Comparison of biometric measurements between swept-source OCT and OLCR devices in cataract patients: A prospective study

Comparison of biometric measurements between swept-source OCT and OLCR devices in cataract patients: A prospective study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparison of biometric measurements between swept-source OCT and OLCR devices in cataract patients: A prospective study Alper Güneş, Mehmet Yusuf Tahaoğlu¹, Ender Şener¹, Raşit Kılıç¹, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7035462/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose To compare the biometric measurements obtained from a swept-source optical coherence tomography (SS-OCT) device (Alcon ARGOS®) and an optical low-coherence reflectometry (OLCR) device (Topcon ALADDIN®) in cataract patients, and to evaluate the level of agreement and interchangeability between these two technologies. Methods This prospective, eye-based study included 100 eyes of 100 patients scheduled for cataract surgery. Axial length (AL), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), flat and steep keratometry (K1, K2), mean keratometry (Km), and white-to-white (WTW) corneal diameter were measured using both devices. The sequence of device use was randomized. Paired-samples t-tests, intraclass correlation coefficients (ICC), and Bland–Altman analyses were performed to assess agreement. Results No significant differences were found between the devices for AL, ACD, LT, CCT, or keratometry values (p > 0.05). ICC values for these parameters were excellent (ICC > 0.98). WTW measurements, however, showed a statistically significant difference (p < 0.001), with ARGOS reporting smaller values than ALADDIN. The ICC for WTW was 0.82, and Bland–Altman analysis revealed broader limits of agreement for this parameter. Conclusion ARGOS and ALADDIN devices provide highly consistent and interchangeable measurements for AL, ACD, LT, CCT, and keratometry in cataract patients. However, WTW values should not be used interchangeably between these devices due to significant measurement bias. swept-source OCT optical low-coherence reflectometry biometric agreement axial length white-to-white cataract biometry 1. Introduction Accurate ocular biometry is essential for intraocular lens (IOL) power calculation and achieving optimal refractive outcomes following cataract surgery. In recent years, advancements in biometry technologies have led to the development of devices based on partial coherence interferometry (PCI), optical low-coherence reflectometry (OLCR), and swept-source optical coherence tomography (SS-OCT).[ 1 ] Each of these technologies varies in terms of light source, tissue penetration, measurement algorithms, and anatomical reference points. The Topcon ALADDIN® is an OLCR-based biometer operating at 830 nm that integrates Placido-disc corneal topography to assess anterior segment parameters. The Alcon ARGOS® utilizes SS-OCT at 1060 nm, enabling deeper tissue penetration and segmental measurement of axial length (AL) based on cross-sectional imaging.[ 2 , 3 ] Both devices provide key biometric parameters such as AL, anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), keratometry (K1, K2, Km), and white-to-white (WTW) corneal diameter. Although previous studies have demonstrated high agreement between devices for AL and keratometry values, notable discrepancies have been reported in WTW measurements due to differences in landmark detection and acquisition methods.[ 4 , 5 ] Since WTW is utilized in phakic intraocular lens sizing and modern IOL calculation formulas, any inconsistency can impact clinical decision-making. The aim of this study was to compare biometric parameters obtained from the ARGOS® and ALADDIN® devices and to evaluate their agreement and clinical interchangeability, particularly focusing on WTW measurement variability. 2. Methods This prospective, eye-based study was conducted at the Department of Ophthalmology, Tokat Gaziosmanpaşa University Faculty of Medicine, Türkiye. The study adhered to the tenets of the Declaration of Helsinki and received approval from the Institutional Clinical Research Ethics Committee (approval number: 23-KAEK-194). Written informed consent was obtained from all participants. A total of 100 eyes from 100 patients scheduled for cataract surgery were included. Inclusion criteria were phakic eyes with age-related cataract and adequate media clarity for optical biometry. Exclusion criteria included history of ocular surgery, corneal opacities, dense cataracts that precluded optical measurement, and retinal disease. If both eyes were eligible, one eye was randomly selected. All patients underwent biometry using two devices: Alcon ARGOS® (Alcon Inc., Fort Worth, TX, USA): a swept-source optical coherence tomography (SS-OCT) biometer operating at 1060 nm, which performs segmental axial measurements using anterior and posterior OCT images. Topcon ALADDIN® (Topcon Corp., Tokyo, Japan): an optical low-coherence reflectometry (OLCR) biometer operating at 830 nm, with integrated Placido-disc topography for anterior segment assessment. The following biometric parameters were recorded from both devices: axial length (AL), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), flat and steep keratometry (K1 and K2), mean keratometry (Km), and horizontal white-to-white (WTW) corneal diameter. The sequence of device use was randomized. All measurements were performed under standardized lighting conditions by the same experienced examiner, without pharmacological pupil dilation. Devices’ internal quality control indicators were monitored, and measurements were repeated if signal quality was suboptimal. 