# Agreement Between Two Swept-Source Optical Coherence Tomography Devices in Assessing Glistening on the Intraocular Lens In Vivo

## TL;DR

This study compares two optical devices for detecting lens glistening in patients who had cataract surgery, finding strong agreement but some differences in higher grades.

## Contribution

The study provides new evidence on the agreement between two swept-source OCT devices in assessing intraocular lens glistening in vivo.

## Key findings

- The ICC between the two SS-OCT devices ranged from 0.8 to 0.9, indicating strong agreement.
- Anterion detected significantly more hyperreflective foci than Triton in higher glistening grades.
- Postsurgical time was the only factor associated with glistening.

## Abstract

Background/Objectives: To analyze the agreement between two swept-source optical coherence tomography (SS-OCT) devices in assessing glistening on intraocular lenses (IOL). Methods: Patients who had previously undergone cataract surgery were included. They were sequentially examined using two SS-OCT devices: Anterion (Heidelberg Engineering Inc., Heidelberg, Germany) and Triton (Topcon, Inc., Tokyo, Japan). Six corresponding scans from both devices were compared, and glistening, observed as hyperreflective foci (HRF), was manually counted. The total number of HRF and the degree of glistening were measured and categorized into four groups. The agreement between the two devices was analyzed using the intraclass correlation coefficient (ICC). Results: A total of 333 eyes from 285 patients were evaluated. The mean age was 76.5 ± 8.0 years (range: 45–95). The median number of HRF detected in a single scan was 1.1 (IQR 0.0–10.2, range 0–176) using Triton and 2.7 (IQR 0.2–20.1, range 0–250) using Anterion. The ICC across different scans ranged from 0.8 to 0.9, indicating strong agreement between the two devices. Bland–Altman plots showed better concordance in lenses with low glistening grades, while higher grades revealed greater discrepancies, with Anterion detecting significantly more HRF than Triton. Among all factors studied, only postsurgical time was associated with glistening. Conclusions: Two different SS-OCT devices can detect and quantify glistening in IOLs. The concordance between them was high, particularly for lower glistening grades. However, in higher grades, Anterion detected significantly more HRF than Triton.