The refractive accuracy between topographic keratometry and biometric keratometry for extended depth-of-focus intraocular lens implantation

Purpose: To investigate the influence of different keratometry (K) measurements on the postoperative outcomes of cataract surgery with extended depth-of-focus (EDOF) intraocular lens (IOL) implantation. Methods: A retrospective cohort study was conducted, and patients who received cataract surgery and one type of EDOF IOL implantation were included. The patients were then categorized according to K measurements, and 70 and 30 eyes were included in the biometric-K and topographic-K groups, respectively. The primary outcomes were postoperative uncorrected distance visual acuity (UDVA), spherical equivalent (SE) and cylinder power. A generalized linear model was applied to compare the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of the outcomes between groups. Results: One month after surgery, the UDVA was 0.15 and 0.07 in the biometric-K group and topographic-K group, respectively. Furthermore, the final SEs were -0.42 D and -0.13 D in the biometric-K group and topographic-K group, respectively, and the final cylinder powers were -0.35 D and -0.13 D in the biometric-K group and topographic-K group, respectively. According to the multivariate analysis, the topographic-K group presented a significantly better UDVA (P = 0.044) and significantly lower cylinder power (P = 0.031) than the biometric-K group. Angle kappa was significantly correlated with high postoperative astigmatism in the topographic-K group (P = 0.033), whereas angle kappa, steep K, and corneal cylinder powers were significantly correlated with high postoperative astigmatism in the biometric-K group (all P < 0.05). Conclusion: Topography-based K measurements yielded better refractive outcomes than biometric-based K measurements did.