Accuracy of Predicted Refraction Using Two Swept-Source Optical Coherence Biometers and an Intraoperative Aberrometer.

Purpose: To compare the refractive accuracy of Optiwave Refractive Analysis (ORA) using biometric measurements of ARGOS and OA-2000 in the same patient planned for a monofocal intraocular lens (IOL) insertion.

Setting: Single center.

Design: Prospective, observational study.

Methods: Patients scheduled for cataract surgery between January 2021 and March 2022 (expected corrected distance visual acuity of ≥0.8 postoperatively at 1-3 months) underwent preoperative ocular measurements using ARGOS and OA-2000 biometers on the same day, which were entered into the intraoperative aberrometer ORA system to assess the refractive accuracy of the IOL implant and postoperative spherical equivalent at 1-3 months. The refractive accuracy was compared between ORA using ARGOS (ORA-AR) and ORA using OA-2000 (ORA-OA). The primary endpoint was the comparison of the mean absolute refractive prediction error (MAE) between the ORA-AR and ORA-OA methods.

Results: A total of 117 eyes of 81 patients were evaluated (mean ± standard deviation [SD] age, 72.8 ± 7.4 years; male, 65.4%). The criteria for noninferiority were met between the ORA-AR and ORA-OA methods, as the upper boundary of the confidence interval (CI) was lower than the noninferiority margin of 0.10 D for the difference in MAE (-0.03 D; 95% CI: -0.061 to 0.001). MAE was numerically smaller with ORA-AR (0.243 ± 0.215 D) but not significantly different from that with ORA-OA (0.269 ± 0.246 D).

Conclusions: Postoperative MAE obtained using ORA-AR was noninferior to that of ORA-OA. However, the MAE and SD of refractive prediction errors with ORA-AR were numerically lower compared with ORA-OA.