Preoperative Ocular Surface Instability And Short-Term Ocular Biometric Variability In Cataract Surgery
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT578 | Type: Free paper | DOI: 10.82333/qzqe-te91
Authors: Sanghyuk Ahn* 1 , Prof. Jong Suk Song 2 , Prof. Dong Hyun Kim 1
1Ophthalmology,Korea University College of Medicine,Seoul,Korea, Republic Of, 2Ophthalmology,Korea University Guro Hospital,Seoul,Korea, Republic Of
Purpose
To evaluate the short-term variability of ocular biometric measurements and identify factors associated with high variability.
Setting
Department of Ophthalmology, Korea University Anam Hospital, Seoul, Republic of Korea.
Methods
This retrospective study included 60 eyes of 60 patients who underwent repeated preoperative ocular biometry using the IOLMaster 700 (Carl Zeiss Meditec AG, Jena, Germany) between March 2023 and November 2023. Variability was assessed using the absolute differences between repeated measurements, and factors associated with increased variability were investigated. Ocular surface parameters, including tear film break-up time (TBUT) and corneal and conjunctival staining scores, were analyzed. Clinically significant IOL power change was defined as a ≥0.5 diopter (D) difference between calculations derived from repeated measurements. Postoperative refractive surprise was defined as a mean absolute error >0.5 D.
Results
Axial length and anterior chamber depth showed high reproducibility between repeated measurements. In contrast, absolute differences in keratometric values and astigmatism amount showed notable variability (0.18±0.17 D and 0.21±0.26 D, respectively). Shortened TBUT and higher corneal staining scores were significantly associated with increased keratometric variability (≥0.25 D) (p=0.040 and p=0.008, respectively). Variability in keratometric values led to clinically significant changes in calculated IOL power in a substantial proportion of eyes. The high K variability group demonstrated a significantly higher incidence of refractive surprise compared with the low K variability group (45.4% vs. 17.7%, p=0.037).
Conclusions
Keratometric measurements exhibited greater short-term variability than axial length and anterior chamber depth. Preoperative lower TBUT and higher corneal staining scores were associated with increased keratometric variability and postoperative refractive surprise, suggesting that preoperative ocular surface instability may compromise refractive accuracy in cataract surgery.