Precision Matters: Repeatability Of Iol Master 700 Biometry In Cataract Surgery Planning

To evaluate the repeatability and measurement consistency of ocular biometry obtained with the IOLMaster 700 in patients undergoing cataract surgery and to identify parameters with potential inter-measurement variability. The study also aims to assess the clinical relevance of measurement precision for intraocular lens power calculation, recognizing that small biometric differences may influence refractive outcomes. In the era of refractive cataract surgery and increasing expectations for visual quality, reliable optical biometry is essential for optimizing surgical planning and minimizing refractive surprises.

Department of Ophthalmology, University Hospital Centre Osijek, Croatia, a tertiary referral center for cataract and anterior segment surgery providing comprehensive preoperative assessment and high-volume phacoemulsification procedures

This prospective study included 60 adult patients (120 eyes) scheduled for phacoemulsification cataract surgery between February and May 2025 at the Department of Ophthalmology, University Hospital Centre Osijek,Croatia.Each patient underwent two consecutive ocular biometry measurements using the IOLMaster 700(Carl Zeiss Meditec).Measured parameters included keratometry (K),axial length (AL),anterior chamber depth (ACD), calculated spherical intraocular lens (IOL) power, total corneal astigmatism (CYL), and astigmatic axis (AXIS). All surgeries were performed by a single surgeon using the CENTURION Vision System (Alcon), followed by intraocular lens implantation. Agreement between measurements and postoperative visual outcomes were analyzed

Postoperative evaluation demonstrated a significant improvement in visual acuity, with median best-corrected visual acuity improving from 0.40 on the day of surgery to 1.0 at postoperative day 30 (Wilcoxon signed-rank test, P < 0.001). Biometric parameters showed excellent repeatability between consecutive measurements. Axial length (AL) and anterior chamber depth (ACD) demonstrated statistically significant differences between measurements; however, the magnitude of these differences was small and not clinically meaningful (Wilcoxon signed-rank test: AL, P < 0.001; ACD, P = 0.001). Other parameters, including keratometry, total corneal astigmatism, and calculated IOL power, showed strong agreement without significant variability

These results demonstrate excellent repeatability and minimal inter-measurement variability, confirming the reliability of IOLMaster 700 biometry for precise preoperative assessment. In the era of premium intraocular lenses and refractive cataract surgery, where patient expectations for spectacle independence and visual quality are increasingly high, consistent and accurate biometric measurements are critical for optimizing lens selection and minimizing refractive surprises. The findings highlight swept-source optical biometry as a cornerstone technology enabling precise surgical planning, enhancing refractive predictability, and supporting superior visual outcomes in modern cataract practice.