[Comparison of optical and ultrasound biometry and assessment of using both methods in practice].

Purpose: The present study compares accuracy of optical biometry (OB) and ultrasound biometry (UB) based on postoperative best corrected visual acuity (BCVA) results, and assesses the extent of the usage of the measurement methods in current practice.

Methods: 335 eyes in total were operated for cataract at Beskydské oční centrum (Beskydy Eye Centre; BOC), Frýdek-Místek hospital, in the period between 7 February 2007 and 7 April 2010. All patients were examined using both IOL-Master and Ocu-Scan prior to the surgery. All surgeries were performed using microcoaxial phacoemulsification, 2,2 mm incision, implanting IOL AcrySof SP, SPN or SPN IQ. BCVA was examined three months after the surgery. We first calculated medians of anterior-posterior axial length (AL) values measured using both methods; with both the whole set and individual subsets created according to the eye length. Difference between the two methods was calculated in mm. We calculated accurate dioptric power of the IOL, which should have been implanted in the lens bag to ensure postoperative emmetropia, using BCVA results. With each eye, we determined the size of diopter variation of the IOLs dioptric power value for emmetropia determined by an optical biometer from the accurate value of the IOLs dioptric power. Ultrasound biometry results were processed in the same way. The SRK-T formula was used for calculation with each biometry. We also calculated the number of variations above 1 D and 2 D with both biometric methods.

Results: The median of axial eye length measured using an optical biometer was 23,08 mm, and the median of axial eye length measured using ultrasound biometry was 22,93 mm. The difference between these values was 0,15 mm (150 microns), which equals the difference between average values of coincident measurement results. Average variation of dioptric power of an implanted IOL from retrospectively established optimum value of the IOLs optical power was 0,40 D lower with optical biometry and 0,16 D lower with ultrasound biometry. In the context of assessing the course of the curves of both methods created using a polynomial graph, this result confirms that the two methods correspond significantly, and therefore selecting any of the methods could not negatively impact determination of the implanted IOLs dioptric power. Comparing the frequency of variations above 1D and 2,0 D with OB and UB from the accurate value of the IOLs dioptric power, we discovered a substantially higher percentage of variations with UB - up to 25 % of the total set above 1,0 D.

Conclusion: RESULTS of comparing accuracy and comfort of AL measurement with both methods justify unambiguous preference of optical biometry over ultrasound biometry in current practice. If measurement using ultrasound probe is done correctly, results of both methods correspond significantly, and so the methods are mutually replaceable. Using ultrasound biometry is therefore adequate in case optical biometry cannot be used.