Refractive Predictability and Biometry Agreement of a Combined Swept Source Optical Coherence and Reflectometry Biometer Compared to an Optical Low Coherence Reflectometry Biometer and an SS-OCT Biometer.

Purpose: To evaluate the agreement of refractive predictability of a swept-source optical coherence tomography (SS-OCT) biometer, which uses segmental AL calculation, with another SS-OCT biometer, and an optical low coherence reflectometry (OLCR) biometer. The secondary objective was to describe the refractive outcomes, visual acuities, and the agreement of different preoperative biometric parameters.
Patients and Methods: The study was a retrospective one-arm study of refractive and visual outcomes after successful cataract surgery. Preoperative biometric data were collected with two different SS-OCT device (Argos, Alcon Laboratories and Anterion, Heidelberg Engineering) and an OLCR device (Lenstar 900, Haag-Streit). The Barrett Universal II formula was used to calculate IOL power for all three devices. Follow-up examination was 1-2 months after surgery. The main outcome measure, refractive prediction error (RPE), was calculated as the achieved postoperative refraction minus the predicted refraction for each device. Absolute error (AE) was calculated by reducing the mean error to zero.
Results: The study included 129 eyes of 129 patients. The mean RPE was 0.06, -0.14 and 0.17 D for the Argos, Anterion and Lenstar, respectively ( p < 0.01). The Argos also had the lowest absolute RPE, while the Lenstar had the lowest median AE, but this was not statistically significant ( p > 0.2). The percentages of eyes with RPE within ±0.5 was 76%, 71%, and 78% for the Argos, Anterion, and Lenstar, respectively. The percentages of eyes with AE within 0.5 D was 79%, 84%, and 82% for the Argos, Anterion and Lenstar, respectively. None of these percentages were statistically significantly different ( p > 0.2).
Conclusion: All three biometers showed good refractive predictability with no statistically significant differences in AE or percentages of eyes within ± 0.5 D of RPE or AE. The lowest arithmetic RPE was found with the Argos biometer.
Competing Interests: Dr. Gundersen is a consultant to Alcon, Staar, Santen, Centricity, and Glaukos. Mr Bjørn Gjerdrum reports grants from Alcon, during the conduct of the study. This study was supported by an investigator-initiated study grant from Alcon, Fort Worth, TX (IIT #68660849). The authors report no other conflicts of interest in this work.
(© 2023 Gjerdrum et al.)