Comparison of Immersion Ultrasound,
Partial Coherence Interferometry, and
Low Coherence Reflectometry for Ocular
Biometry in Cataract Patients
Robert Montés-Micó, PhD; Francesco Carones, MD; Antonietta Buttacchio, OD;
Teresa Ferrer-Blasco, PhD; David Madrid-Costa, PhD
ABSTRACT
PURPOSE: To compare ocular biometry parameters
measured with immersion ultrasound, partial coherence
interferometry, and low coherence reflectometry in cata-
ract patients.
METHODS: Measurements of axial length and anterior
chamber depth were analyzed and compared using im-
mersion ultrasound, partial coherence interferometry, and
low coherence reflectometry. Keratometry (K), flattest
axis, and white-to-white measurements were compared
between partial coherence interferometry and low
coherence reflectometry. Seventy-eight cataract (LOCS
II range: 1 to 3) eyes of 45 patients aged between 42
and 90 years were evaluated. A subanalysis as a function
of cataract degree was done for axial length and anterior
chamber depth between techniques.
RESULTS: No statistically significant differences were
noted for the study cohort or within each cataract
degree among the three techniques for axial length and
anterior chamber depth (P⬎.05, ANOVA test). Mea-
surements between techniques were highly correlated
for axial length (R=0.99) and anterior chamber depth
(R=0.90 to 0.96) for all methods. Keratometry, flattest
axis, and white-to-white measurements were compa-
rable (paired t test, P⬎.1) and correlated well between
partial coherence interferometry and low coherence
reflectometry (K1 [R=0.95), K2 [R=0.97], flattest axis
[R=0.95], and white-to-white [R=0.92]).
CONCLUSIONS: Immersion ultrasound, partial coherence
interferometry, and low coherence reflectometry provided
comparable ocular biometry measurements in cataractous
eyes. [J Refract Surg. 2011;27(9):665-671.]
doi:10.3928/1081597X-20110202-01
Journal of Refractive Surgery • Vol. 27, No. 9, 2011
A
ccurate biometry estimating ocular dimensions is nec-
essary in cataract and refractive surgery. Axial length,
anterior chamber depth, and corneal power are needed
for theoretical intraocular lens (IOL) power calculation.
Current ocular biometry techniques include both ultra-
sound and optical biometers. Applanation ultrasound is the
most widely used technique for ocular biometry.1 However,
direct applanation may compress the cornea and result in
an underestimation of axial length by 0.14 to 0.47 mm com-
pared to immersion ultrasound.2-4 Immersion ultrasound is
an accurate method for axial length measurement, generally
considered superior to applanation ultrasound techniques.
Immersion ultrasound is used only by a minority of cataract
and refractive surgeons (12%)1 despite its reduced range of
postoperative refractive errors when compared to applana-
tion ultrasound.
Optical biometry uses laser instead of ultrasound for data
acquisition. Two different types of optical laser systems based
on different technology for ocular biometry measurement
are available currently. The IOLMaster (Carl Zeiss Meditec,
Jena, Germany) uses partial coherence interferometry and the
Lenstar LS 900/Biograph (Haag-Streit AG, Koeniz, Switzerland/
Alcon Laboratories Inc, Ft Worth, Texas) uses low coher-
ence reflectometry. Partial coherence interferometry has been
shown to have the same accuracy as immersion ultrasound
biometry,5-8 whereas low coherence reflectometry has yet to
be compared to immersion ultrasound biometry to determine
possible differences. Partial coherence interferometry and
From Optometry Research Group, University of Valencia, Valencia, Spain
(Montés-Micó, Ferrer-Blasco, Madrid-Costa); and Carones Ophthalmology
Center, Milan, Italy (Carones, Buttacchio).
This research was supported in part by Ministerio de Ciencia e Innovación
Research Grants to Robert Montés-Micó (#SAF2008-01114-E/# and #SAF2009-
13342-E#).
The authors have no proprietary interest in the materials presented herein.
Correspondence: Robert Montés-Micó, PhD, Dept of Optics, University of
Valencia, C/ Dr Moliner 50, 46100 Burjassot, Spain. Tel: 34 96 354 4764;
Fax: 34 96 354 4715; E-mail: robert.montes@uv.es
Received: September 12, 2010; Accepted: January 18, 2011
Posted online: February 15, 2011
665
Comparison of Three Biometers/Montés-Micó et al
low coherence reflectometry have been compared in
healthy, cataract, pseudophakic, aphakic, and silicon
oil-filled eyes with comparable results between tech-
niques.9-15
The present study measures and compares ocular
biometry values with immersion ultrasound, partial
coherence interferometry, and low coherence reflec-
tometry in cataractous eyes.
PATIENTS AND METHODS
Seventy-eight cataractous eyes of 45 patients (20
