Agreement in Biometric Parameters Between Swept-Source-Optical Coherence Tomography and Optical Low-Coherence Interferometry: Insights into Clinical Precision

Background/Objectives: Accurate biometric measurements are critical for achieving optimal refractive outcomes in cataract surgery. This study evaluated the agreement of biometric measurements between a swept-source optical coherence tomography (SS-OCT) biometer (Argos (R), Movu Inc.) and an optical low-coherence interferometry (OLCI) biometer (Aladdin (R), Topcon Corp.). Parameters analyzed included axial length (AL), anterior chamber depth (ACD), lens thickness (LT), keratometry (K1, K2), and white-to-white corneal diameter (WTW). Methods: A total of 170 eyes were examined, and agreement was assessed using Bland-Altman analysis, intraclass correlation coefficients (ICCs), and Pearson correlation coefficients. Results: Excellent agreement was observed for AL (ICC = 0.975), ACD (ICC = 0.960), LT (ICC = 0.951), K1 (ICC = 0.921), and K2 (ICC = 0.927). Moderate agreement was found for astigmatism axis (ICC = 0.655) and cylinder power (ICC = 0.891). Poor agreement was noted for astigmatism-related Jackson cross-cylinder vectors J0 (ICC = 0.334) and J45 (ICC = -0.311), as well as for WTW (ICC = 0.338). Bland-Altman plots demonstrated narrow limits of agreement for most parameters, with mean differences of 0.009 mm for AL and 0.06 mm for ACD. Conclusions: Both devices demonstrated high degrees of agreement for core biometric parameters, supporting their clinical interchangeability. However, the variability in WTW and astigmatism-related measurements highlights the need for caution when precise corrections are required.