Yuhas Phillip T, Fortman Maddison M, Nye Michael, Mahmoud Ashraf M, Roberts Cynthia J
College of Optometry, The Ohio State University, Columbus, OH, United States.
Department of Ophthalmology and Visual Sciences, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
Front Med (Lausanne). 2025 Jul 24;12:1605641. doi: 10.3389/fmed.2025.1605641. eCollection 2025.
This study evaluated the agreement between a third-generation (G3) ocular response analyzer (ORA) and a first-generation (G1) ORA, and tested the ability of the keratoconus match index (KMI) to identify keratoconus.
Healthy participants ( = 149 eyes) and participants with keratoconus ( = 78 eyes) were enrolled for this study. Four measurements were taken bilaterally using the G1 and G3 ORA. Goldmann-correlated intraocular pressure (IOPg), corneal-compensated IOP (IOPcc), corneal hysteresis (CH), waveform score, KMI, and waveform parameters area under the first applanation peak (p1area), area under the second applanation peak (p2area), width of the first applanation peak (w1), width of the second applanation peak (w2), height of the first applanation peak (h1), and height of the second applanation peak (h2) were recorded from the measurement with the highest waveform score in the left eye. Paired -tests or Wilcoxon signed-rank tests were used to assess agreement between the devices, and receiver-operating characteristic curves determined the ability of KMI to identify eyes with keratoconus.
There was no difference in IOPcc or IOPg between the devices in both cohorts. CH was significantly greater for the G3 than for the G1 in healthy participants but not in keratoconus participants. For both cohorts, measurements of waveform score, KMI, p1area, p2area, w2, h1, and h2 were greater for the G3 than for the G1. Only w1 was smaller for the G3 than for the G1. There was no difference in the ability of KMI to differentiate ectatic from healthy eyes between the devices.
Although the G1 and G3 can identify keratoconus using KMI, there is meaningful variation between them in IOP and biomechanical outcome parameters. Thus, clinicians and researchers should compare results between the devices with caution and should state which generation produced the data.
本研究评估了第三代（G3）眼反应分析仪（ORA）与第一代（G1）ORA之间的一致性，并测试了圆锥角膜匹配指数（KMI）识别圆锥角膜的能力。
本研究纳入了健康参与者（149只眼）和圆锥角膜患者（78只眼）。使用G1和G3 ORA对双侧进行了四项测量。记录了与Goldmann相关的眼内压（IOPg）、角膜补偿眼内压（IOPcc）、角膜滞后（CH）、波形评分、KMI以及第一个压平峰下的波形参数面积（p1area）、第二个压平峰下的波形参数面积（p2area）、第一个压平峰的宽度（w1）、第二个压平峰的宽度（w2）、第一个压平峰的高度（h1）和第二个压平峰的高度（h2），这些数据来自左眼波形评分最高的测量结果。采用配对t检验或Wilcoxon符号秩检验来评估两台设备之间的一致性，通过受试者操作特征曲线确定KMI识别圆锥角膜眼的能力。
在两个队列中，两台设备的IOPcc或IOPg均无差异。在健康参与者中，G3的CH显著高于G1，但在圆锥角膜参与者中并非如此。对于两个队列，G3的波形评分、KMI、p1area、p2area、w2、h1和h2测量值均高于G1。只有w1，G3比G1小。两台设备在KMI区分扩张性眼与健康眼的能力上没有差异。
虽然G1和G3可以使用KMI识别圆锥角膜，但它们在眼内压和生物力学结果参数方面存在有意义的差异。因此，临床医生和研究人员在比较两台设备的结果时应谨慎，并应说明数据是由哪一代设备产生的。