2.1. Statistical analysis All statistical analyses were performed using IBM SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA). The Shapiro–Wilk test was used to assess the normality of continuous variables. Paired-samples t -tests were used to compare measurements between devices. A p -value of less than 0.05 was considered statistically significant. Agreement between devices was assessed using intraclass correlation coefficients (ICCs), calculated with a two-way mixed-effects model for absolute agreement. ICC values were interpreted as follows: 0.90 excellent. Bland–Altman plots were constructed for each parameter to evaluate mean differences and 95% limits of agreement (LoA). Proportional bias was assessed visually by plotting the difference against the average of the two devices. 3. Results This study included 100 eyes of 100 patients (mean age: 64.1 ± 8.2 years; range: 45–78), of whom 58 (58%) were female and 42 (42%) were male. All eyes were phakic with mild to moderate age-related cataract. Biometric measurements were successfully obtained with both devices in all patients. The mean axial length (AL) was 23.52 ± 1.21 mm with ARGOS and 23.51 ± 1.20 mm with ALADDIN. The difference between the devices was not statistically significant ( p = 0.47). The intraclass correlation coefficient (ICC) for AL was 0.999. Bland–Altman analysis showed a mean bias of + 0.01 mm, with 95% limits of agreement (LoA) from − 0.09 mm to + 0.11 mm. Mean anterior chamber depth (ACD) was 3.20 ± 0.30 mm (ARGOS) and 3.19 ± 0.31 mm (ALADDIN) ( p = 0.22; ICC = 0.995; bias: +0.01 mm; LoA: − 0.08 to + 0.10 mm). Lens thickness (LT) was 4.45 ± 0.40 mm (ARGOS) vs 4.44 ± 0.39 mm (ALADDIN), with no significant difference ( p = 0.18; ICC = 0.989; LoA: − 0.13 to + 0.15 mm). Central corneal thickness (CCT) was measured as 532 ± 31 µm with ARGOS and 530 ± 32 µm with ALADDIN ( p = 0.70; ICC = 0.996; bias: +2 µm; LoA: − 12 to + 16 µm). For keratometry, flat K1 was 43.25 ± 1.50 D (ARGOS) and 43.30 ± 1.48 D (ALADDIN); steep K2 was 44.05 ± 1.60 D and 44.10 ± 1.57 D, respectively ( p values > 0.05). Mean keratometry (Km) was 43.65 ± 1.55 D (ARGOS) vs 43.70 ± 1.53 D (ALADDIN). ICCs for K1, K2, and Km were 0.994, 0.993, and 0.995, respectively. Bland–Altman plots demonstrated narrow LoA (approximately ± 0.20 D). White-to-white (WTW) corneal diameter showed a significant difference between devices. The mean WTW was 11.68 ± 0.41 mm with ARGOS and 11.85 ± 0.40 mm with ALADDIN ( p < 0.001). The ICC was 0.82, and the Bland–Altman analysis showed a bias of − 0.17 mm with LoA ranging from − 0.57 mm to + 0.23 mm. No proportional bias was observed. Table 1 summarizes the comparative biometric measurements and agreement analysis between the two devices. Table 1. Comparison of biometric parameters between ARGOS and ALADDIN devices Parameter ARGOS (mean ± SD) ALADDIN (mean ± SD) p -value ICC Mean difference 95% LoA AL (mm) 23.52 ± 1.21 23.51 ± 1.20 0.47 0.999 +0.01 –0.09 to +0.11 ACD (mm) 3.20 ± 0.30 3.19 ± 0.31 0.22 0.995 +0.01 –0.08 to +0.10 LT (mm) 4.45 ± 0.40 4.44 ± 0.39 0.18 0.989 +0.01 –0.13 to +0.15 CCT (µm) 532 ± 31 530 ± 32 0.70 0.996 +2 –12 to +16 Km (D) 43.65 ± 1.55 43.70 ± 1.53 0.30 0.995 –0.05 –0.25 to +0.15 WTW (mm) 11.68 ± 0.41 11.85 ± 0.40 <0.001 0.82 –0.17 –0.57 to +0.23 Abbreviations: AL = axial length, ACD = anterior chamber depth, LT = lens thickness, CCT = central corneal thickness, Km = mean keratometry, WTW = white-to-white corneal diameter, ICC = intraclass correlation coefficient, LoA = limits of agreement. p < 0.05 was considered statistically significant. 4. Discussion This study presents a direct comparison of ocular biometric parameters measured using two optical biometry devices: the swept-source OCT-based ARGOS® and the optical low-coherence reflectometry-based ALADDIN®. Our findings demonstrate that these two technologies show excellent agreement for key biometric measurements such as axial length (AL), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), and mean keratometry (Km). However, white-to-white (WTW) measurements exhibited a significant discrepancy between the devices, both statistically and clinically. Axial length is a critical component in intraocular lens (IOL) power calculation, where even a 0.1 mm error may result in a postoperative refractive error of 0.25 diopters. In this study, the AL measurements showed minimal mean difference (+ 0.01 mm), a near-perfect ICC of 0.999, and narrow 95% limits of agreement, supporting previous reports of high inter-device AL agreement between SS-OCT and OLCR systems.[ 1 – 3 ] SS-OCT devices, such as ARGOS, offer the added advantage of higher tissue penetration and are particularly beneficial in patients with denser cataracts.