Influence of measurement differences of anterior chamber depth and axial length on lens thickness evaluation in cataract patients: a comparison of two tests

BACKGROUND: The purpose of this study was to investigate the agreement of lens thickness (LT) measurements made by contact A-scan ultrasonography and Lenstar LS900 as well as the influence of anterior chamber depth (ACD) and axial length (AL) measurement differences on LT measurement in cataract patients in the two techniques. METHODS: 1247 cataract patients (1247 eyes) participated in this retrospective cross-sectional study. Ocular biometric measurements were performed with Lenstar LS900 and A-scan ultrasonography respectively, and the measured results of AL, ACD and LT were compared using Pearson correlation coefficients (r) and Bland-Altman analyses. RESULTS: Bland-Altman analyses showed poor agreement between the A-scan ultrasonography and Lenstar LS900 in measuring AL and ACD. The average difference of LT was 0.01 mm; the consistency limit was − 0.86 mm, 0.88 mm; and 95.27% of datapoints were within the 95% consistency limit. The consistency of LT measurements between the two techniques was poor for those subjects whose ACD or AL values were beyond the 95% consistency limit. Among the subjects whose AL or ACD values measured by A-scan ultrasonography were greater than those measured by Lenstar LS900, 93.33% of them were within the 95% consistency limit, suggesting that the consistency of LT measurement between the two techniques was poor. Of patients whose ACD or AL measured by A-scan ultrasonography were smaller than that of Lenstar LS900, 96.01% of them were within the 95% consistency limit. CONCLUSIONS: There was good agreement of the LT measurements between A-scan ultrasonography and Lenstar LS900, except for the axis deviating from the apparent axis during A-scan ultrasonography. If this error can be avoided, A-scan ultrasonography can replace Lenstar LS900 in LT measurement in cataract patients.