Agreement Between Pentacam Axl And Iolmaster Axial Length Measurements Across Axial Length Subgroups In A Routine Cataract Population

To evaluate the agreement between axial length (AL) measurements obtained using Pentacam AXL and IOLMaster in a routine cataract population and to determine whether axial length stratification and anterior segment parameters influence inter-device differences.

retrospective observational study

This retrospective observational study included 65 eyes of 65 patients who underwent preoperative biometry prior to cataract surgery between 2023 and 2025. Axial length measurements were obtained using Pentacam AXL and IOLMaster during the same visit. Agreement was assessed using Pearson correlation, intraclass correlation coefficient (ICC), and Bland–Altman analysis. Eyes were stratified into short (<22.0 mm), normal (22.0–25.0 mm), and long (>25.0 mm) axial length subgroups. Associations between inter-device AL differences (ΔAL) and endothelial cell morphology and optical quality parameters were analyzed.

The mean axial length was 23.46 ± 0.95 mm with IOLMaster and 23.44 ± 0.94 mm with Pentacam AXL. A very strong correlation was observed between devices (r = 0.998). The mean ΔAL was +0.019 ± 0.054 mm, with 95% limits of agreement ranging from −0.087 to +0.124 mm. Agreement was preserved across short, normal, and long axial length subgroups. No significant associations were found between ΔAL and endothelial cell density, hexagonality, higher-order aberrations, or corneal densitometry parameters (all p > 0.05).

Pentacam AXL and IOLMaster demonstrate excellent agreement in axial length measurements in a routine cataract population. Agreement is maintained across different axial length ranges and appears independent of endothelial and optical quality parameters, supporting the clinical interchangeability of these devices.