A comparative analysis of predicted spherical refractive outcomes between two swept-source optical biometers

To compare the predicted spherical equivalent (PSEq) between the ANTERION^® anterior segment OCT device (Heidelberg Engineering GmbH, Heidelberg, Germany) and the IOLMaster 700 (Carl Zeiss Meditec AG, Jena, Germany) in patient undergoing cataract surgery.

Ocular biometry was performed by a single investigator for each patient scheduled for cataract surgery, with ANTERION and IOLMaster 700. Intraocular lens (IOL) power for TECNIS^® 1-Piece Aspheric IOL (Model ZCB00) and corresponding PSEq were calculated using IOL formulas including Barrett Universal II, Cooke K6, EVO 2.0, Hill-RBF 3.0, Hoffer^®QST, Kane, Pearl-DGS and SRK/T. The main outcomes assessed were the mean difference in PSEq between the two devices and the proportion of eyes where the PSEq difference exceeded 0.35 dioptres (D), considered clinically significant as it would likely result in a different IOL power being implanted.

A total of 155 right eyes from 155 patients were analysed. The ANTERION consistently produced more hyperopic PSEq compared to the IOLMaster, with mean differences across all IOL formulas ranging from + 0.11 to + 0.18 D. These differences were statistically significant (P < 0.05). Agreement analysis demonstrated that the majority of data points between the devices were within the 95% limits of agreement (- 0.39 D to 0.79 D), regardless of the IOL power calculation formula applied. However, 15-25% of eyes showed a PSEq difference greater than 0.35 D.

PSEq derived from ANTERION is slightly hyperopic compared to IOLMaster, with discrepancies significant enough to affect IOL power selection in up to 25% of eyes.