Evaluation of Refractive Predictive Accuracy in Intraocular Lens Power Calculations: A Comparative Study of Swept-Source Optical Coherence Tomography and Optical Low-Coherence Interferometry

<b>Background/Objectives:</b> Precise intraocular lens (IOL) power calculations are essential for achieving optimal refractive outcomes in cataract surgery. This study compares the predictive accuracy of swept-source optical coherence tomography (SS-OCT) and optical low-coherence interferometry (OLCI) in biometry measurements and refractive outcomes. <b>Methods:</b> This retrospective study included 170 eyes from 102 patients undergoing cataract surgery. Biometry was performed using Argos^® (MOVU Inc., Komaki, Japan) (SS-OCT) and Aladdin^® (Topcon Corp., Tokyo, Japan) (OLCI), measuring axial length (AL), anterior chamber depth (ACD), lens thickness (LT), white to white (WTW), and keratometry. <b>Results:</b> Postoperative outcomes, including uncorrected and corrected distance visual acuity (UDVA, CDVA), spherical equivalent (SE), and refractive error, were assessed at one and six months. Predictive accuracy was evaluated by mean error (ME), mean absolute error (MAE), median absolute error (MedAE), and the percentage of eyes within ±0.25 D to ±1.00 D of predicted SE. <b>Conclusions:</b> Both technologies achieved high refractive accuracy, with 97.7% (SS-OCT) and 97.2% (OLCI) of eyes within ±1.00 D of target SE. SS-OCT demonstrated superior axis alignment, while OLCI provided enhanced postoperative SE. Significant differences were observed in LT (<i>p</i> = 0.030) and ACD (<i>p</i> = 0.009). Postoperative UDVA of 20/20 or better was achieved in 98% of SS-OCT eyes and 100% of OLCI eyes. SS-OCT and OLCI provide comparable refractive outcomes and high reliability in cataract surgery.