Clinical comparison of automated and manual keratometry in pre-operative ocular biometry

Corneal measurements, using the manual (Topcon OM-4) and automated (Canon RK-1) keratometers was performed on 104 eyes of 104 patients undergoing cataract and implant surgery to assess the role of automated keratometry in pre-operative ocular biometry. Four eyes of four patients were excluded from statistical analyses for various reasons. The time taken to perform automated keratometry was a mean of 61 (SD 21) seconds compared to 205 (SD 37) seconds for manual keratometry; the difference was statistically significant (p < 0.001). In terms of the various keratometry values compared, mean K (corneal refractive power), flattest K, steepest K, astigmatism and the axis of astigmatism, 65% to 75% of the cases on automated keratometry were within 0.26 dioptres or 11 degrees of manually determined values; the difference was statistically significant (p < 0.001). Although automated keratometry was significantly quicker than manual keratometry, we continue to use manual keratometry values for intraocular lens power calculations as the accuracy demonstrated by automated keratometry was considered inadequate for this purpose.