RESUMEN
PURPOSE: To use a combination of partial least squares regression and a machine learning approach to predict intraocular lens (IOL) tilt using preoperative biometry data. SETTING: Kepler University Clinic Linz, Linz, Austria. DESIGN: Prospective single-center study. METHODS: Optical coherence tomography, autorefraction, and subjective refraction were performed at baseline and 8 weeks after cataract surgery. In analysis I, only 1 eye per patient was included and a tilt prediction model was generated. In analysis II, a pairwise comparison between right and left eyes was performed. RESULTS: In analysis I, 50 eyes of 50 patients were analyzed. Difference in amount, orientation, and vector from preoperative to postoperative lens tilt was -0.13 degrees, 2.14 degrees, and 1.20 degrees, respectively. A high predictive power (variable importance for projection [VIP]) for postoperative tilt prediction was found for preoperative tilt (VIP = 2.2), pupil decentration (VIP = 1.5), lens thickness (VIP = 1.1), axial eye length (VIP = 0.9), and preoperative lens decentration (VIP = 0.8). These variables were applied to a machine learning algorithm resulting in an out of bag score of 0.92 degrees. In analysis II, 76 eyes of 38 patients were included. The difference of preoperative to postoperative IOL tilt of right and left eyes of the same individual was statistically relevant. CONCLUSIONS: Postoperative IOL tilt showed excellent predictability using preoperative biometry data and a combination of partial least squares regression and a machine learning algorithm. Preoperative lens tilt, pupil decentration, lens thickness, axial eye length, and preoperative lens decentration were found to be the most relevant parameters for this prediction model.
Asunto(s)
Biometría , Implantación de Lentes Intraoculares , Lentes Intraoculares , Aprendizaje Automático , Facoemulsificación , Refracción Ocular , Tomografía de Coherencia Óptica , Humanos , Estudios Prospectivos , Biometría/métodos , Masculino , Refracción Ocular/fisiología , Femenino , Tomografía de Coherencia Óptica/métodos , Anciano , Persona de Mediana Edad , Migracion de Implante de Lente Artificial/fisiopatología , Seudofaquia/fisiopatología , Agudeza Visual/fisiologíaRESUMEN
Purpose: The purpose of this study was to investigate the diagnostic value of anterior segment optical coherence tomography (AS-OCT) scans for Pseudomonas keratitis. Methods: Patients with treatment-naïve keratitis underwent AS-OCT imaging. The following parameters were evaluated: corneal thickness (CT), infiltrate thickness (IT), infiltrate diameter (ID), tissue loss/gain, entropy, and distance of the lesion from the corneal pupillary center. Three different OCT devices were used for the analysis. The relationship between the detected pathogen and the OCT patterns was analyzed. Results: Nineteen eyes of 19 patients were included in the analysis: seven cases in the Pseudomonas group and 12 cases in the Gram-positive group. The mean (SD) values for the Pseudomonas and Gram-positive groups, respectively, were as follows: CT, 834 µm (165 µm) and 760 µm (120 µm); IT, 290 µm (152 µm) and 287 µm (84 µm); ID, 2067 µm (1470 µm) and 1307 µm (745 µm); distance to center, 3.0 mm (1.2 mm) and 3.0 mm (1.6 mm); epithelial defect, 1193 µm (586 µm) and 484 µm (615 µm); tissue gain, +31% (19%) and +10% (12%); and entropy level, 4.0 (0.8) and 3.9 (1.1). Conclusions: This study introduces novel insights by identifying specific OCT parameters that distinguish Pseudomonas keratitis, including a 30% tissue gain. These findings align with earlier research that underscores the potential of OCT in differentiating various pathogens causing keratitis. Translational Relevance: The findings of this study could be used to develop new diagnostic strategies for Pseudomonas keratitis. The OCT findings could be used to develop new biomarkers for the infection.
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Queratitis , Tomografía de Coherencia Óptica , Humanos , Queratitis/diagnóstico por imagen , Córnea/diagnóstico por imagen , Pseudomonas , PupilaRESUMEN
PURPOSE: To compare the lens tilt after apex-centered capsulotomy with standard pupil-centered capsulotomy. SETTING: Clinical practice. DESIGN: Prospective, randomized, investigator-masked trial. METHODS: This prospective, randomized, investigator masked study included 40 patients with age-related cataract scheduled for femtosecond laser-assisted cataract surgery (FLACS) in both eyes. The main outcome was the tilt of the intraocular lens (IOL), measured with the IOLMaster 700. RESULTS: The study enrolled 80 eyes of 40 patients. The mean distance from the center of the apex-centered capsulotomy to the pupil-centered capsulotomy was 175.8 ± 97.2 µm. The amount of IOL tilt was not significantly reduced with the new technique (P > .05). Tilt orientation was more stable in eyes treated with apex-centered capsulotomy. CONCLUSIONS: Centration of the capsulotomy on the lens apex in FLACS does not influence the amount of IOL tilt but the orientation stability. The clinical importance of this finding has to be further elucidated.