title: A comparison of in-air and in-saline focimeter measurement of the back vertex power of spherical soft contact lenses.
abstract: OBJECTIVE
  To compare the repeatability and validity of measurements of the back vertex power (BVP) of spherical soft contact lenses made in-air using the method specified in the International Standard (ISO 18369-3:2006) with the corresponding values when BVP was calculated from measurements made using a wet cell and focimeter method that is not approved by this Standard.
  
  
  METHODS
  The BVP of 20 hydrogel and 20 silicone hydrogel lenses, with labelled powers ranging from +8.00 to -12.00 D, were measured with a focimeter by two operators on two occasions in-air in accordance with the relevant International Standard. Equivalent sets of measurements were made with the lenses immersed in-saline within a wet cell and their BVPs in-air were calculated. The validity of each method was assessed by comparing their results with an instrument that used the Hartmann method.
  
  
  RESULTS
  The reliability results were generally a little better for the in-saline measurements than for the in-air measurements, although all reliability data demonstrated absolute values of mean errors (inter-operator and inter-session) that were <0.05 D for hydrogel lenses and <0.07 D for silicone hydrogel lenses. The in-air 95% confidence intervals were <0.45 D and <0.40 D for hydrogel and silicone hydrogel lenses, respectively and in-saline <0.39 and <0.31 D for hydrogel and silicone hydrogel lenses, respectively. The validity data revealed a relationship between measurement error and BVP for the in-air data (the focimeter overestimates the power of high plus and high minus lenses compared with the Hartmann instrument) and possibly a more complex relationship for the in-saline data. The 95% limits of agreement indicate better agreement for the in-saline validity data (-0.55 to +0.48 D for hydrogel lenses and -0.42 to +0.54 D for silicone hydrogel lenses) than those obtained in-air (-0.64 to +0.68 D for hydrogel lenses and -0.57 to +0.44 D for silicone hydrogel lenses).
  
  
  CONCLUSIONS
  Using equipment readily available in a clinical setting, the wet cell method of measurement of the BVP of spherical soft contact lenses has been shown to provide results for reliability and validity that were at least as good as those obtained with the in-air method approved by the International Standard.
authors.affiliation: Department of Optometry & Visual Science, City University, London, UK. rpearson@contacts.fsnet.co.uk
authors.forename: Richard M
authors.initials: RM
authors.lastname: Pearson
authors.forename: Bruce J W
authors.initials: BJ
authors.lastname: Evans
mesh_terms: D000065:Accommodation, Ocular; D000388:Air; D003263:Contact Lenses, Hydrophilic / Q000592:standards*; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D015588:Observer Variation; D012029:Refraction, Ocular; D012031:Refractometry; D015203:Reproducibility of Results; D012462:Saline Solution, Hypertonic; D012828:Silicones
chemical_list: D012462:Saline Solution, Hypertonic; D012828:Silicones; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate