Interrater Agreement: Graft Detachment.

Purpose To evaluate the efficacy of the smart eye camera (SEC), a portable smartphone-attachable camera, in assessing eyes following lamellar corneal transplantation. Methods This retrospective study included consecutive patients who underwent lamellar corneal transplantation between December 1st 2023 and August 31st 2024. Postoperative evaluations were performed using the SEC and a slit-lamp microscope. All images from the two devices were evaluated by two corneal specialists in a blinded fashion to determine the amount of air or gas in the anterior chamber, and the presence of pupillary block and graft detachment. Sensitivity, specificity, and interrater agreement were calculated. Results A total of 26 eyes from 23 patients (12 males and 11 females, mean age: 68.7 ± 15.2 years) were included in this study. Indications for lamellar keratoplasty included endothelial dysfunction (11 eyes were treated with Descemet membrane endothelial keratoplasty and 9 with Descemet stripping automated endothelial keratoplasty), as well as corneal opacity (3 eyes were treated with deep anterior lamellar keratoplasty). Regarding the amount of air or gas in the anterior chamber, the two raters had consistent judgments using the SEC (intraclass correlation coefficient = 0.817 [95% confidence interval: 0.616, 0.918]). A difference in pupillary block identification was found between the two examiners using the SEC, with a Kappa coefficient of 0.646. Neither examiner was able to identify the presence of graft detachment using the SEC. Conclusions The smartphone-attachable SEC was useful in the evaluation of air/gas volume and pupillary block but not for detecting graft detachment.### 研究目的 评估可附着于智能手机的便携式智能眼摄像头（smart eye camera, SEC）在板层角膜移植术（lamellar corneal transplantation）术后眼部评估中的应用效能。 ### 研究方法 本回顾性研究纳入了2023年12月1日至2024年8月31日期间接受板层角膜移植术的连续性患者。术后分别采用智能眼摄像头（SEC）与裂隙灯显微镜（slit-lamp microscope）进行眼部评估。由两名角膜病专科医师以盲法对两种设备获取的所有图像进行评估，判断前房（anterior chamber）内空气或气体量、瞳孔阻滞（pupillary block）及移植片脱离（graft detachment）的存在情况，并计算灵敏度、特异度及组间一致性。 ### 研究结果 本研究共纳入23例患者的26只眼（男性12例，女性11例，平均年龄68.7±15.2岁）。板层角膜移植术的适应证包括内皮功能障碍（11只眼接受后弹力膜内皮角膜移植术（Descemet membrane endothelial keratoplasty），9只眼接受自动后弹力膜剥除内皮角膜移植术（Descemet stripping automated endothelial keratoplasty））及角膜混浊（3只眼接受深板层角膜移植术（deep anterior lamellar keratoplasty））。针对前房内空气或气体量的评估，两名评估者采用SEC得出的判断一致性良好（组内相关系数（intraclass correlation coefficient）=0.817，95%置信区间（95% confidence interval）：0.616~0.918）。采用SEC时，两名检查者对瞳孔阻滞的识别存在差异，Kappa系数（Kappa coefficient）为0.646。两名评估者均无法通过SEC检测出移植片脱离的情况。 ### 研究结论 可附着于智能手机的SEC可有效评估前房内空气/气体量及瞳孔阻滞，但无法用于检测移植片脱离。