men and 25 women) with a mean age of 65.3⫾12.9
years (range: 42 to 90 years) were included in this non-
randomized, prospective evaluation study. Cataracts
ranged from grade 1 to 3 according to the Lens Opaci-
ties Classification System (LOCS) II (mean: 1.8⫾0.8).
The study was conducted in accordance with the
Declaration of Helsinki, and investigational review
board approval was obtained from the Carones Oph-
thalmology Center (Milan, Italy). Patients with cor-
neal pathology, previous refractive surgery, or abnor-
malities in the anterior segment were excluded from
the study. Patients were fully informed about the pur-
pose of the study and provided informed consent.
BIOMETRY TECHNIQUES
Ocular biometry was performed using immersion
ultrasound, partial coherence interferometry, and low
coherence reflectometry in all patients. Partial coher-
ence interferometry and low coherence reflectometry
were performed first using block randomization, after
which measurement by immersion ultrasound was car-
ried out. Immersion ultrasound was the last technique
performed to avoid any possible discomfort to the patient
due to the use of the shell. Five consecutive measure-
ments were taken per eye with each instrument. Three
examiners (A.B., F.C., T.F.B.), one per technique, par-
ticipated and were masked to the values found using
the other two instruments.
The IOLMaster optical biometer uses partial coher-
ence interferometry with a 780-mm laser diode infra-
red light to measure axial length. The anterior chamber
depth is measured through a lateral slit-illumination
and is defined as the measurement between the corneal
epithelium and anterior lens surface. The keratom-
etry readings are calculated by analyzing the anterior
corneal curvature at six reference points oriented in a
hexagonal pattern at approximately the 2.3-mm optical
zone. White-to-white distance is also measured.
The Lenstar LS 900/Biograph optical biometer is
based on low coherence reflectometry, with an 820-mm
superluminescent diode. In addition to axial length,
the unit measures central corneal thickness and ante-
666
rior chamber depth, defined as the measurement from
the corneal endothelium to the anterior lens surface.
It also measures crystalline lens thickness and retinal
thickness. The keratometry readings are calculated by
analyzing the anterior corneal curvature at 32 refer-
ence points orientated in 2 circles at approximately the
2.30-mm and 1.65-mm optical zones. It also measures
white-to-white distance.
Immersion ultrasound was done using the Hansen
Shell immersion technique with the Ocuscan (Alcon
Laboratories Inc) ultrasound biometer.
DATA ANALYSIS
Data analysis was performed using SPSS for Win-
dows version 12.0 (SPSS Inc, Chicago, Illinois). Nor-
mality was checked by the Shapiro-Wilk test. For axial
length and anterior chamber depth measured with par-
tial coherence interferometry, low coherence reflec-
tometry, and immersion ultrasound, analysis of vari-
ance (ANOVA) was used to compare the outcomes. A
subanalysis as a function of cataract degree was also
performed. Paired t tests were applied to compare
keratometry, flattest axis, and white-to-white measure-
ments between partial coherence interferometry and
low coherence reflectometry. To determine the rela-
tionship between measurements of the two devices,
the Pearson correlation coefficient (R) was used. The
distribution of differences between each device was
plotted by means of Bland-Altman plots. This method
also computed 95% limits of agreement as ⫾2 stan-
dard deviations of the differences between two mea-
surement techniques. Differences were considered sta-
tistically significant at P⬍.05.
RESULTS
Table 1 shows the axial length and anterior cham-
ber depth measurements with the three techniques as
well as the difference in measurements between the
units for all eyes and as a function of cataract degree.
No statistically significant differences were noted for
the entire cohort and cataract degree among the three
techniques for axial length and anterior chamber depth
(P⬎.05, ANOVA test). Measurements between tech-
niques were highly correlated for axial length (partial
coherence interferometry vs low coherence reflectom-
etry, R=0.99; partial coherence interferometry vs im-
mersion ultrasound, R=0.99; and low coherence reflec-
tometry vs immersion ultrasound, R=0.99) and anterior
chamber depth (partial coherence interferometry vs low
coherence reflectometry, R=0.90; partial coherence in-
terferometry vs immersion ultrasound, R=0.96; and
low coherence reflectometry vs immersion ultrasound,
R=0.92). Figure 1 shows the distribution of differences
Copyright © SLACK Incorporated
 Comparison of Three Biometers/Montés-Micó et al

