: +0.28 D (SD: 0.67), BIOV: +0.60 D (SD: 0.88), AHUB: + 0.26 D (SD: 0.92). There were no statistically significant differences between IOLM and BIOV, or respectively, AHUB and BIOV (p<0.0001), but a significant difference was found between IOLM and AHUB, (p = 0.906). To adjust for systematic differences of the agreement, one can calculate the postoperative refraction at week 6 (REF6) from IOLM by using the linear regression formula: REF6 = 1.1 × IOLM + 0.3. Conclusion: A comparison between the three biometric methods and the refractive results at day 1 and week 6 after cataract surgery with implantation of a posterior chamber intraocular lens showed that the calculated mean values obtained from the three biometric methods are higher than the real postoperative refraction. Calculations using the Zeiss IOL-Master and the Allergan Humphrey Ultrasonic Biometer are closer to the patient's postoperative refraction than calculations using the Biovision Echograph.