Comparison of Ocular Biometry and Refractive Prediction Between Swept-Source Optical Coherence Tomography and Low-Coherence Reflectometry

Purpose: To compare ocular biometric measurements and postoperative refractive prediction accuracy between swept-source optical coherence tomography (Anterion®) and low-coherence reflectometry (Lenstar LS900®) using five intraocular lens (IOL) power calculation formulas.Methods: This retrospective study included 72 patients (72 eyes) who underwent phacoemulsification with IOL implantation. Axial length, keratometry, anterior chamber depth, lens thickness, white-to-white distance, and central corneal thickness were measured using both devices. Mean prediction error and mean absolute error were calculated based on postoperative spherical equivalent using the SRK/T, Hoffer Q, Holladay 1, Haigis, and Barrett Universal II formulas.Results: Axial length and white-to-white distance showed no significant differences between the two devices, whereas keratometry, anterior chamber depth, lens thickness, and central corneal thickness differed significantly (p < 0.05). Bland-Altman analysis demonstrated wider limits of agreement for keratometry and white-to-white distance than for the other biometric parameters. Mean prediction error showed a myopic shift with both devices across all formulas, with Anterion® demonstrating a significantly greater myopic bias than Lenstar LS900® (p < 0.001). Mean absolute error was significantly lower with Lenstar LS900® for the SRK/T, Hoffer Q, and Holladay 1 formulas but did not differ significantly between devices for the Haigis or Barrett Universal II formulas. Among all formulas, Barrett Universal II yielded the lowest mean absolute error for both devices.Conclusions: The two devices demonstrated strong agreement for most ocular biometric measurements despite significant differences in several parameters. Under the conditions of this study, Lenstar LS900® achieved lower mean absolute error with some IOL power calculation formulas than Anterion®, indicating that interdevice differences in refractive prediction should be considered when the two devices are used interchangeably.