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Purpose <p>This study aimed to explore the agreement of biometric measurements and evaluate a parameter-hybrid strategy for intraocular lens (IOL) power calculations among CASIA2, IOL Master 700, and OA2000 in cataract patients.</p> Methods <p>Preoperative measurements were obtained from all three devices. Parameters included axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), keratometry (Km, Kf, Ks), white-to-white distance (WTW), and corneal cylinder (CYL). Since the CASIA2 does not provide AL measurement, a hybrid calculation strategy was designed. IOL power was calculated using the Barrett Universal II formula in four configurations: (1) IOLMaster 700 (standalone), (2) OA2000 (standalone), (3) CASIA2-derived anterior segment parameters + IOL Master 700 AL, and (4) CASIA2-derived anterior segment parameters + OA2000 AL. Refractive prediction accuracy was evaluated at one month postoperatively. Statistical analyses included repeated-measures ANOVA, the Friedman test, intraclass correlation coefficient (ICC), and Bland-Altman plots.</p> Results <p>The three SS-OCT devices showed excellent agreement for most parameters. However, clinically significant differences were observed in corneal curvature (Km, Kf, Ks) measurements among devices. The calculated IOL power providing emmetropia showed a statistically significant result. The standard strategy using IOL Master 700 parameters yielded the highest prediction precision (lowest mean absolute error) and the highest percentage of eyes within ± 0.50 D of the target refraction. Both hybrid strategies resulted in a systematic hyperopia bias, higher prediction errors, and a reduced proportion of eyes within ± 0.50 D. All strategies maintained safety, with over 91% of eyes within ± 1.00 D.</p> Conclusions <p>The hybrid strategy introduces a hyperopia bias and reduces refractive prediction accuracy. Using a single, consistent device for preoperative measurements is recommended for routine cataract surgery. The hybrid approach may serve only as a contingency in complex cases.</p>

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Agreement of ocular biometry and evaluation of IOL calculation using a parameter‑hybrid strategy: a comparison of CASIA2, IOL Master 700, and OA2000 in cataract patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月17日

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  • Weiwen Lin,
  • Siping Wu,
  • Yingyan Chen,
  • Shirong Chen,
  • Xinyu Liu,
  • Zhiqiang Guan,
  • Kunliang Qiu

摘要

Purpose

This study aimed to explore the agreement of biometric measurements and evaluate a parameter-hybrid strategy for intraocular lens (IOL) power calculations among CASIA2, IOL Master 700, and OA2000 in cataract patients.

Methods

Preoperative measurements were obtained from all three devices. Parameters included axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), keratometry (Km, Kf, Ks), white-to-white distance (WTW), and corneal cylinder (CYL). Since the CASIA2 does not provide AL measurement, a hybrid calculation strategy was designed. IOL power was calculated using the Barrett Universal II formula in four configurations: (1) IOLMaster 700 (standalone), (2) OA2000 (standalone), (3) CASIA2-derived anterior segment parameters + IOL Master 700 AL, and (4) CASIA2-derived anterior segment parameters + OA2000 AL. Refractive prediction accuracy was evaluated at one month postoperatively. Statistical analyses included repeated-measures ANOVA, the Friedman test, intraclass correlation coefficient (ICC), and Bland-Altman plots.

Results

The three SS-OCT devices showed excellent agreement for most parameters. However, clinically significant differences were observed in corneal curvature (Km, Kf, Ks) measurements among devices. The calculated IOL power providing emmetropia showed a statistically significant result. The standard strategy using IOL Master 700 parameters yielded the highest prediction precision (lowest mean absolute error) and the highest percentage of eyes within ± 0.50 D of the target refraction. Both hybrid strategies resulted in a systematic hyperopia bias, higher prediction errors, and a reduced proportion of eyes within ± 0.50 D. All strategies maintained safety, with over 91% of eyes within ± 1.00 D.

Conclusions

The hybrid strategy introduces a hyperopia bias and reduces refractive prediction accuracy. Using a single, consistent device for preoperative measurements is recommended for routine cataract surgery. The hybrid approach may serve only as a contingency in complex cases.