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Improvements to Phakometry Using Bessel Beams

Suheimat, Marwan PhD1; Bhattarai, Dipesh MPH, BOptom1; Maher, Hannah K. MOptom, BVisSc1; Chandra, Meera MOptom, BVisSc1; Chelepy, William MOptom, BVisSc1; Halloran, Sarah K. MOptom, BVisSc1; Lambert, Andrew J. PhD2; Atchison, David A. DSc1*

doi: 10.1097/OPX.0000000000001130
Original Investigations

SIGNIFICANCE The main problem with phakometry is the low visibility of the third Purkinje image. We built a phakometer using Bessel beams, which have properties of being resistant to diffraction and the potential for self-reconstruction. This instrument had lenticular images three times brighter than those of a conventional phakometer.

PURPOSE To investigate Purkinje image brightness, accuracy, and repeatability of a “Bessel” phakometer compared with those of a conventional phakometer.

METHODS Phakometers were developed with a telecentric imaging system focused at the pupil plane of the eye to capture anterior cornea, anterior lens (PIII), and posterior lens (PIV) Purkinje images. A Bessel beam was generated by a diode laser beam passing through a high-powered doublet with a central obstruction. Software was used to determine image sizes and estimate lens anterior and posterior surface radii of curvature (R a, R p), equivalent refractive index (RI), and equivalent power (F). The Bessel phakometer's accuracy was assessed using a model eye. Repeatability (interobserver and intraobserver) and Purkinje images brightnesses of Bessel and conventional phakometers were assessed with six participants.

RESULTS The lens parameters of the model eye determined by the Bessel phakometer were similar to those provided by the model eye's manufacturer with differences (manufacturer − Bessel) in R a and R p, RI, and F of +1.18 mm, 0.18 mm, +0.0053, and −0.55 D, respectively. The intraobserver repeatabilities for the Bessel and conventional phakometers were similar. The interobserver repeatabilities of R a, R p, and RI for the Bessel phakometer were almost half those (i.e., two times better) for the conventional phakometer. Brightnesses of PIII and PIV were approximately three times higher with the Bessel phakometer than with the conventional phakometer.

CONCLUSIONS The Bessel beam phakometer provided accurate estimates of lens parameters of a model eye and produced brighter Purkinje images and better interobserver repeatability than that of a conventional phakometer.

Supplemental digital content is available in the text.

1School of Optometry & Vision Science and Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia

2School of Engineering and Information Technology, University of New South Wales, Canberra, Australian Capital Territory, Australia.*

Supplemental Digital Content: The Appendix, a technical description of Bessel beam formation and an explanation of their properties, is available at

Submitted: February 13, 2017

Accepted: July 11, 2017

Funding/Support: This research was supported by Australian Research Council Discovery grant DP140101480.

Conflict of Interest Disclosure: None of the authors have reported a conflict of interest.

Author Contributions: Conceptualization, Investigation, Methodology, Supervision, Writing – Original Draft, and Writing – Review & Editing: MS; Methodology, Writing – Original Draft, Writing – Review & Editing: DB; Formal Analysis, Investigation, and Methodology: HKM, WC, MC, SKH; Conceptualization, Funding Acquisition, and Writing – Original Draft: AJL; Conceptualization, Funding Acquisition, Investigation, Project Administration, Resources, Supervision, Writing – Original Draft, and Writing – Review & Editing: DAA.

© 2017 American Academy of Optometry