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Automated digital analysis of intraoperative keratoscopy and its correlation with postoperative astigmatism after big-bubble deep anterior lamellar keratoplasty

  • Cornea
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Abstract

Purpose

To investigate the correlation between postoperative corneal astigmatism (PCA) and values of intraoperative keratoscopy analyzed with a newly developed automated technique in patients undergoing big-bubble (BB) deep anterior lamellar keratoplasty (DALK).

Methods

Photographs of keratoscope rings taken at the end of BB-DALK were analyzed using ImageJ for the calculation of “roundness” (R): values = 1 indicate a perfect circle. Pearson’s correlation was used to evaluate the relationship between R and PCA that measured 1 week (V1), 3 months (V2), and 18 months (V3), postoperatively. The area under the curve (AUC) of receiver operating characteristic (ROC) curve was used to evaluate the accuracy of R for identifying patients with PCA < 3 diopters (D). The point on the ROC curve nearest to the coordinate (0,100) was used as a cutoff to determine sensitivity and specificity.

Results

Data from 121 patients were included. The mean value of R*was 0.93 ± 0.04 (range 0.76–0.99). R showed a significant correlation with PA at V3 (R = − 0.42, P < 0.01). The ROC curve had an AUC of 0.69 (95% CI 0.59–0.79). A cutoff value of R = 0.93 had a sensitivity of 70.3% and specificity of 61.0% for identifying patients with PA < 3D at V3.

Conclusions

This new digital analysis of keratoscope rings allows to identify with reasonably good diagnostic accuracy patients with low values of post-DALK astigmatism correctable with spectacles.

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Authors and Affiliations

  1. Department of Ophthalmology, University Magna Graecia of Catanzaro, Viale Europa, 88100, Germaneto, Catanzaro, Italy

    Giuseppe Giannaccare, Andrea Lucisano, Gianfranco Scuteri & Vincenzo Scorcia

  2. Ophthalmology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    Marco Pellegrini & Federico Bernabei

Authors
  1. Giuseppe Giannaccare
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  2. Andrea Lucisano
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  3. Marco Pellegrini
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  4. Federico Bernabei
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  5. Gianfranco Scuteri
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  6. Vincenzo Scorcia
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Correspondence to Giuseppe Giannaccare.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Comitato Etico Regione Calabria Sezione Area Centro – 280-2019) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Giannaccare, G., Lucisano, A., Pellegrini, M. et al. Automated digital analysis of intraoperative keratoscopy and its correlation with postoperative astigmatism after big-bubble deep anterior lamellar keratoplasty. Graefes Arch Clin Exp Ophthalmol 259, 469–474 (2021). https://doi.org/10.1007/s00417-020-04912-4

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  • DOI: https://doi.org/10.1007/s00417-020-04912-4

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