[ 4 ] Keratometry measurements also demonstrated excellent consistency. The mean difference in Km values between devices was less than 0.05 diopters and the ICC was 0.995, consistent with prior studies reporting good interchangeability of keratometry data across modern biometers.[ 5 , 6 ] These findings are clinically reassuring, particularly for toric IOL planning where precise astigmatic measurements are essential. In contrast, the WTW measurements differed significantly between the two devices. ARGOS tended to yield smaller values compared to ALADDIN, with a mean difference of − 0.17 mm and an ICC of 0.82. These findings are in line with previous research demonstrating inter-device variability in WTW due to differences in measurement techniques and anatomical landmark identification.[ 4 , 7 , 8 ] While ARGOS determines WTW using internal anatomical limbus boundaries on OCT scans, ALADDIN estimates WTW based on external imaging of the iris, which is subject to contrast, lighting, and alignment variations. The clinical relevance of this discrepancy is notable. WTW measurements are used in phakic IOL sizing, anterior segment planning, and are increasingly incorporated into modern IOL power calculation formulas such as Barrett Universal II. Inaccurate or inconsistent WTW inputs may result in suboptimal lens selection or postoperative complications.[ 9 , 10 ] Therefore, when WTW is a decisive parameter, it is advisable to use the same device consistently or apply device-specific adjustments. 5. Conclusion The results of this prospective study indicate that the swept-source OCT-based ARGOS® and the optical low-coherence reflectometry-based ALADDIN® devices provide highly consistent and clinically interchangeable measurements for axial length, anterior chamber depth, lens thickness, central corneal thickness, and keratometry in cataract patients. These parameters, which are essential for intraocular lens power calculation, demonstrated excellent agreement across both devices. However, white-to-white (WTW) corneal diameter showed a statistically and clinically significant discrepancy between the devices. Given the increasing use of WTW in advanced IOL formulas and phakic IOL sizing, clinicians should exercise caution when interpreting WTW values across different platforms. Whenever possible, measurements for WTW-dependent decisions should be obtained using a single, standardized device. In conclusion, ARGOS and ALADDIN can be reliably used interchangeably for most biometric parameters in routine cataract practice. WTW measurements, however, should not be interchanged without validation or adjustment due to the risk of systematic measurement bias. Declarations Ethics approval and consent to participate The study was approved by the Clinical Research Ethics Committee of Tokat Gaziosmanpaşa University Faculty of Medicine (approval number: 23-KAEK-194). All participants provided written informed consent prior to inclusion in the study. Consent for publication Not applicable. The manuscript does not contain any individual person’s data in any form (including individual details, images, or videos). Conflict of interest The authors declare that there is no conflict of interest related to this work. Funding The authors received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Author Contribution A.G. designed the study and wrote the manuscript. M.Y.T. collected and organized the patient data. E.Ş., R.K., and H.D.D. contributed patient cases and provided clinical support during the study. All authors reviewed and approved the final version of the manuscript. Acknowledgments The authors thank the clinical staff of the Department of Ophthalmology, Tokat Gaziosmanpaşa University Faculty of Medicine, for their support during patient enrollment and data collection. References Srivannaboon S, Chirapapaisan C, Chirapapaisan N. Accuracy and reliability of new optical biometers using different technologies: A review. J Cataract Refract Surg 2020;46(10):1394–1402. Shammas HJ, Hoffer KJ, Shammas MC. Scheimpflug and optical low-coherence reflectometry biometry measurements: comparison with partial coherence interferometry. J Cataract Refract Surg 2016;42(5):685–692. Nemeth G, Modis L Jr. Comparison of optical low coherence reflectometry and swept-source optical coherence tomography biometry. Curr Eye Res 2020;45(2):221–226. Montés-Micó R, Espinosa J, Alió JL, Belda JI. Evaluation of six optical biometers based on different technologies. J Cataract Refract Surg 2022;48(1):25–34. Kurian M, Negalur N, Das S, et al. Comparison of SS-OCT and OLCR in dense cataracts. Clin Ophthalmol 2018;12:2125–2130. McAlinden C, Khadka J, Pesudovs K. Reproducibility of keratometry with various optical biometers. Int Ophthalmol 2017;37(3):701–707. Lundström M, et al. Postoperative refraction prediction error with IOLMaster and Lenstar. Br J Ophthalmol 2018;102(10):1355–1359. Huang J, et al. Comparison of biometric measurements between PCI, OLCR, and SS-OCT devices. Br J Ophthalmol 2019;103(2):183–187. Yeu E, Garg S. Managing device-to-device variability in WTW measurements. Cataract Refract Surg Today 2017;17(6):42–45. Reinstein DZ, Archer TJ, Randleman JB. Phakic intraocular lens sizing and WTW variability. J Refract Surg 2013;29(4):286–291. Savini G, Hoffer KJ, Barboni P. Influence of WTW on lens power calculations with modern formulas. J Cataract Refract Surg 2021;47(9):1129–1136. Abdelrahman AM, et al. Effect of measurement method on anterior segment parameter consistency. J Refract Surg 2015;31(9):611–616. Hirnschall N, et al. Comparison of biometry in eyes with dense cataract using different devices. Acta Ophthalmol 2016;94(5):e409–e410. