Precision of a new SS-OCT biometer to measure anterior segment parameters and agreement with 3 instruments with different measurement principles.

Purpose: To evaluate the repeatability of a new swept source optical coherence tomography (SS-OCT)-based biometer to measure anterior segment parameters and to assess the agreement with 3 other imaging devices based on different measurement principles.
Setting: Unit of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Design: Prospective, comparative case series.
Methods: 3 consecutive measurements were obtained in unoperated eyes with the Eyestar900 (SS-OCT), Lenstar 900, MS-39, and Sirius. The following anterior segment parameters were evaluated: central corneal thickness (CCT), corneal diameter (CD), aqueous depth (AQD), and corneal power metrics. The repeatability limit (Rlim), coefficient of variation (CoV), and a repeated measures Bland-Altman analysis were performed.
Results: 74 eyes of 74 participants were measured. The Rlims for CCT, CD, and AQD were lower than 10 μm, 0.3 mm, and 0.10 mm for all devices, respectively. The corresponding CoVs for these parameters never exceeded 1.2%. The Rlim for the corneal power metrics never exceeded 0.60 diopter (D) for any of the instruments. Lenstar showed the best agreement with the MS-39 to measure CCT, CD, and AQD (limit of agreement interval, LoA: 15.54 μm, 0.55 mm, and 0.16 mm, respectively). The mean difference for keratometry parameters was lower than 0.3 D for all device comparisons, and the LoA interval ranged between 0.52 D and 1.21 D.
Conclusions: The repeatability for measuring anterior segment parameters was good, and the agreement among all the instruments was good for CD and AQD measurements. However, for CCT and keratometer parameters, the instruments cannot be used interchangeably due to large LoA interval.
(Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of ASCRS and ESCRS.)