TABLE 1
Comparison of Axial Length and Anterior Chamber Depth Among Instruments in All
Eyes and as a Function of Cataract Degree (LOCS II Classification)
Mean⫾Standard Deviation (Range) (mm)
Difference Difference PCI- Difference LCR-
Parameter PCI LCR Immersion US PCI-LCR Immersion US Immersion US
All eyes AL 24.70⫾2.23 24.70⫾2.26 24.59⫾2.23 ⫺0.004⫾0.14 0.11⫾0.14 0.11⫾0.13
(N=78) (21.00 to 31.15) (20.95 to 31.28) (20.90 to 31.31) (⫺0.43 to 0.42) (⫺0.33 to 0.95) (⫺0.47 to 0.40)
ACD 3.12⫾0.42 3.19⫾0.40 3.30⫾0.39 ⫺0.07⫾0.28 ⫺0.18⫾0.28 ⫺0.11⫾0.15
(2.15 to 3.95) (2.31 to 4.15) (2.44 to 4.11) (⫺1.38 to 0.38) (⫺1.37 to 0.37) (⫺0.49 to 0.48)
LOCS II 1 AL 25.44⫾2.57 25.47⫾2.60 25.33⫾2.58 ⫺0.04⫾0.03 0.10⫾0.13 0.14⫾0.13
(n=32) (21.00 to 31.15) (20.95 to 31.28) (20.90 to 31.31) (⫺0.13 to 0.06) (⫺0.33 to 0.31) (⫺0.31 to 0.32)
ACD 3.23⫾0.40 3.33⫾0.36 3.40⫾0.33 ⫺0.10⫾0.35 ⫺0.17⫾0.34 ⫺0.06⫾0.18
(2.56 to 3.84) (2.36 to 3.97) (2.56 to 3.84) (⫺1.37 to 0.32) (⫺1.37 to 0.37) (⫺0.24 to 0.47)
LOCS II 2 AL 24.14⫾1.66 24.11⫾1.73 24.0⫾1.67 0.02⫾0.21 0.12⫾0.18 0.09⫾0.14
(n=27) (21.25 to 27.33) (21.15 to 27.37) (21.20 to 27.20) (⫺0.11 to 0.35) (⫺0.10 to 0.95) (⫺0.47 to 0.29)
ACD 3.08⫾0.42 3.13⫾0.38 3.26⫾0.41 ⫺0.10⫾0.24 ⫺0.17⫾0.25 ⫺0.12⫾0.07
(2.15 to 3.82) (2.31 to 3.87) (2.44 to 4.03) (⫺0.60 to 0.38) (⫺0.71 to 0.32) (⫺0.24 to 0.06)
LOCS II 3 AL 24.24⫾2.06 24.24⫾2.02 24.15⫾2.02 0.005⫾0.07 0.09⫾0.08 0.08⫾0.11
(n=19) (21.63 to 29.10) (21.62 to 28.87) (21.67 to 28.97) (⫺0.07 to 0.32) (⫺0.05 to 0.33) (⫺0.10 to 0.40)
ACD 2.98⫾0.39 3.03⫾0.40 3.18⫾0.44 ⫺0.05⫾0.15 ⫺0.20±0.19 ⫺0.15±0.17
(2.32 to 3.95) (2.38 to 4.15) (2.50 to 4.11) (⫺0.27 to 0.32) (⫺0.66 to 0.12) (⫺0.48 to 0.23)
PCI = partial coherence interferometry, LCR = low coherence reflectometry, US = ultrasound, AL = axial length, ACD = anterior chamber depth (from epithelium)