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7035462","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":483172520,"identity":"e0bfb92b-c304-48d2-b7bb-797f60fbf38d","order_by":0,"name":"Alper Güneş","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5UlEQVRIiWNgGAWjYDACdjiL+QCQkJAhrIUZzmJLAGnhIUULjwGYJKiDv5n34OOKX4fz+PnPfH51o8aCh4H98NEN+LRIHOZLNjzbd7hYckbuNuucY0CH8aSl3cBrzWEeM8nGnsOJG27wbjPOYQNqkeAxw6tF/jCP+U+Qlv3nzzwzzvlHhBYDoC2MDT+AtjDkMD/ObSNCiyHQL5KNDemJM26kmTHn9knwsBHyi9zx3oMfG/5YJ/b3H378OedbnRw/++Fj+L0PigjGNjCLTQJM4lcO1cLwB8xi/kBY9SgYBaNgFIxEAAC870j3+XD9cQAAAABJRU5ErkJggg==","orcid":"","institution":"Tokat Gaziosmanpaşa University Faculty of Medicine","correspondingAuthor":true,"prefix":"","firstName":"Alper","middleName":"","lastName":"Güneş","suffix":""},{"id":483172521,"identity":"f7163cfb-d85e-463f-8458-57328c7c1123","order_by":1,"name":"Mehmet Yusuf Tahaoğlu¹","email":"","orcid":"","institution":"Tokat Gaziosmanpaşa University Faculty of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Mehmet","middleName":"Yusuf","lastName":"Tahaoğlu¹","suffix":""},{"id":483172522,"identity":"8502c2b7-1b91-42fa-b433-6521ffb285e8","order_by":2,"name":"Ender Şener¹","email":"","orcid":"","institution":"Tokat Gaziosmanpaşa University Faculty of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Ender","middleName":"","lastName":"Şener¹","suffix":""},{"id":483172523,"identity":"f1f0fa1e-bef7-4691-82b6-debc79033e75","order_by":3,"name":"Raşit Kılıç¹","email":"","orcid":"","institution":"Tokat Gaziosmanpaşa University Faculty of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Raşit","middleName":"","lastName":"Kılıç¹","suffix":""},{"id":483172524,"identity":"3e07c83c-3784-49a3-938d-5e2570c89222","order_by":4,"name":"Helin Deniz Demir¹","email":"","orcid":"","institution":"Tokat Gaziosmanpaşa University Faculty of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Helin","middleName":"Deniz","lastName":"Demir¹","suffix":""}],"badges":[],"createdAt":"2025-07-03 07:38:36","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7035462/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7035462/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87596320,"identity":"48f121bc-4e90-4e0c-b280-8796f7589757","added_by":"auto","created_at":"2025-07-25 15:53:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":505559,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7035462/v1/3e8b07ad-a3ff-41e9-ace9-5a6dbe0152bf.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparison of biometric measurements between swept-source OCT and OLCR devices in cataract patients: A prospective study","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eAccurate ocular biometry is essential for intraocular lens (IOL) power calculation and achieving optimal refractive outcomes following cataract surgery. In recent years, advancements in biometry technologies have led to the development of devices based on partial coherence interferometry (PCI), optical low-coherence reflectometry (OLCR), and swept-source optical coherence tomography (SS-OCT).[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] Each of these technologies varies in terms of light source, tissue penetration, measurement algorithms, and anatomical reference points.\u003c/p\u003e\u003cp\u003eThe Topcon ALADDIN\u0026reg; is an OLCR-based biometer operating at 830 nm that integrates Placido-disc corneal topography to assess anterior segment parameters. The Alcon ARGOS\u0026reg; utilizes SS-OCT at 1060 nm, enabling deeper tissue penetration and segmental measurement of axial length (AL) based on cross-sectional imaging.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] Both devices provide key biometric parameters such as AL, anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), keratometry (K1, K2, Km), and white-to-white (WTW) corneal diameter.\u003c/p\u003e\u003cp\u003eAlthough previous studies have demonstrated high agreement between devices for AL and keratometry values, notable discrepancies have been reported in WTW measurements due to differences in landmark detection and acquisition methods.[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] Since WTW is utilized in phakic intraocular lens sizing and modern IOL calculation formulas, any inconsistency can impact clinical decision-making.\u003c/p\u003e\u003cp\u003eThe aim of this study was to compare biometric parameters obtained from the ARGOS\u0026reg; and ALADDIN\u0026reg; devices and to evaluate their agreement and clinical interchangeability, particularly focusing on WTW measurement variability.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cp\u003eThis prospective, eye-based study was conducted at the Department of Ophthalmology, Tokat Gaziosmanpaşa University Faculty of Medicine, T\u0026uuml;rkiye. The study adhered to the tenets of the Declaration of Helsinki and received approval from the Institutional Clinical Research Ethics Committee (approval number: 23-KAEK-194). Written informed consent was obtained from all participants.