{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:18:14Z","timestamp":1790007494013,"version":"4.0.1"},"reference-count":37,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T00:00:00Z","timestamp":1730160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>The determination of sulcus-to-sulcus measurements has been challenging due to the limitations of current approaches. Ultrasound methods are highly operator-dependent and require extensive training, while traditional optical devices cannot visualize structures posterior to the iris. However, modern optical anterior segment coherence tomography (AS-OCT) devices are changing this paradigm by identifying some anatomical landmarks posterior to the iris. This study evaluates the reproducibility of optical sulcus measurements in the context of sizing a novel accommodative intraocular lens (IOL). Preoperative OCT scans of patients scheduled for cataract surgery were analyzed regarding the dimensions of the ciliary sulcus using a custom scan method with a clinically available anterior segment optical coherence tomographer. Measurements were compared between two different readers, and various derived parameters were compared. The measurements by both readers were highly correlated (R2 &gt; 0.96), and their agreement was excellent (mean difference 0.02 mm with 95% limits of agreement from \u22120.11 to 0.15 mm). In contrast, the sulcus diameter measurement did not agree well with automatically calculated values, such as the anterior chamber width or white-to-white. This leads to the conclusion that modern swept-source AS-OCT measurements of the ciliary sulcus dimensions are feasible, reproducible, and may be a clinically useful tool.<\/jats:p>","DOI":"10.3390\/s24216950","type":"journal-article","created":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T13:21:39Z","timestamp":1730208099000},"page":"6950","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Direct Measurement of the Ciliary Sulcus Diameter Using Optical Coherence Tomography\u2014Inter-Rater Variability"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0661-6239","authenticated-orcid":false,"given":"Timo","family":"Eppig","sequence":"first","affiliation":[{"name":"Institute of Experimental Ophthalmology, Saarland University, 66421 Homburg, Germany"},{"name":"AMIPLANT GmbH, 91220 Schnaittach, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Seer","sequence":"additional","affiliation":[{"name":"AMIPLANT GmbH, 91220 Schnaittach, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Martinez-Abad","sequence":"additional","affiliation":[{"name":"Vissum Grupo Miranza, 03016 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4587-5364","authenticated-orcid":false,"given":"Virgilio","family":"Galvis","sequence":"additional","affiliation":[{"name":"Centro Oftalmologico Virgilio Galvis, Floridablanca 681004, Colombia"},{"name":"Department of Ophthalmology, Faculty of Health, Universidad Aut\u00f3noma de Bucamaranga (UNAB), Bucamaranga 680002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"Sch\u00fctz","sequence":"additional","affiliation":[{"name":"AMIPLANT GmbH, 91220 Schnaittach, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5081-0720","authenticated-orcid":false,"given":"Alejandro","family":"Tello","sequence":"additional","affiliation":[{"name":"Centro Oftalmologico Virgilio Galvis, Floridablanca 681004, Colombia"},{"name":"Department of Ophthalmology, Faculty of Health, Universidad Aut\u00f3noma de Bucamaranga (UNAB), Bucamaranga 680002, Colombia"},{"name":"Department of Surgery, Faculty of Health, Universidad Industrial de Santander (UIS), Bucamaranga 680002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel C.","family":"Rombach","sequence":"additional","affiliation":[{"name":"AKKOLENS International b.v., 4836 BA Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8082-1751","authenticated-orcid":false,"given":"Jorge L.","family":"Ali\u00f3","sequence":"additional","affiliation":[{"name":"Vissum Grupo Miranza, 03016 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1097\/ICU.0000000000001018","article-title":"A review of posterior chamber phakic intraocular lenses","volume":"35","author":"Reinstein","year":"2024","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.2147\/OPTH.S456397","article-title":"Implantable Collamer Lens Procedure Planning: A Review of Global Approaches","volume":"18","author":"Thompson","year":"2024","journal-title":"Clin. Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.ajo.2017.10.033","article-title":"Impacts of Implantable Collamer Lens V4c Placement on Angle Measurements Made by Optical Coherence Tomography: Two-Year Follow-up","volume":"186","author":"Galvis","year":"2018","journal-title":"Am. J. