The CRW1 Index: Identification of Eyes with Previous Myopic Laser Vision Correction Using Only a Swept-Source OCT Biometer

David L. Cooke, Kamran M. Riaz*, David A. Murphy, Oliver Findl, Achim Langenbucher, David Gu, Surendra Basti, Nathan Cannon, Seth M. Pantanelli, Matthias Bolz, Jascha Wendelstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

PURPOSE: To develop and test a novel index (Cooke−Riaz−Wendelstein [CRW1]) that uses swept-source optical coherence tomography (SS-OCT) biometry measurements (IOLMaster700, Zeiss Meditec), including total keratometry, to alert clinicians that previous myopic laser vision correction (M-LVC) was present in a measured eye. DESIGN: Retrospective, multicenter, comparative diagnostic analysis. METHODS: The study took place at 6 centers in the United States and Austria. Anonymized SS-OCT biometry datasets acquired between 2018 and 2020 and containing 49,199 eyes were analyzed. The LVC status, as identified by the biometrist, was used to segregate eyes into LVC and non-LVC eyes. Data were split into training (10,780 eyes) and validation (38,419 eyes) sets. Subset analysis was performed for CRW1 Index accuracy compared to posterior/anterior corneal curvature ratio (Rpost/Rant), topography with corneal analysis software (Atlas 9000 with Pathfinder II, Zeiss Meditec), tomography (Pentacam, Oculus), dual Scheimpflug−Placido system (Galilei G6, Ziemer), and a cloud-based platform for cataract surgery planning (Veracity, Zeiss Meditec). A positive predictive value (PPV) of ≥90% was targeted for the CRW1 index. True positives, true negatives, sensitivity, and specificity were recorded. RESULTS: The CRW1 Index compared favorably against Rpost/Rant showing a higher PPV (93% vs 65%), with fewer false-positive results (29 vs 180). CRW1 performed similarly to topography software and better than the corneal imaging devices. The CRW1 cutoff value can be adjusted to increase sensitivity (CRW1-IS) to detect additional M-LVC eyes. CONCLUSIONS: The CRW1 and CRW1-IS indices offer surgeons and researchers a readily accessible method to use only SS-OCT biometry measurements to detect eyes with a high probability of previous M-LVC.

Original languageEnglish (US)
Pages (from-to)79-87
Number of pages9
JournalAmerican journal of ophthalmology
Volume247
DOIs
StatePublished - Mar 2023

Funding

Funding/Support: This study received no funding. Financial Disclosures: K.M.R. reports consulting fees from Ambrx Pharmaceuticals and ImmunoGen and personal fees from Bausch and Lomb and CorneaGen outside the submitted work. O.F. is a scientific advisor to Alcon, BVI, Carl Zeiss Meditec AG, Croma, and Johnson & Johnson. A.L. reports personal fees from Hoya Surgical and Johnson & Johnson Vision outside the submitted work. He has no consulting function in any of the companies as mentioned above. S.B. is a consultant for Johnson & Johnson Vision. S.M.P. is a consultant for Carl Zeiss Meditec. M.B. reports personal fees from Carl Zeiss Meditec AG outside the submitted work. He has no consulting function in any of the companies as mentioned above. J.W. reports personal fees from Carl Zeiss Meditec AG, Alcon Surgical, Rayner Surgical, and Johnson & Johnson Vision outside the submitted work. He has no consulting function in any of the companies as mentioned above. None of the other authors report any financial disclosures about the data, results, conclusions, drugs, and devices mentioned in the manuscript. All authors attest that they meet the current ICMJE criteria for authorship. Acknowledgments: The authors acknowledge Jaime Rodriguez, ultrasound/photography technician, DMEI; and Manuel Ruiß, Orthoptist, VIROS/Hanusch Hospital.

ASJC Scopus subject areas

  • Ophthalmology

Fingerprint

Dive into the research topics of 'The CRW1 Index: Identification of Eyes with Previous Myopic Laser Vision Correction Using Only a Swept-Source OCT Biometer'. Together they form a unique fingerprint.

Cite this