ESCRS - PO338 - Argos® Swept-Source Oct Biometry Improves Refractive Accuracy In Cataract Surgery For Long Axial Length Eyes With Multifocal Iols

Argos® Swept-Source Oct Biometry Improves Refractive Accuracy In Cataract Surgery For Long Axial Length Eyes With Multifocal Iols

Published 2025 - 43rd Congress of the ESCRS

Reference: PO338 | Type: Free paper | DOI: 10.82333/c6bh-v548

Authors: Takahiko Hayashi* 1 , Yusuke Hara 1 , Chihiro Sunouchi 1 , Kentaro Yuda 2 , Takashi Kojima 3 , Naoko Kato 4 , David Gunn 5 , Brendan Cronin 5 , Satoru Yamagami 1

1Ophthalmology,Nihon University,Tokyo,Japan, 2Ophthalmology,Kikunayuda Eye Clinic,Yokohama,Japan, 3Ophthalmology,Nagoya Eye Clinic,Nagoya,Japan, 4Ophthalmology,Minamiaoyama Eye Clinic,Tokyo,Japan, 5Ophthalmology,The Queensland Eye Institute,Brisbane,Australia

Purpose

To evaluate the refractive prediction accuracy and postoperative visual outcomes of cataract surgery with multifocal intraocular lenses (IOLs) in eyes with long axial length, using the ARGOS® swept-source optical coherence tomography (SS-OCT) biometer for preoperative measurements.

Setting

Single-center study at a tertiary eye hospital specialized in cataract surgery. Long axial length eyes pose challenges for intraocular lens power calculation, often leading to refractive surprises​. Accurate biometry is especially critical for multifocal IOLs, which are sensitive to small residual refractive errors​. The ARGOS® SS-OCT biometer offers advanced axial length measurement and has shown better predictive accuracy in long eyes compared to earlier optical biometers​.

Methods

This prospective study included cataract patients with long axial length (≥ 26 mm) undergoing phacoemulsification and multifocal IOL implantation. All eyes received preoperative biometry with the ARGOS® SS-OCT optical biometer to measure axial length, keratometry, and anterior chamber depth. IOL power was calculated using the Barrett Universal II formula, targeting emmetropia. Postoperative refraction and uncorrected distance visual acuity (UDVA) were measured at 3 months. Outcome measures included the prediction error (difference between expected and actual refraction), mean absolute prediction error (MAE), and the percentage of eyes within ±0.50 D of target refraction.

Results

The mean absolute prediction error was low (~0.3 diopters), indicating high refractive accuracy. Nearly 90% of eyes achieved a postoperative spherical equivalent within ±0.50 D of the target, and all eyes were within ±1.00 D. The refractive outcomes showed minimal bias (no significant hyperopic or myopic shift). Postoperative visual results were excellent: a majority of eyes attained an uncorrected distance visual acuity of 20/25 or better (approximately 0.1 logMAR), reflecting successful visual rehabilitation with the multifocal IOLs.

Conclusions

The ARGOS® swept-source OCT biometer provided highly accurate IOL power predictions in long axial length eyes, leading to excellent refractive outcomes and successful multifocal IOL performance. These findings demonstrate that advanced biometry can mitigate refractive surprises in high-myopia cataract cases, enabling safer and more effective use of multifocal IOLs. Incorporating the ARGOS® biometer into preoperative planning for long eyes may improve the predictability of cataract surgery outcomes and enhance patient satisfaction.