Comparative Analysis Of Iol Master 700 And Anterion Swept-Source Oct Biometry For Key Ocular Parameters

To compare biometric measurements obtained with two swept-source optical coherence tomography biometers, the IOLMaster 700 (Carl Zeiss Meditec) and the Anterion (Heidelberg Engineering), and to evaluate inter-device agreement and correlation. The aim is to determine whether any systematic differences are clinically acceptable for interchangeable use in cataract surgery planning and intraocular lens power calculations, including toric and phakic lens selection.

Phakic patients presenting to the cataract clinic between October 2024 and November 2025 at Frimley Park Hospital, United Kingdom.

Retrospective comparative study analysing ocular biometry measurements acquired using IOLMaster 700 and Anterion. Measured parameters were axial length (AL), flat and steep keratometry (K1, K2), anterior chamber depth (ACD), lens thickness (LT), and white-to-white corneal diameter (WTW). Inclusion criteria comprised patients listed for cataract surgery with biometry measurements from both devices; only eyes with complete datasets were included. Statistical analysis was performed using Microsoft Excel 2019 v2508 and Jamovi v2.6.44.0; it included paired t-tests, Pearson correlation tests and intraclass correlation coefficients (ICC). P-value <0.05 was considered statistically significant.

Fourty-six eyes from 26 patients with mean age 72.5years; 24 eyes were excluded due to incomplete datasets. Mean AL 23.86±1.87mm (IOLMaster 700) and 23.85±1.86mm (Anterion), mean difference 0.007±0.021mm (r= 0.999, ICC= 0.999; p = 0.04). Mean K1 43.25±1.58D and 43.12±1.52D, mean difference 0.132±0.255D (r= 0.987, ICC= 0.983, p < 0.01). Mean K2 44.18±1.72D and 44.00±1.67D, mean difference 0.188±0.276D (r= 0.987, ICC= 0.981, p < 0.01). Mean ACD 3.10±0.42 and 3.16±0.39, mean difference -0.059±0.114 (r= 0.962, ICC= 0.951, p < 0.01). Mean LT 4.61±0.37mm and 4.67±0.38mm, mean difference -0.058±0.025mm (r= 0.998, ICC= 0.986, p < 0.01). Mean WTW 12.05±0.45mm and 11.86±0.41mm, mean difference 0.198±0.172mm (r= 0.923, ICC= 0.833, p < 0.01).

The IOLMaster 700 and Anterion showed excellent agreement for axial length, keratometry, ACD and lens thickness. Axial length measurements were almost identical with negligible bias. Small but statistically significant systematic biases were observed for keratometry and lens thickness, with the IOLMaster 700 measuring slightly higher K values and thinner lenses. White-to-white demonstrated the weakest agreement and greatest variability, limiting interchangeability where precise corneal diameter assessment is required. Overall, while most biometric parameters exhibit interchangeability for routine IOL power calculations, caution is required where more precision planning is required such as toric lenses or ICL sizing.