Purpose: To compare central topography (CT) from IOLMaster 700 with predicate topographic (PT) maps from a Placido disk-dual Scheimpflug tomographer in detection of irregularities that would influence the decision-making for implanting premium intraocular lenses (IOLs) (toric, multifocal, or extended depth-of-focus).
Setting: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
Design: Prospective comparative case series.
Methods: Eyes with various corneal conditions were randomly selected: regular/irregular corneas, previous corneal refractive surgery, and keratoconus or pellucid marginal degeneration. Three observers compared the CT and PT maps and answered a questionnaire for each eye. The questionnaire focused on (1) overall shape similarity between CT and PT and (2) decision-making for premium IOL implantation based on CT and PT. Answers to the questionnaire and agreement in answers among observers were evaluated.
Results: The study included 105 eyes. Comparing CT and PT, similar shape was observed in 68.6% to 89.5% of cases, and comparable map symmetries were reported in 60.0% to 83.8%; the same decision regarding premium IOL implantation was made in 75.2% to 97.1% of cases. There were significant interobserver agreements among 3 observers for all questions, with Fleiss κ values ranging from 0.141 to 0.450 (all P < .05). Peripheral corneal steeping or flattening was the primary finding that was visible on PT but not on CT.
Conclusions: Compared with the PT, CT provided similar overall shape and comparable symmetries in most cases. The same decision was made whether to recommend a premium IOL based on CT and PT in 75% to 97% of cases.
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