Assessment of a new averaging algorithm to increase the sensitivity of axial eye length measurement with optical biometry in eyes with dense cataract

PurposeTo assess the capability of new software to decrease the proportion of eyes that have insufficient signal-to-noise ratio (SNR) in optical biometry.SettingMoorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.DesignEvaluation of diagnostic test or technology.MethodsIn a prospective study, consecutive cataract patients coming for biometry who were unsuccessfully measured with the former software (version 4) of the IOLMaster partial coherence interferometry (PCI) device were reevaluated with the new composite software (version 5). Subsequently, in a retrospective study, consecutive cataract patients were measured with software version 5. For unsuccessful scans, the type and intensity of cataract were assessed at the slitlamp.ResultsAltogether, 2713 eyes (1956 patients) were included in the study. The prospective study comprised 458 eyes (244 patients), 10.6% of which could not be measured successfully with software version 4. With the composite software, 30% of cases were measured successfully, with a higher proportion (42%) in the posterior subcapsular cataract subgroup. In the retrospective study, of 2255 eyes (1712 patients), 4.7% were not measured successfully using the new algorithm because of white cataract (70 eyes), posterior subcapsular cataract (14 eyes), or dense nuclear cataract combined with posterior subcapsular cataract (13 eyes) or for other reasons (8 eyes).ConclusionThe composite software (version 5) enhanced the SNR, allowing valid measurements in eyes in which optical biometry had previously failed, especially in cases of posterior subcapsular cataract.Financial DisclosureNo author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes.