title: Reproducibility of digital image analysis for measuring corneal haze after myopic photorefractive keratectomy.
abstract: OBJECTIVE
  To evaluate the usefulness of digital image analysis for quantifying corneal haze by determining the reproducibility of its measurements at the corneal plane.
  
  
  METHODS
  In a prospective study, 20 randomly selected eyes that had undergone myopic photorefractive keratectomy were photographed focusing the slit beam on their anterior corneal surface. Each photograph was examined using computer image analysis techniques that detect the edge of the reticular pattern of the image. Quantification of the difference between two areas, treated and adjacent untreated cornea, each containing 3,750 pixels with a resolution of 256 gray levels, was performed. Intra-analyzer variation was determined by evaluating the photographs obtained by two analyzers under standard conditions on four separate visits. Interanalyzer variation was calculated using one measurement and the mean of the four measurements.
  
  
  RESULTS
  The pooled standard deviation of the measurements for the analyzers was 0.63 and 0.62 gray levels (coefficient of variation, 4.1% and 3.3%). An association between less severe haze measurements and higher reproducibility scores was found (r = .42; P = .007). The mean interanalyzer variation was smaller for the average of four measurements, 0.55 +/- 0.37 gray levels, than for one measurement, 0.94 +/- 0.73 gray levels (P = .014).
  
  
  CONCLUSIONS
  Good reproducibility for haze measurements by digital image analysis of the differences between the treated and adjacent untreated corneal areas was obtained. When the average of four measurements was used instead of a single measurement, interanalyzer reproducibility increased significantly. This new technique may be used to quantify and analyze corneal haze after myopic photorefractive keratectomy.
authors.affiliation: Department of Ophthalmology, La Fe University Hospital, Valencia, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Maldonado
authors.forename: V
authors.initials: V
authors.lastname: Arnau
authors.forename: R
authors.initials: R
authors.lastname: Martínez-Costa
authors.forename: A
authors.initials: A
authors.lastname: Navea
authors.forename: F M
authors.initials: FM
authors.lastname: Mico
authors.forename: A L
authors.initials: AL
authors.lastname: Cisneros
authors.forename: J L
authors.initials: JL
authors.lastname: Menezo
mesh_terms: D000328:Adult; D003315:Cornea / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications; D011446:Prospective Studies; D015203:Reproducibility of Results