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.ajo.2017.12.015","article-title":"Implantable Collamer Lens Sizing Method Based on Swept-Source Anterior Segment Optical Coherence Tomography","volume":"187","author":"Nakamura","year":"2018","journal-title":"Am. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1016\/j.jcrs.2014.12.051","article-title":"Posterior chamber phakic intraocular lens sizing based on iris pigment layer measurements by anterior segment optical coherence tomography","volume":"41","author":"Malyugin","year":"2015","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.ajo.2011.06.031","article-title":"Optimization of an implantable collamer lens sizing method using high-frequency ultrasound biomicroscopy","volume":"153","author":"Kojima","year":"2012","journal-title":"Am. J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/j.jcrs.2019.02.020","article-title":"Predictability of the vault after posterior chamber phakic intraocular lens implantation using anterior segment optical coherence tomography","volume":"45","author":"Igarashi","year":"2019","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1007\/s10792-018-0859-5","article-title":"A model for predicting sulcus-to-sulcus diameter in posterior chamber phakic intraocular lens candidates: Correlation between ocular biometric parameters","volume":"39","author":"Ghoreishi","year":"2019","journal-title":"Int. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"272","DOI":"10.3928\/1081597X-20220302-01","article-title":"New Sizing Parameters and Model for Predicting Postoperative Vault for the Implantable Collamer Lens Posterior Chamber Phakic Intraocular Lens","volume":"38","author":"Reinstein","year":"2022","journal-title":"J. Refract. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1097\/j.jcrs.0000000000001304","article-title":"Comparative evaluation of multiple nomograms for predicting postoperative vault after implantable collamer lens surgery","volume":"50","author":"Moshirfar","year":"2024","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kim, T., Kim, S.J., Lee, B.Y., Cho, H.J., Sa, B.G., Ryu, I.H., Kim, J.K., Lee, I.S., Han, E., and Kim, H. (2023). Development of an implantable collamer lens sizing model: A retrospective study using ANTERION swept-source optical coherence tomography and a literature review. BMC Opthalmol., 23.","DOI":"10.1186\/s12886-023-02814-7"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S0886-3350(00)00830-0","article-title":"Predicting sulcus size using ocular measurements","volume":"27","author":"Pop","year":"2001","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/S0181-5512(06)73853-0","article-title":"Assessment of the Quantel Medical 20-Mhz Ultrasound Cinescan in intraocular measurements","volume":"29","author":"Lebaillif","year":"2006","journal-title":"J. Francais Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"185","DOI":"10.3928\/1081597X-20090201-03","article-title":"Correlation of anterior chamber angle and ciliary sulcus diameters with white-to-white corneal diameter in high myopes using artemis VHF digital ultrasound","volume":"25","author":"Reinstein","year":"2009","journal-title":"J. Refract. Surg."},{"key":"ref_15","first-page":"955","article-title":"Accuracy and repeatability of direct ciliary sulcus diameter measurements by full-scale 50-megahertz ultrasound biomicroscopy","volume":"122","author":"Li","year":"2009","journal-title":"Chin. Med. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.jcrs.2007.11.034","article-title":"Correlation between ciliary sulcus diameter measured by 35 MHz ultrasound biomicroscopy and other ocular measurements","volume":"34","author":"Kim","year":"2008","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.joco.2017.11.011","article-title":"Adjustment formulae to improve the correlation of white-to-white measurement with direct measurement of the ciliary sulcus diameter by ultrasound biomicroscopy","volume":"30","author":"Hashemian","year":"2018","journal-title":"J. Curr. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.1016\/j.jcrs.2011.03.048","article-title":"Evaluation of ciliary sulcus diameter using ultrasound biomicroscopy in emmetropic eyes and myopic eyes","volume":"37","author":"Biermann","year":"2011","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.jcrs.2011.01.024","article-title":"Repeatability of the ciliary sulcus-to-sulcus diameter measurement using wide-scanning-field ultrasound biomicroscopy","volume":"37","author":"Yokoyama","year":"2011","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/j.jcrs.2011.12.027","article-title":"Sulcus anatomy and diameter in pseudophakic eyes and correlation with biometric data: Evaluation with a 50 MHz ultrasound biomicroscope","volume":"38","author":"Petermeier","year":"2012","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Wang, H., Zhang, B., Du, W., Sun, Z., Fan, Q., and Pang, C. (2024). The optimization of the vault-predicting formula based on the anterior segment measurements from artemis insight 100. