Comparação entre diferentes equipamentos utilizados na avaliação do paciente para a cirurgia de catarata

• Autor(a) principal: Ventura, Bruna Vieira Oliveira Carvalho [UNIFESP]
• Data de Publicação: 2017
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300002nf42
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5254084; http://repositorio.unifesp.br/handle/11600/50516
• topic: Cataract surgery; Preoperative evaluation; Devices; Cataract; Cirurgia de catarata; Avaliação pré-operatória; Dispositivos; Catarata

Purpose: To compare the measurements obtained by the Cassini, the Atlas 9000 and the Galilei G2 in normal and post-refractive surgery eyes. To evaluate the repeatability of corneal power and astigmatism measurements acquired by the Cassini in normal eyes, comparing it to those of the Atlas 9000 and the Lenstar LS 900. Furthermore, to compare the biometry measurements and intraocular lens (IOL) power calculations obtained by the Galilei G6 and the IOLMaster 500. Methods: Retrospectively, data was collected and compared regarding corneal power, astigmatism and aberrations measured by the Cassini (limited edition), the Atlas 9000 and the Galilei G2 in normal and post-refractive surgery eyes. Prospectively, three consecutive exams were done in normal eyes with the Cassini (version 1), the Atlas 9000 e the Lenstar LS 900. The intraclass correlation coefficient (ICC) and the within-subject standard deviation (Sw) were calculated. Tthe astigmatism was evaluated using vector analysis. In a subsequent study, the following data was compared between the Galilei G6 and the IOLMaster 500: axial length (AL), keratometry (K), anterior chamber depth (ACD) and IOL power calculation to achieve emetropia using a SN60WF Acrysof IOL and the Haigis formula. The 95% limits of agreement (LoA) were calculated. Results: In the retrospective analysis, there was no statistically significant difference between the devices in mean corneal power measured in normal eyes and post-refractive surgery eyes, and in mean astigmatism magnitude in post-refractive surgery eyes (all P > 0.05). In both groups of patients, there was no significant difference in mean coma and spherical aberration amongst the devices (P > 0.05). In the prospective analysis, the Cassini, Atlas 9000 and Lenstar LS 900 attained good repeatability (ICC > 0.9) in corneal power and astigmatism measurements, except for the Atlas 9000 with regards to J45 (ICC = 0.721). The Sw evidenced that the Cassini had a worst repeatability than the Lenstar LS 900 regarding corneal power (P < 0.0001) and than the Lenstar LS 900 (P = 0.0002) and the Atlas 9000 (P = 0.002) regarding astigmatism magnitude. The Galilei G6 and the IOLMaster 500 attained statistically similar mean of AL, K, ACD and IOL power chosen to reach emmetropia (95% LoA: 0.27 mm; 1.08 diopters (D); 0.66 mm, and 1.56 D, respectively). Conclusion: In normal and post-refractive surgery eyes, the Cassini, Atlas 9000 and Galilei G2 obtained similar mean corneal power, astigmatism, coma and spherical aberration. The Cassini presented a good repeatability in corneal power and astigmatism measurements; however, its performance was worse than that of the Lenstar LS 900 for corneal power and of the Lenstar LS 900 and the Atlas 9000 for astigmatism magnitude. The Galilei G6 and the IOLMaster 500 obtained similar mean biometric measurements and mean IOL power chosen to reach emmetropia. However, the wide range of differences amongst the devices suggests they should not be used interchangeably.