by means of six Bland-Altman plots of axial length and DISCUSSION

anterior chamber depth measured by partial coherence
interferometry, low coherence reflectometry, and im-
mersion ultrasound for all eyes analyzed. Results show
that the observed distribution of differences in axial
length and anterior chamber depth measurements for
each comparison between techniques was unrelated to
the mean axial length and anterior chamber depth values,
respectively.
Table 2 shows the keratometry (K1 [flat] and K2
[steep] meridians), flattest axis, and white-to-white
measurements with partial coherence interferom-
etry and low coherence reflectometry for all eyes. All
values were comparable between techniques show-
ing no statistically significant differences among
them (paired t test, P⬎.1). Measurements between
techniques were highly correlated for both K1
(R=0.95), K2 (R=0.97), flattest axis (R=0.95), and
white-to-white (R=0.92). Figures 2 and 3 show the
Bland-Altman plots of white-to-white and keratom-
etry, respectively, measured by partial coherence
interferometry and low coherence reflectometry for
all eyes analyzed. Results show that the observed
differences in white-to-white and keratometry (K1
and K2) measurements between techniques were un-
related to the mean white-to-white and keratometry
values, respectively.
Previous reports have shown that both devices (par-
tial coherence interferometry [IOLMaster] and low co-
herence reflectometry [Lenstar LS 900/Biograph], which
are based on different technologies, correlate well for
axial length, anterior chamber depth, and keratometry,
providing valid measurements to be used for preopera-
tive examination of cataract patients.9-15 However, some
discrepancies exist among studies although they are not
clinically significant. The purpose of the present study
was to analyze and compare both devices to one another
as well as to immersion ultrasound for axial length and
anterior chamber depth measurements. A subanalysis
as a function of cataract degree was done, considering
that cataract opacity might affect the outcomes.
AXIAL LENGTH AND ANTERIOR CHAMBER DEPTH
MEASUREMENTS
Comparable and highly correlated (R⬎0.9 for all
comparisons) measurements of axial length and ante-
rior chamber depth were obtained with the three tech-
niques analyzed. No statistically significant differences
were noted among the values found for all eyes or as a
function of cataract degree (P⬎.05). No previous stud-
ies comparing the three techniques in the same eyes
have been published to date and hence direct compari-
son with the present study is not possible. However,

Journal of Refractive Surgery • Vol. 27, No. 9, 2011 667

Comparison of Three Biometers/Montés-Micó et al

0.5 2.0 2.0

0.4 1.5 1.5
0.3
1.0 1.0
0.2
0.1 0.5 0.5

0 0 0
-0.1 -0.5 -0.5
-0.2
-1.0 -1.0
-0.3
-1.5 -1.5
-0.4
-0.5 -2.0 -2.0
20 22 24 26 28 30 32 20 22 24 26 28 30 32 20 22 24 26 28 30 32

1.0 1.0 1.0

0.8 0.8 0.8
0.6 0.6 0.6
0.4 0.4 0.4
0.2 0.2 0.2
0 0 0
-0.2 -0.2 -0.2
-0.4 -0.4 -0.4
-0.6 -0.6 -0.6
-0.8 -0.8 -0.8
-1.0 -1.0 -1.0
2.0 2.5 3.0 3.5 4.0 2.0 2.5 3.0 3.5 4.0 2.0 2.5 3.0 3.5 4.0

Figure 1. Bland-Altman plots showing the distribution of differences as a function of mean values for top) axial length (AL) and bottom) anterior cham-
ber depth (ACD) among the three techniques (partial coherence interferometry [PCI], low coherence reflectometry [LCR], and immersion ultrasound
[IU]). The 95% limits of agreement are represented by dotted lines and the bold horizontal line refers to the mean difference between techniques.

TABLE 2
Comparison of Keratometry, Flattest Axis, and White-to-White Between
Partial Coherence Interferometry and Low Coherence Reflectometry
Mean⫾Standard Deviation (Range)
Parameter PCI LCR Difference PCI-LCR P Value
Keratometry K1 (D) 42.32⫾1.71 42.24⫾1.68 0.08⫾1.41 .310
(36.37 to 46.49) (35.42 to 45.68) (⫺0.01 to 1.65)
Keratometry K2 (D) 43.33⫾1.81 43.12⫾1.72 0.22⫾1.53 .108
(36.72 to 48.01) (36.01 to 46.94) (⫺0.26 to 2.78)
Flattest axis (°) 93.33⫾59.98 93.27⫾60.48 0.77⫾61.55 .495
(1 to 178) (0 to 179) (⫺170 to 169)
White-to-white (mm) 12.08⫾0.47 12.11⫾0.39 ⫺0.04⫾0.50 .269
(11.08 to 12.70) (11.01 to 12.86) (⫺1.16 to 1.40)
PCI = partial coherence interferometry, LCR = low coherence reflectometry, K1 = flat meridian, K2 = steep meridian

