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Comparative Analysis of Anterior Segment Biometry: Agreement and Correlation between Swept-Source Optical Coherence
Eun Hye Jung1, Hyunjo Lee2, Tae-Im Kim3,4
1Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
Purpose:
To evaluate the inter-device agreement of keratometry, central corneal thickness (CCT), pupil diameter (PD), and white-to-white (WTW) measurements among three anterior segment biometers: Anterion (Heidelberg Engineering), Pentacam HR (Oculus), and IOLMaster 700 (Carl Zeiss Meditec).
Methods:
This retrospective study analyzed 165 eyes of 88 patients who underwent measurements using all three devices on the same day under standardized mesopic illumination. Parameters included anterior and total keratometry, CCT, PD, and WTW. Agreement was assessed using repeated-measures ANOVA, intraclass correlation coefficient (ICC), Bland-Altman analysis, and Deming regression.
Results:
Anterior keratometry (simulated keratometry [SimK]) and CCT showed excellent agreement (ICC ≥ 0.96) with minimal bias (<0.2 diopters and approximately 8 μm, respectively). The IOLMaster 700 measured slightly steeper keratometry than the Anterion, whereas the Pentacam yielded thicker CCT values than both IOLMaster 700 and Anterion. Total keratometry exhibited larger discrepancies than anterior keratometry. The Anterion reported smaller WTW measurements than the IOLMaster 700. Deming regression revealed proportional bias in total keratometry and constant bias in CCT and PD across the three devices.
Conclusions:
Although SimK and CCT showed a strong statistical agreement, they were not found to be fully interchangeable. The need for consistent use of devices or validated conversion methods in clinical settings is emphasized by the significant differences in total keratometry, PD, and WTW. These findings are clinically relevant for proper cataract surgery, refractive surgery planning, and diagnosis of corneal diseases.
