Analysis of Ocular Biometric Differences Between Two Optical Biometers in High Myopia Cataract Patients: A Prospective Study

Purpose: To compare the differences and consistency of Lenstar LS 900 and IOL Master 700 in measuring ocular biometry for cataract patients with high myopia. Patients and Methods: In this prospective study, 48 cataract patients (67 eyes) with high myopia were included. Paired comparisons were performed for axial length (AL), anterior chamber depth (ACD), lens thickness (LT), keratometry (K1, K2), corneal astigmatism (AST), and white-to-white distance (WTW) in IOL Master 700 and Lenstar LS 900. Agreement between devices was evaluated using Bland-Altman plots, and AL-based subgroup analysis was conducted using measurements from the IOL Master 700. Results: Among the 67 eyes, AL measurement failed in 6 eyes with Lenstar LS 900 but in none with IOL Master 700. Mean inter-device differences were as follows: AL: 0.07 ± 0.11 mm (p = 0.001); ACD: -0.02 ± 0.16 mm (p = 0.351); LT: -0.02 ± 0.28 mm (p = 0.534); K1: -0.03 ± 0.50 D (p = 0.658); K2: -0.04 ± 0.47 D (p = 0.492); AST: -0.03 ± 0.35 D (p = 0.492); WTW: -0.13 ± 0.43 mm (p = 0.017). Two devices were highly correlated for AL, ACD, LT, K1, K2 and AST (ICC > 0.75). Bland-Altman analysis indicated high agreement, with 95% of differences within limits of agreement. No statistically significant difference was found in absolute IOL power prediction between devices. Conclusion: In highly myopic cataract patients, IOL Master 700 shows a higher AL acquisition rate than Lenstar LS 900. Despite statistically significant differences in AL and WTW, no clinically relevant effect on refractive prediction was observed.