Purpose: To compare the predictive accuracy of the Barrett Toric IOL formula—when incorporating either Predicted or Measured posterior corneal astigmatism (PCA)—with the Castrop Toric formula. Methods: In this retrospective study, patients diagnosed as having age-related cataract who underwent phacoemulsification with the implantation of a monofocal non-toric IOL were reviewed. Four methods of calculating a toric IOL—the Castrop formula based on Predicted PCA (C-PPCA), the Castrop formula based on Measured PCA (C-MPCA), the Barrett Toric Calculator based on Predicted PCA (B-PPCA), and the Barrett Toric Calculator based on Measured PCA (B-MPCA)—were applied to calculate the predicted residual astigmatism and spherical equivalent (SE). The mean absolute astigmatic prediction error (MAPEastig), centroid of astigmatic prediction error (PE), proportion of eyes within the astigmatic prediction error of ±0.50, ±0.75, and ±1.00 diopters (D), and PE of SE were all calculated for the four methods. Results: One hundred eyes of 100 patients were reviewed. No significant differences were seen for MAPEastig ( P = .379) or the centroid vectors of astigmatic PE among the four methods ( P = .138), although the differences of the predictability rate within ±1.00 D were significant ( P = .008). B-PPCA and B-MPCA yielded better clinical results, with 89% and 90% of eyes achieving an astigmatic PE of less than 1.00 D, compared to that of the Castrop Calculator ( P = .006 and P = .002, respectively). For the 71 eyes with axial length of 22 to 26 mm and anterior corneal refractive power of 42.00 to 46.00 diopters, no significant differences in the PE of SE were seen between B-PPCA and B-MPCA ( P = 1.000), or between C-PPCA and C-MPCA ( P = .078). Further comparison showed that the PE of the SE of the Castrop Calculator was significantly greater than the Barrett Toric Calculator ( P < .001). Conclusions: The current study revealed comparable outcomes of the accuracy of cylindrical power calculation between the Barrett Toric and Castrop Calculators, both using Predicted and Measured PCA mode, although the Barrett Toric Calculator showed a lower PE than the Castrop Calculator in IOL spherical power calculation.

Background: Diabetes increases the risk of cataract formation fivefold. Immune-mediated inflammation has been reported to play a role in this process; however, whether alterations in the immune landscape are involved remains unknown. Therefore, we conducted a multi-omics analysis to evaluate the impact of immune inflammation on the lens. Methods: Bulk RNA sequencing was performed on peripheral blood mononuclear cells (PBMCs) from diabetic patients and lens tissues from diabetic rats. Single-cell RNA sequencing was utilized to characterize intercellular interactions. Key gene and protein expressions were validated via laboratory assays. Results: An integrated RNA-seq analysis revealed a disruption of the blood-aqueous barrier integrity in the diabetic group, enhanced monocyte migration and adhesion, increased differentiation from classical to non-classical monocytes, and the upregulation of TNF and IFN-γ signaling pathways. The transcriptomic profiling of rat lenses revealed an increased proportion of monocytes and the activation of apoptotic pathways in lens epithelial cells. Immunohistochemistry and immunofluorescence staining demonstrated elevated caspase-3 and IL-6 levels in lens epithelial cells and increased immune cell infiltration in the diabetic group. The qRT-PCR and ELISA confirmed elevated levels of the pro-inflammatory cytokines IL-6 and IFN-γ, alongside reduced anti-inflammatory cytokine IL-10 in the peripheral blood and aqueous humor of diabetic patients. Conclusions: Diabetes alters the peripheral immune microenvironment and disrupts the blood-aqueous barrier, promoting intraocular inflammation and lens epithelial cell apoptosis, thereby accelerating cataract development.