reports comparing the IOLMaster and Lenstar are of
interest.
Rohrer et al9 compared the IOLMaster with the Len-
star LS 900 in 144 eyes (83 cataractous, 28 pseudo-
phakic, 5 aphakic, 14 silicon oil-filled, and 14 healthy
phakic eyes). In all eyes, the results showed a high cor-
relation for axial length and anterior chamber depth
measurements between both instruments (R coefficient
close to 1). Holzer et al10 compared 200 healthy eyes
using both instruments, showing that axial length and
anterior chamber depth were similar and comparable.
However, in 112 cataract patients, Buckhurst et al11
showed significant differences between devices for
axial length (longer for low coherence reflectometry by
0.01⫾0.15 mm, P⬍.001) and anterior chamber depth
(longer for low coherence reflectometry by 0.10⫾0.40 mm,
P⬍.001). Regarding the anterior chamber depth dis-
crepancy in the study by Buckhurst et al, the IOLMas-
ter does not use coherent interferometry to measure
anterior chamber depth, using instead image analy-
sis of the distance between the anterior surface of the
cornea and crystalline lens when illuminated by an

668 Copyright © SLACK Incorporated


1.5
1.0
0.5
0 0
-0.5
-1.0
-1.5
11 11.5 12 12.5 13
Figure 2. Bland-Altman plot showing the distribution of differences as
a function of mean values for white-to-white measurement between
the partial coherence interferometry and low coherence reflectometry
techniques. The 95% limits of agreement are represented by dotted lines
and the bold horizontal line represents the mean difference between
techniques. Results show that the observed differences in white-to-white
measurements between techniques were unrelated to the mean white-
to-white.
optical section with a 0.7-mm wide slit beam of light
through the anterior segment of the eye at an angle of
38° to the visual axis.16 The Lenstar detects the ante-
rior and posterior corneal and anterior crystalline lens
peaks in the low coherence reflectometry waveform to
measure the anterior chamber depth and corneal thick-
ness, which were combined for comparison with the
IOLMaster result.
Rabsilber et al12 compared the IOLMaster and Lenstar
in 100 cataractous eyes showing comparable outcomes
for axial length (P⬎.1) but significantly higher mea-
surements for anterior chamber depth with the Lenstar
(0.05⫾0.11 mm, P⬍.1). In 145 cataractous eyes, Liampa
et al13 showed a small, systematic statistically, although
not clinically, significant difference in axial length
(0.03 mm, P⬍.0001) and anterior chamber depth (0.2 mm,
P⬍.0001) between the devices. Hoffer et al14 evaluated
50 cataract and 50 clear lens eyes. They found a good
correlation between axial length and anterior chamber
depth in both groups. However, the Lenstar measured
a slightly longer axial length (mean difference 0.026 mm
and 0.023 mm for cataract and clear lens eyes, respec-
tively; P⬍.0001) and a deeper anterior chamber depth
(0.128 mm and 0.146 mm for cataract and clear lens
eyes, respectively; P⬍.0001). Cruysberg et al15 ana-
lyzed 78 healthy eyes showing that the correlation
between these two devices regarding the axial length
was very high (R=1.000), yet a significant difference
was found (P⬍.001). Anterior chamber depth measure-
ments of the IOLMaster were significantly lower than
the Lenstar (P=.011).
Although no differences between partial coherence
interferometry and low coherence reflectometry were
Journal of Refractive Surgery • Vol. 27, No. 9, 2011
Comparison of Three Biometers/Montés-Micó et al
2.0
1.5
1.0
0.5
-0.5
-1.0
-1.5
2.0
38 40 42 44 46 48
Figure 3. Bland-Altman plot showing differences against mean values
for keratometry (K1 and K2) between the partial coherence interfer-
ometry and low coherence reflectometry techniques. The 95% limits of
agreement are not represented to avoid confusion. The bold and dotted
horizontal lines represent the mean difference between techniques for
K1 and K2, respectively. Results show that the observed differences in
keratometry measurements between techniques were unrelated to the
mean keratometry for both meridians.
found in the present study, discrepancies may exist in
axial length and anterior chamber depth measurements.
Hoffer et al14 suggested that the reason for axial length
measurement discrepancy is unclear. We believe it is
likely to be related to the fact that measurements from
the partial coherence interferometry unit are recali-
brated to improve agreement with immersion ultra-
sound. The partial coherence interferometry unit mea-
sures the distance from the anterior corneal vertex to
the retinal pigment epithelium, whereas immersion
ultrasound measures the distance up to the internal
limiting membrane.15 Without recalibration, partial
coherence interferometry would result in higher mea-
surements than immersion ultrasound. Similarly, it
