Modification, calibration, and comparative testing of an automated surgical keratometer

A new digital surgical keratometer (SK-1, Canon Inc) designed to fit existing operating microscopes and provide quantitative measurements at a nominal 2.0- and 3.6-mm diameter optical zone of the central cornea was modified for single foot-switch operation by the surgeon. The instrument was tested against three calibrated steel spheres, an astigmatic test-jig, and compared with a standard clinical keratometer (CLC, A.O. Co) in two studies involving six eye bank eyes and five healthy human corneas. Assessed with the steel spheres, the SK-1 calibration error was -0.042 diopters at the 3.6-mm diameter and +0.207 D at the 2.0-mm chord, while it was -0.120 D for the CLC. With cylindrical power greater than 0.50 D, the astigmatic angle was accurate to +/- 1 degree. After correction for calibration error, the CLC readings on eye bank eyes were 1.00 D higher in average (range +0.45 to +1.90) than those obtained with the SK-1 which gave lower keratometric values at the 2-mm chord diameter (-0.254 D, range: +0.05 to -0.7). The human subject corrected readings at the 3.6-mm chord were within 0.137 D (range -0.09 to +0.41) from the CLC values. A mean corrected difference of +0.068 D (range -0.27 to +0.30) was found between the two chords. The SK-1 instrument was easier to use than the CLC. A more accurate calibration and the addition of automated averaging and video display of readings as well as of a motorized Placido disc would further augment its clinical usefulness.