This study evaluated the performance of four popular large-scale language models (ChatGPT o3-mini, Gemini 2.0 pro experimental, Deep Seek Thinking R1, and Kimi Thinking K1.5) in addressing frequently asked patient questions about cataracts and cataract surgery in Chinese. DeepSeek Thinking R1 performed comparably to Gemini 2.0 pro experimental in accuracy, while outperforming both ChatGPT o3-mini and Kimi Thinking K1.5. In terms of completeness and consistency, DeepSeek Thinking R1 showed superior performance over the other three LLMs. Regarding legibility and safety, DeepSeek Thinking R1, Gemini 2.0 pro experimental, and ChatGPT o3-mini exhibited comparable results, all performing better than Kimi Thinking K1.5. Deep Seek Thinking R1 demonstrated the strongest overall performance among the four LLMs in this comparative evaluation. The modern LLMs are promising tools for public education in ophthalmology while human oversight is still required.

BACKGROUND:Achieving accurate intraocular lens (IOL) power calculation is crucial for successful refractive outcomes in cataract surgery. This study aimed to evaluate the interchangeability of keratometry (K) values obtained from four biometric devices (IOLMaster 700, CASIA2, Pentacam, and iTrace) and assess the predictive accuracy of five modern IOL calculation formulas (Barrett Universal II, Cooke K6, EVO 2.0, Kane, and PEARL-DGS) when using K values from these different devices. METHODS:This prospective study included K values obtained from four biometric devices for use in five IOL power calculation formulas. Predictive accuracy was assessed using multiple statistical parameters, including standard deviation (SD), mean absolute error (MAE), median absolute error (MedAE) and root mean square absolute error (RMSAE). The interchangeability of devices was evaluated by comparing predictive outcomes across devices and formulas, with statistical analyses focusing on consistency and agreement. RESULTS:Predictive accuracy across the five IOL formulas was stable and showed no statistically significant differences when using keratometry measurements from the same biometric device. However, significant variability was noted when comparing K values from different devices using the same formula. The SS-OCT-based devices (IOLMaster 700 and CASIA2) showed higher consistency in predictive accuracy compared to Scheimpflug-based Pentacam and ray-tracing-based iTrace. Despite this inter-device variability, all five IOL formulas showed overall robust performance across different devices. CONCLUSIONS:Our findings indicate that keratometry measurements from different biometric devices are not fully interchangeable. SS-OCT-based devices (IOLMaster 700 and CASIA2) provided superior consistency in refractive prediction accuracy. Therefore, clinicians should carefully select biometric device-formula combinations based on the specific measurement principles and desired refractive outcomes. Further research involving larger sample sizes, additional IOL types and biometric devices, as well as assessment of surgeon-related factors, is warranted to optimize refractive accuracy in cataract surgery.

Background Insulin therapy is still the most important treatment for T2DM, but the discussion about whether insulin brings more benefits or harms to T2DM patients has not stopped. Therefore, we used high-throughput RNA sequencing to investigate the role of insulin in T2DM and its molecular changes. Method We collected peripheral blood samples from 16 patients with T2DM, and performed RNA-seq on peripheral blood mononuclear cells. Bioinformatics analysis and machine learning were uesd to identify the key differential genes and transcription factor networks. In addition, we performed the flow cytometry and staining to observe ROS level and endothelial-monocyte adhesion in PBMCs of both groups. Results A total of 529 differential genes were identified by bioinformatics analysis. 8 genes were identified as key genes, among which IL-6 had high importance in the random forest model. In transcription factor analysis, IL-6, RETN, CTSG and ELANE have abundant transcriptional regulatory relationships. Flow cytometry showed that ROS production, phagocytosis, leukocyte adhesion in insulin treatment group were lower than that in non-insulin treatment group. Conclusion Insulin therapy is bidirectional, it can cause islet B cell damage and vascular complications, but also can reduce the level of inflammation and oxidative stress.