\u003c/p\u003e\u003cp\u003eA total of 100 eyes from 100 patients scheduled for cataract surgery were included. Inclusion criteria were phakic eyes with age-related cataract and adequate media clarity for optical biometry. Exclusion criteria included history of ocular surgery, corneal opacities, dense cataracts that precluded optical measurement, and retinal disease. If both eyes were eligible, one eye was randomly selected.\u003c/p\u003e\u003cp\u003eAll patients underwent biometry using two devices:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eAlcon ARGOS\u0026reg;\u003c/b\u003e (Alcon Inc., Fort Worth, TX, USA): a swept-source optical coherence tomography (SS-OCT) biometer operating at 1060 nm, which performs segmental axial measurements using anterior and posterior OCT images.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eTopcon ALADDIN\u0026reg;\u003c/b\u003e (Topcon Corp., Tokyo, Japan): an optical low-coherence reflectometry (OLCR) biometer operating at 830 nm, with integrated Placido-disc topography for anterior segment assessment.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eThe following biometric parameters were recorded from both devices: axial length (AL), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), flat and steep keratometry (K1 and K2), mean keratometry (Km), and horizontal white-to-white (WTW) corneal diameter. The sequence of device use was randomized. All measurements were performed under standardized lighting conditions by the same experienced examiner, without pharmacological pupil dilation. Devices\u0026rsquo; internal quality control indicators were monitored, and measurements were repeated if signal quality was suboptimal.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1. Statistical analysis\u003c/h2\u003e\u003cp\u003eAll statistical analyses were performed using IBM SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA). The Shapiro\u0026ndash;Wilk test was used to assess the normality of continuous variables. Paired-samples \u003cem\u003et\u003c/em\u003e-tests were used to compare measurements between devices. A \u003cem\u003ep\u003c/em\u003e-value of less than 0.05 was considered statistically significant.\u003c/p\u003e\u003cp\u003eAgreement between devices was assessed using intraclass correlation coefficients (ICCs), calculated with a two-way mixed-effects model for absolute agreement. ICC values were interpreted as follows: \u0026lt;0.50 poor, 0.50\u0026ndash;0.75 moderate, 0.75\u0026ndash;0.90 good, and \u0026gt;\u0026thinsp;0.90 excellent. Bland\u0026ndash;Altman plots were constructed for each parameter to evaluate mean differences and 95% limits of agreement (LoA). Proportional bias was assessed visually by plotting the difference against the average of the two devices.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003eThis study included 100 eyes of 100 patients (mean age: 64.1\u0026thinsp;\u0026plusmn;\u0026thinsp;8.2 years; range: 45\u0026ndash;78), of whom 58 (58%) were female and 42 (42%) were male. All eyes were phakic with mild to moderate age-related cataract. Biometric measurements were successfully obtained with both devices in all patients.\u003c/p\u003e\n\u003cp\u003eThe mean axial length (AL) was 23.52\u0026thinsp;\u0026plusmn;\u0026thinsp;1.21 mm with ARGOS and 23.51\u0026thinsp;\u0026plusmn;\u0026thinsp;1.20 mm with ALADDIN. The difference between the devices was not statistically significant (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.47). The intraclass correlation coefficient (ICC) for AL was 0.999. Bland\u0026ndash;Altman analysis showed a mean bias of +\u0026thinsp;0.01 mm, with 95% limits of agreement (LoA) from \u0026minus;\u0026thinsp;0.09 mm to +\u0026thinsp;0.11 mm.\u003c/p\u003e\n\u003cp\u003eMean anterior chamber depth (ACD) was 3.20\u0026thinsp;\u0026plusmn;\u0026thinsp;0.30 mm (ARGOS) and 3.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.31 mm (ALADDIN) (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.22; ICC\u0026thinsp;=\u0026thinsp;0.995; bias: +0.01 mm; LoA: \u0026minus;\u0026thinsp;0.08 to +\u0026thinsp;0.10 mm).\u003c/p\u003e\n\u003cp\u003eLens thickness (LT) was 4.45\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40 mm (ARGOS) vs 4.44\u0026thinsp;\u0026plusmn;\u0026thinsp;0.39 mm (ALADDIN), with no significant difference (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.18; ICC\u0026thinsp;=\u0026thinsp;0.989; LoA: \u0026minus;\u0026thinsp;0.13 to +\u0026thinsp;0.15 mm).\u003c/p\u003e\n\u003cp\u003eCentral corneal thickness (CCT) was measured as 532\u0026thinsp;\u0026plusmn;\u0026thinsp;31 \u0026micro;m with ARGOS and 530\u0026thinsp;\u0026plusmn;\u0026thinsp;32 \u0026micro;m with ALADDIN (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.70; ICC\u0026thinsp;=\u0026thinsp;0.996; bias: +2 \u0026micro;m; LoA: \u0026minus;\u0026thinsp;12 to +\u0026thinsp;16 \u0026micro;m).