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-64390-0"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1097\/j.jcrs.0000000000001285","article-title":"Evaluation of ciliary body morphology and position of the implantable collamer lens in low-vault eyes using ultrasound biomicroscopy","volume":"49","author":"Yiming","year":"2023","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Li, P., Johnstone, M., and Wang, R.K. (2014). Full anterior segment biometry with extended imaging range spectral domain optical coherence tomography at 1340 nm. J. BioMmed Opt., 19.","DOI":"10.1117\/1.JBO.19.4.046013"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Lanza, M. (2018). Imaging the Cornea, Anterior Chamber, and Lens in Corneal and Refractive Surgery. OCT\u2014Applications in Ophthalmology, InTech.","DOI":"10.5772\/intechopen.74129"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.3928\/1081597X-20091016-08","article-title":"Ciliary sulcus diameter and two anterior chamber parameters measured by optical coherence tomography and VHF ultrasound","volume":"25","author":"Puche","year":"2009","journal-title":"J. Refract. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Dong, J., Yao, J., Chang, S., Kanclerz, P., Khoramnia, R., and Wang, X. (2023). Evaluation of Ocular Diameter Parameters Using Swept-Source Optical Coherence Tomography. Medicina, 59.","DOI":"10.3390\/medicina59050899"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"625","DOI":"10.18240\/ijo.2020.04.15","article-title":"Repeatability and agreement of two anterior segment OCT in myopic patients before implantable collamer lenses implantation","volume":"13","author":"Zhang","year":"2020","journal-title":"Int. J. Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Naujokaitis, T., Auffarth, G.U., \u0141abuz, G., Kessler, L.J., and Khoramnia, R. (2023). Diagnostic Techniques to Increase the Safety of Phakic Intraocular Lenses. Diagnostics, 13.","DOI":"10.3390\/diagnostics13152503"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1097\/ICU.0000000000000870","article-title":"Phakic intraocular lenses: An update and review for the treatment of myopia and myopic astigmatism in the United States","volume":"33","author":"Moshirfar","year":"2022","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"7757","DOI":"10.1364\/OE.14.007757","article-title":"Cubic optical elements for an accommodative intraocular lens","volume":"14","author":"Simonov","year":"2006","journal-title":"Opt. Express"},{"key":"ref_31","unstructured":"Alvarez, L.W. (1967). Two-Element Variable-Power Spherical Lens. (US3305294A)."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"78","DOI":"10.3928\/1081597X-20171205-01","article-title":"Analysis of Accommodative Performance of a New Accommodative Intraocular Lens","volume":"34","author":"Simonov","year":"2018","journal-title":"J. Refract. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"5100","DOI":"10.1364\/BOE.9.005100","article-title":"Ciliary muscle thickness profiles derived from optical coherence tomography images","volume":"9","author":"Wagner","year":"2018","journal-title":"BioMed Opt. Express"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"109","DOI":"10.4103\/ijo.IJO_1779_22","article-title":"Iridociliary measurements using the Anterion swept-source optical coherence tomography","volume":"71","author":"Patyal","year":"2022","journal-title":"Indian J. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"307","DOI":"10.2307\/2987937","article-title":"Measurement in Medicine: The Analysis of Method Comparison Studies","volume":"32","author":"Altman","year":"1983","journal-title":"Statistician"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.survophthal.2005.08.011","article-title":"Phakic intraocular lenses","volume":"50","author":"Lovisolo","year":"2005","journal-title":"Surv. Ophthalmol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2880","DOI":"10.4103\/ijo.IJO_2326_20","article-title":"Phakic intraocular lens: Getting the right size","volume":"68","author":"Deshpande","year":"2020","journal-title":"Indian J. Ophthalmol."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/21\/6950\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:23:33Z","timestamp":1760113413000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/21\/6950"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,29]]},"references-count":37,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["s24216950"],"URL":"https:\/\/doi.org\/10.3390\/s24216950","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,29]]}}}