Corneal Aberrations From Ss-Oct Biometry: Optical Zone Repeatability For Iol Design Selection In Cataract Surgery

To assess the reliability of corneal optical quality parameters derived from swept-source optical coherence tomography (SS-OCT) biometry and to determine their measurement precision in the context of intraocular lens (IOL) selection for cataract surgery.

Department of Ophthalmology, Hanusch Hospital, Vienna, Austria.

Three consecutive preoperative scans acquired in cataract patients were evaluated using an SS-OCT biometer (ANTERION; Heidelberg Engineering). Corneal higher-order aberrations (HOAs) were expressed as individual signed Zernike coefficients, vector components, and root mean square (RMS) values. Measurement precision was quantified using pooled within-subject standard deviation (Sw), repeatability limits (R = 2.77 × Sw), coefficient of variation (CoV), and intraclass correlation coefficients (ICC) at 3.0-mm, 4.0-mm, and 5.0-mm optical zones.

At the 4.0-mm zone, repeatability limits for anterior, posterior, and total corneal HOAs were below 0.10 µm, with ICC values ranging from 0.76 to 0.97 and CoV values below 25%. For the total cornea, RMS HOA and spherical aberration demonstrated repeatability limits of 0.07 µm and 0.03 µm, respectively. Measurement variance increased with larger optical zone diameters and reflected both pupil-dependent effects and interindividual variation.

SS-OCT biometry enables a repeatability quantification of corneal optical quality parameters at optical zones relevant for cataract surgery. However, because measurement uncertainty will prohibit the reliability of these parameters, repeatability limits should be factored in when interpreting them in clinical practice or for visual outcomes-based endpoints.