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Updated: Dec 22, 2025

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Change in optical axial length after cataract surgery: segmental method vs composite method.

So Goto1, Naoyuki Maeda, Toru Noda

  • 1From the Department of Ophthalmology, Osaka University Graduate School of Medicine (Goto, Maeda, Koh, Nishida), Osaka, Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center (Noda, Iehisa), Tokyo, Japan; School of Optometry, University of California Berkeley (Goto), Berkeley, California, USA; Laboratorio de Lente Verde (Ohnuma), Chiba, Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University (Nishida), Osaka, Japan.

Journal of Cataract and Refractive Surgery
|May 3, 2020
PubMed
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The segmental method of swept-source optical coherence tomography (SS-OCT/SM) offers more accurate axial length measurements after cataract surgery compared to partial coherence interferometry (PCI) and the composite method (SS-OCT/CM). This indicates SS-OCT/SM is superior for post-operative assessments.

Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Accurate axial length (AL) measurement is crucial for refractive outcomes after cataract surgery.
  • Cataract surgery may potentially alter ocular structures, affecting AL measurements.
  • Different biometry techniques exist, including partial coherence interferometry (PCI) and various swept-source optical coherence tomography (SS-OCT) methods.

Purpose of the Study:

  • To compare axial length (AL) changes post-cataract surgery using three measurement methods: PCI, SS-OCT with composite method (SS-OCT/CM), and SS-OCT with segmental method (SS-OCT/SM).
  • To evaluate the accuracy and agreement of AL measurements obtained by these techniques.

Main Methods:

  • Retrospective case series involving 139 patients (268 eyes) who underwent cataract surgery.

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  • Axial length (AL) was measured preoperatively and 1 month postoperatively using PCI, SS-OCT/CM, and SS-OCT/SM.
  • Statistical analysis included paired t-tests and Bland-Altman analysis to assess differences and agreement.

    • Main Results:

    • PCI and SS-OCT/CM showed statistically significant decreases in mean AL post-surgery (P < .0001), with mean differences of 0.083 ± 0.044 mm and 0.096 ± 0.045 mm, respectively.
    • Bland-Altman analysis revealed fixed bias between preoperative and postoperative AL measurements for both PCI and SS-OCT/CM.
    • SS-OCT/SM demonstrated no significant change in mean AL (P = 0.97), with a mean difference of 0.00 ± 0.03 mm and good agreement between pre- and postoperative values.

    Conclusions:

    • The SS-OCT/SM method exhibited less variation between preoperative and postoperative axial length measurements compared to PCI and SS-OCT/CM.
    • Assuming no true change in AL due to cataract surgery, SS-OCT/SM provides more accurate AL measurements.
    • SS-OCT/SM is recommended for precise axial length assessment in the context of cataract surgery outcomes.