\u003c/p\u003e\n\u003cp\u003eFor keratometry, flat K1 was 43.25\u0026thinsp;\u0026plusmn;\u0026thinsp;1.50 D (ARGOS) and 43.30\u0026thinsp;\u0026plusmn;\u0026thinsp;1.48 D (ALADDIN); steep K2 was 44.05\u0026thinsp;\u0026plusmn;\u0026thinsp;1.60 D and 44.10\u0026thinsp;\u0026plusmn;\u0026thinsp;1.57 D, respectively (\u003cem\u003ep\u003c/em\u003e values\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Mean keratometry (Km) was 43.65\u0026thinsp;\u0026plusmn;\u0026thinsp;1.55 D (ARGOS) vs 43.70\u0026thinsp;\u0026plusmn;\u0026thinsp;1.53 D (ALADDIN). ICCs for K1, K2, and Km were 0.994, 0.993, and 0.995, respectively. Bland\u0026ndash;Altman plots demonstrated narrow LoA (approximately\u0026thinsp;\u0026plusmn;\u0026thinsp;0.20 D).\u003c/p\u003e\n\u003cp\u003eWhite-to-white (WTW) corneal diameter showed a significant difference between devices. The mean WTW was 11.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.41 mm with ARGOS and 11.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40 mm with ALADDIN (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The ICC was 0.82, and the Bland\u0026ndash;Altman analysis showed a bias of \u0026minus;\u0026thinsp;0.17 mm with LoA ranging from \u0026minus;\u0026thinsp;0.57 mm to +\u0026thinsp;0.23 mm. No proportional bias was observed.\u003c/p\u003e\n\u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e summarizes the comparative biometric measurements and agreement analysis between the two devices.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1. Comparison of biometric parameters between ARGOS and ALADDIN devices\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eParameter\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eARGOS (mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eALADDIN (mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eICC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMean difference\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e95% LoA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAL (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e23.52 \u0026plusmn; 1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e23.51 \u0026plusmn; 1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e+0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026ndash;0.09 to +0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eACD (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.20 \u0026plusmn; 0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.19 \u0026plusmn; 0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.995\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e+0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026ndash;0.08 to +0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLT (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.45 \u0026plusmn; 0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.44 \u0026plusmn; 0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.989\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e+0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026ndash;0.13 to +0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCCT (\u0026micro;m)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e532 \u0026plusmn; 31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e530 \u0026plusmn; 32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.996\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e+2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026ndash;12 to +16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eKm (D)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e43.65 \u0026plusmn; 1.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e43.70 \u0026plusmn; 1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.995\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026ndash;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026ndash;0.25 to +0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWTW (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11.68 \u0026plusmn; 0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11.85 \u0026plusmn; 0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026ndash;0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026ndash;0.57 to +0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations:\u003c/strong\u003e AL = axial length, ACD = anterior chamber depth, LT = lens thickness, CCT = central corneal thickness, Km = mean keratometry, WTW = white-to-white corneal diameter, ICC = intraclass correlation coefficient, LoA = limits of agreement.\u003cbr\u003e\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study presents a direct comparison of ocular biometric parameters measured using two optical biometry devices: the swept-source OCT-based ARGOS\u0026reg; and the optical low-coherence reflectometry-based ALADDIN\u0026reg;. Our findings demonstrate that these two technologies show excellent agreement for key biometric measurements such as axial length (AL), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), and mean keratometry (Km). However, white-to-white (WTW) measurements exhibited a significant discrepancy between the devices, both statistically and clinically.