Swept-Source OCT Biometry-Derived Corneal Optical Quality: Repeatability Limits for IOL Design Selection in...

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Optical Metrology

Background:

• Accurate corneal optical quality assessment is crucial for refractive cataract surgery.
• Intraocular lens (IOL) selection and surgical outcomes depend on precise biometric data.
• Swept-source optical coherence tomography (SS-OCT) offers advanced biometry capabilities.

Purpose of the Study:

• To evaluate the reliability of corneal optical quality metrics derived from SS-OCT biometry.
• To assess the impact of these metrics on intraocular lens design selection in refractive cataract surgery.
• To provide the first reliability analysis of SS-OCT biometry for corneal optical quality.

Main Methods:

• Retrospective instrument evaluation of SS-OCT biometer (ANTERION) scans.
• Analysis of corneal higher order aberrations (HOAs) using Zernike polynomial decomposition.
• Calculation of repeatability metrics including pooled within-subject standard deviation (Sw), coefficient of variation, and intraclass correlation coefficient (ICC).

Main Results:

• High repeatability for anterior, posterior, and total HOAs with repeatability limits below 0.10 µm at a 4-mm optical zone.
• Excellent intraclass correlation coefficients (ICCs) ranging from 0.76 to 0.97.
• Root mean square HOA and spherical aberration showed strong repeatability (ICC: 0.89 and 0.84, respectively).

Conclusions:

• SS-OCT biometry reliably characterizes corneal optical quality at clinically relevant zones.
• Repeatability limits are essential for informed IOL design selection and outcome-based research.
• Measurement uncertainty necessitates consideration of repeatability data in clinical decision-making.