title: Accuracy of intraoperative retinoscopy in corneal power and axial length estimation using a high plus soft contact lens.
abstract: OBJECTIVE
  To assess the accuracy of intraoperative retinoscopy with high plus soft contact lens (CL) in estimating corneal power and the axial length compared with standard keratometry and biometry measurement.
  
  
  METHODS
  Intraoperative retinoscopy was performed in 30 eyes prior to the implantation of an intraocular lens (IOL). A +10 D disposable soft contact lens was applied on the cornea to minimize retinoscopic error. Corneal power was derived from refraction using biometric axial length while the axial length was derived using keratometric measurement. Refraction derived corneal powers and axial lengths from 26 eyes within +/-1.00 D of the target postoperative refraction were compared with preoperative standard keratometry and biometry measurements.
  
  
  RESULTS
  In the 26 eyes, the mean difference between the corneal powers derived from refraction and keratometry was 0.35 D (S.D.=1.678). The 95% limits of agreement were -3.006 to +3.706. The mean difference between the axial lengths derived from refraction and biometry was 0.15 mm (S.D.=0.721). The 95% limits of agreement were -1.292 to 1.542.
  
  
  CONCLUSIONS
  Intraoperative retinoscopy with a high plus soft contact lens after phacoemulsification is useful but not accurate in estimating corneal power or axial length of the eye. It should be used cautiously in IOL power calculation as a substitute for standard keratometry or biometry machines when either of these is not available or in error.
authors.affiliation: Department of Ophthalmology and Optometry, Wycombe Hospital, Queen Alexandra Road, High Wycombe, HP11 2TT, UK.
authors.forename: I
authors.initials: I
authors.lastname: Ahmed
authors.forename: A
authors.initials: A
authors.lastname: Toufeeq
mesh_terms: D000368:Aged; D001699:Biometry / Q000379:methods; D003263:Contact Lenses, Hydrophilic; D003315:Cornea / Q000473:pathology / Q000503:physiopathology*; D019781:Corneal Topography / Q000379:methods; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D018918:Phacoemulsification; D011474:Prosthesis Design; D012029:Refraction, Ocular; D042262:Retinoscopy / Q000379:methods*