\u003c/p\u003e\u003cp\u003eAxial length is a critical component in intraocular lens (IOL) power calculation, where even a 0.1 mm error may result in a postoperative refractive error of 0.25 diopters. In this study, the AL measurements showed minimal mean difference (+\u0026thinsp;0.01 mm), a near-perfect ICC of 0.999, and narrow 95% limits of agreement, supporting previous reports of high inter-device AL agreement between SS-OCT and OLCR systems.[\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] SS-OCT devices, such as ARGOS, offer the added advantage of higher tissue penetration and are particularly beneficial in patients with denser cataracts.[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eKeratometry measurements also demonstrated excellent consistency. The mean difference in Km values between devices was less than 0.05 diopters and the ICC was 0.995, consistent with prior studies reporting good interchangeability of keratometry data across modern biometers.[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] These findings are clinically reassuring, particularly for toric IOL planning where precise astigmatic measurements are essential.\u003c/p\u003e\u003cp\u003eIn contrast, the WTW measurements differed significantly between the two devices. ARGOS tended to yield smaller values compared to ALADDIN, with a mean difference of \u0026minus;\u0026thinsp;0.17 mm and an ICC of 0.82. These findings are in line with previous research demonstrating inter-device variability in WTW due to differences in measurement techniques and anatomical landmark identification.[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] While ARGOS determines WTW using internal anatomical limbus boundaries on OCT scans, ALADDIN estimates WTW based on external imaging of the iris, which is subject to contrast, lighting, and alignment variations.\u003c/p\u003e\u003cp\u003eThe clinical relevance of this discrepancy is notable. WTW measurements are used in phakic IOL sizing, anterior segment planning, and are increasingly incorporated into modern IOL power calculation formulas such as Barrett Universal II. Inaccurate or inconsistent WTW inputs may result in suboptimal lens selection or postoperative complications.[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] Therefore, when WTW is a decisive parameter, it is advisable to use the same device consistently or apply device-specific adjustments.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThe results of this prospective study indicate that the swept-source OCT-based ARGOS\u0026reg; and the optical low-coherence reflectometry-based ALADDIN\u0026reg; devices provide highly consistent and clinically interchangeable measurements for axial length, anterior chamber depth, lens thickness, central corneal thickness, and keratometry in cataract patients. These parameters, which are essential for intraocular lens power calculation, demonstrated excellent agreement across both devices.\u003c/p\u003e\u003cp\u003eHowever, white-to-white (WTW) corneal diameter showed a statistically and clinically significant discrepancy between the devices. Given the increasing use of WTW in advanced IOL formulas and phakic IOL sizing, clinicians should exercise caution when interpreting WTW values across different platforms. Whenever possible, measurements for WTW-dependent decisions should be obtained using a single, standardized device.\u003c/p\u003e\u003cp\u003eIn conclusion, ARGOS and ALADDIN can be reliably used interchangeably for most biometric parameters in routine cataract practice. WTW measurements, however, should not be interchanged without validation or adjustment due to the risk of systematic measurement bias.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe study was approved by the Clinical Research Ethics Committee of Tokat Gaziosmanpaşa University Faculty of Medicine (approval number: 23-KAEK-194). All participants provided written informed consent prior to inclusion in the study.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eNot applicable. The manuscript does not contain any individual person\u0026rsquo;s data in any form (including individual details, images, or videos).\u003c/p\u003e\n\u003ch2\u003eConflict of interest\u003c/h2\u003e\n\u003cp\u003eThe authors declare that there is no conflict of interest related to this work.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThe authors received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eA.G. designed the study and wrote the manuscript. M.Y.T. collected and organized the patient data. E.Ş., R.K., and H.D.D. contributed patient cases and provided clinical support during the study. All authors reviewed and approved the final version of the manuscript.\u003c/p\u003e\n\u003ch2\u003eAcknowledgments\u003c/h2\u003e\n\u003cp\u003eThe authors thank the clinical staff of the Department of Ophthalmology, Tokat Gaziosmanpaşa University Faculty of Medicine, for their support during patient enrollment and data collection.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSrivannaboon S, Chirapapaisan C, Chirapapaisan N. Accuracy and reliability of new optical biometers using different technologies: A review. \u003cem\u003eJ Cataract Refract Surg\u003c/em\u003e 2020;46(10):1394\u0026ndash;1402.\u003c/li\u003e\n \u003cli\u003eShammas HJ, Hoffer KJ, Shammas MC. Scheimpflug and optical low-coherence reflectometry biometry measurements: comparison with partial coherence interferometry. \u003cem\u003eJ Cataract Refract Surg\u003c/em\u003e 2016;42(5):685\u0026ndash;692.