Comparison of keratometry and total corneal power, as measured by an SS-OCT-based optical biometer, for intraocular lens power calculation in Asian eyes.

Purpose: To investigate whether standard keratometry (K) or total corneal power (TCP) leads to more accurate refractive outcomes for intraocular lens (IOL) power calculation.

Setting: Public hospital.

Design: Retrospective evaluation of a diagnostic test instrument.

Methods: Preoperatively, all patients underwent optical biometry with Anterion, a swept-source optical coherence tomography device providing both K and TCP. The same IOL model was implanted in all cases. The whole sample was divided into a training dataset, used to optimize the formula constants, and a testing dataset, used to investigate the spherical equivalent prediction error (SEQ-PE) of 8 IOL power formulas. Trueness, precision, and accuracy were evaluated by means of the robust 2-sample t test. Cochran Q test was performed to assess whether the percentage of eyes with an SEQ-PE within each threshold was significantly different; in such an event, the McNemar test was then applied.

Results: Both the training and testing datasets included 317 eyes. No significant differences were detected for trueness because of constant optimization. Precision and accuracy were better when K was entered, although a statistically significant difference was observed only with the EVO (precision: P = .02 and accuracy: P = .03) and Haigis ( P < .01 for both precision and accuracy) formulas. No significant differences were observed for the percentage of eyes with an absolute SEQ-PE within any threshold.

Conclusions: With most formulas, IOL power calculation is not more accurate when TCP is used instead of K.