can be speculated that longer mean axial length mea-
sured by low coherence reflectometry depends on a
different algorithm used to closely reflect ultrasound
values. Despite recalibration, the clinical significance
of 0.01,11 0.02,14 and 0.0313 mm axial length variation
between units reported in other IOL power calculation
studies would be a ⬍0.10-diopter difference.17 Regard-
ing anterior chamber depth, as previously discussed,
differences found in some studies might be attributed
to the different technique for measurement used by
each instrument. Partial coherence interferometry
devices measure anterior chamber depth through a
lateral slit illumination,18 whereas low coherence re-
flectometry devices measure anterior chamber depth
with optical biometry.
In addition, differences as a function of cataract
degree were not found. The presence of dense media
seems to be a similar problem for both devices. Buck-
hurst et al11 reported that axial length measurement
669
Comparison of Three Biometers/Montés-Micó et al
was not possible in 9% to 10% of patients because of
this factor.
KERATOMETRY, FLATTEST AXIS, AND WHITE-TO-WHITE
MEASUREMENTS
The results reported herein revealed no significant
differences between partial coherence interferometry
and low coherence reflectometry for keratometry, flat-
test axis, or white-to-white measurements. Both units
correlated well, achieving R values close to 1. Bland-
Altman plots in Figures 2 and 3 show that the ob-
served differences in white-to-white and keratometry
measurements between techniques were unrelated to
the actual white-to-white and keratometry values mea-
sured, respectively.
Previous studies found comparable outcomes be-
tween units for keratometry,9-11 flattest axis,9 and white-
to-white11,15 measurements. However, others reported
small but statistically significant differences between
the devices when analyzing keratometry. Rabsilber et
al12 and Liampa et al13 showed mean differences be-
tween R2 and (R1⫹R2)/2 corneal radii of ⭐0.02 mm
(P⬍.01) and 0.01 mm (P⬍.0001), respectively. Hoffer et
al14 reported a flatter keratometry with low coherence
reflectometry compared to partial coherence interfer-
ometry (⫺0.107 D and ⫺0.121 D for cataract and clear
lens eyes, respectively; P⬍.0001). Cruysberg et al15 re-
ported larger keratometry readings for low coherence
reflectometry versus partial coherence interferometry
(K1: 7.80 vs 7.79 mm, P=.034; K2: 7.65 vs 7.63 mm,
P⬍.001). For keratometry, both units acquire corneal
radius measurements in the flat and steep meridian by
analyzing a pattern of light-emitting diodes (LEDs) im-
aged by the corneal front surface. With the Lenstar, the
corneal curvature value is calculated by 32 projected
light reflections, which are arranged on 2 circles with
16 measuring points each. It has been suggested that
compared to an arrangement with fewer LEDs, the
evaluation of a larger number of LEDs has the poten-
tial to improve the measurement reproducibility and
accuracy because of the averaging over a larger number
of measurement points.9 The outer circle consisting of
16 LEDs is projected onto the cornea in a ring 2.3 mm
in diameter corresponding to the typical measurement
zone of commercially available keratometers. The in-
ner circle consisting of 16 LEDs is projected onto the
cornea in a ring 1.65 mm in diameter. Rohrer et al9 sug-
gested that the relatively small diameter of the inner
LEDs may be beneficial for keratometry of corneas that
are centrally altered after excimer laser correction.
Discrepancies among literature studies are found for
corneal radius estimation.9-12,15 However, keratometry
variations reported were approximately 0.12 D, which
670
in our opinion, is not clinically significant. Caution
must be taken when using a dioptric representation
of corneal curvature, as differences in the refractive in-
dex attributed to the cornea between the instruments
(n=1.3375 [IOLMaster] and n=1.332 [Lenstar]) would
result in a clinically significant difference in average
curvature.
Partial coherence interferometry, low coherence
reflectometry, and immersion ultrasound provided
comparable ocular biometry in cataract patients. Non-
contact optical biometry using partial coherence in-
terferometry or low coherence reflectometry can be
used in clinical practice to measure those parameters
needed for accurate IOL power calculation in cataract
and refractive surgery. Future studies should include a
large sample of eyes, considering short and long eyes,
to analyze possible differences.
AUTHOR CONTRIBUTIONS
Study concept and design (R.M.M., F.C., A.B., D.M.C.); data col-
lection (F.C., A.B., T.F.B., D.M.C.); analysis and interpretation of
data (R.M.M., T.F.B.); drafting of the manuscript (R.M.M., F.C., A.B.,
T.F.B., D.M.C.); critical revision of the manuscript (R.M.M.)
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