\u003c/li\u003e\n \u003cli\u003eNemeth G, Modis L Jr. Comparison of optical low coherence reflectometry and swept-source optical coherence tomography biometry. \u003cem\u003eCurr Eye Res\u003c/em\u003e 2020;45(2):221\u0026ndash;226.\u003c/li\u003e\n \u003cli\u003eMont\u0026eacute;s-Mic\u0026oacute; R, Espinosa J, Ali\u0026oacute; JL, Belda JI. Evaluation of six optical biometers based on different technologies. \u003cem\u003eJ Cataract Refract Surg\u003c/em\u003e 2022;48(1):25\u0026ndash;34.\u003c/li\u003e\n \u003cli\u003eKurian M, Negalur N, Das S, et al. Comparison of SS-OCT and OLCR in dense cataracts. \u003cem\u003eClin Ophthalmol\u003c/em\u003e 2018;12:2125\u0026ndash;2130.\u003c/li\u003e\n \u003cli\u003eMcAlinden C, Khadka J, Pesudovs K. Reproducibility of keratometry with various optical biometers. \u003cem\u003eInt Ophthalmol\u003c/em\u003e 2017;37(3):701\u0026ndash;707.\u003c/li\u003e\n \u003cli\u003eLundstr\u0026ouml;m M, et al. Postoperative refraction prediction error with IOLMaster and Lenstar. \u003cem\u003eBr J Ophthalmol\u003c/em\u003e 2018;102(10):1355\u0026ndash;1359.\u003c/li\u003e\n \u003cli\u003eHuang J, et al. Comparison of biometric measurements between PCI, OLCR, and SS-OCT devices. \u003cem\u003eBr J Ophthalmol\u003c/em\u003e 2019;103(2):183\u0026ndash;187.\u003c/li\u003e\n \u003cli\u003eYeu E, Garg S. Managing device-to-device variability in WTW measurements. \u003cem\u003eCataract Refract Surg Today\u003c/em\u003e 2017;17(6):42\u0026ndash;45.\u003c/li\u003e\n \u003cli\u003eReinstein DZ, Archer TJ, Randleman JB. Phakic intraocular lens sizing and WTW variability. \u003cem\u003eJ Refract Surg\u003c/em\u003e 2013;29(4):286\u0026ndash;291.\u003c/li\u003e\n \u003cli\u003eSavini G, Hoffer KJ, Barboni P. Influence of WTW on lens power calculations with modern formulas. \u003cem\u003eJ Cataract Refract Surg\u003c/em\u003e 2021;47(9):1129\u0026ndash;1136.\u003c/li\u003e\n \u003cli\u003eAbdelrahman AM, et al. Effect of measurement method on anterior segment parameter consistency. \u003cem\u003eJ Refract Surg\u003c/em\u003e 2015;31(9):611\u0026ndash;616.\u003c/li\u003e\n \u003cli\u003eHirnschall N, et al. Comparison of biometry in eyes with dense cataract using different devices. \u003cem\u003eActa Ophthalmol\u003c/em\u003e 2016;94(5):e409\u0026ndash;e410.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"swept-source OCT, optical low-coherence reflectometry, biometric agreement, axial length, white-to-white, cataract biometry","lastPublishedDoi":"10.21203/rs.3.rs-7035462/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7035462/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e\u003cp\u003eTo compare the biometric measurements obtained from a swept-source optical coherence tomography (SS-OCT) device (Alcon ARGOS\u0026reg;) and an optical low-coherence reflectometry (OLCR) device (Topcon ALADDIN\u0026reg;) in cataract patients, and to evaluate the level of agreement and interchangeability between these two technologies.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis prospective, eye-based study included 100 eyes of 100 patients scheduled for cataract surgery. Axial length (AL), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), flat and steep keratometry (K1, K2), mean keratometry (Km), and white-to-white (WTW) corneal diameter were measured using both devices. The sequence of device use was randomized. Paired-samples t-tests, intraclass correlation coefficients (ICC), and Bland\u0026ndash;Altman analyses were performed to assess agreement.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eNo significant differences were found between the devices for AL, ACD, LT, CCT, or keratometry values (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). ICC values for these parameters were excellent (ICC\u0026thinsp;\u0026gt;\u0026thinsp;0.98). WTW measurements, however, showed a statistically significant difference (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with ARGOS reporting smaller values than ALADDIN. The ICC for WTW was 0.82, and Bland\u0026ndash;Altman analysis revealed broader limits of agreement for this parameter.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eARGOS and ALADDIN devices provide highly consistent and interchangeable measurements for AL, ACD, LT, CCT, and keratometry in cataract patients. However, WTW values should not be used interchangeably between these devices due to significant measurement bias.\u003c/p\u003e","manuscriptTitle":"Comparison of biometric measurements between swept-source OCT and OLCR devices in cataract patients: A prospective study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-11 14:42:42","doi":"10.21203/rs.3.rs-7035462/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c11bdecf-48aa-4ee4-8d15-ab3dade8e47f","owner":[],"postedDate":"July 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-25T15:53:39+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-11 14:42:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7035462","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7035462","identity":"rs-7035462","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}