To statistically analyze the distribution characteristics and related influencing factors of lens decentration and tilt in Chinese patients with age-related cataracts. This cross-sectional study collected basic information and measurement results of patients with age-related cataracts scheduled for surgery. Axial length (AL) was recorded using the IOL Master 700. Corneal topography and lens biometrics were obtained using CASIA 2, and parameters including mean keratometry (Km), keratometric corneal astigmatism, white-to-white distance, horizontal angle-to-angle distance, anterior chamber depth, lens thickness (LT), lens decentration, lens tilt, anterior/posterior lens surface curvature radius (ALR/PLR), and lens equator diameter were documented. Univariate and multivariate regression analyses were conducted to evaluate the correlations between these ocular parameters and lens tilt and decentration. A total of 750 eyes from 750 patients were included. The lens tilted an average of 4.57° towards the inferotemporal direction, with an average decentration of 0.15 mm. Among these, 3.73

Diabetic cataract (DC) is a prevalent complication of diabetes. This condition often leads to significant visual impairment and, in some cases, blindness. Recent studies have highlighted the potential protective effects of natural plant extracts in the context of DC. Stachydrine (STA), an alkaloid derived from Leonurus heterophyllus Sweet, has been identified as a natural compound with superior bioavailability and fewer side effects than conventional antioxidants. However, its protective role in high-glucose-induced lens epithelial cell damage remains to be fully elucidated. In this study, we established a high-glucose model using HLE-B3 cells and assessed apoptosis following STA treatment. Mitochondrial network morphology was analyzed using the ImageJ software. To further investigate the role of autophagy in STA's effects, we employed the autophagy inhibitor 3-Methyladenine (3-MA). Our results indicated that high glucose exposure decreased autophagosome formation and lysosomal activity, while STA treatment significantly increased both. Furthermore, STA enhanced LC3B expression and reduced P62 levels, counteracting the effects of high glucose. Regarding mitochondrial morphology, STA effectively restored the shape, branching, and area, all of which were diminished by high glucose exposure. Additionally, STA effectively ameliorated mitochondrial network damage induced by high glucose. Notably, when the cells were treated with 3-MA, STA's protective effects on apoptosis and mitochondrial morphology were significantly reversed. In conclusion, our findings suggest that STA exerts protective effects against high-glucose-induced damage by regulating mitophagy, and this autophagy-dependent mechanism may hold therapeutic potential for the treatment of diabetic cataract.

To investigate the correlation between the corneal biomechanical properties of cataract patients measured by Corvis-ST and surgically induced corneal astigmatism (CSIA) derived from anterior segment swept-source OCT (CASIA2). A total of 149 eyes from 149 patients received phacoemulsification with a 2.2-mm clear corneal incision at the 135° were involved. Before surgery, all patients were examined by Corvis-ST for dynamic corneal response parameters (DCRs). The total corneal astigmatism was measured using CASIA2 before the operation and at 1 month follow-up. CSIA was obtained using Alpins vector analysis. After adjustment for age, central corneal thickness, and biomechanically corrected intraocular pressure, partial correlation analysis was used to analyze the correlation between the CSIA and DCRs. The centroid of CSIA was 0.48 D @ 43°, with a magnitude of 0.75 ± 0.44 D. The age of the patient was positively correlated with the magnitude of CSIA (r = .22, P = .009). The partial correlation analysis revealed that deformation amplitude ratio (DA ratio, r = -.17, P = .045) and integrated radius (IR, r = - .20, P = .014) were both negatively correlated with the magnitude of CSIA. The magnitude of CSIA can be expressed as: [Formula: see text]. DA ratio and IR were negatively correlated with the magnitude of CSIA in 2.2-mm cataract surgery indicating an association of increased corneal stiffness with increased magnitude of CSIA.

Purpose:This prospective cohort study aimed to assess the influence of tear film stability on corneal refractive power measurement and surgical planning in cataract patients. Methods:Participants were divided into tear film instability (tear film stability level 2) and control (level 0-1) groups based on Keratograph 5M results. Using IOL Master 700, two consecutive measurements were obtained with a 10-min interval. Parameters including standard keratometry (Kf, Ks and K), keratometric corneal astigmatism (KCA), total keratometry (TKf, TKs and TK) and total corneal astigmatism (TCA) were recorded. IOL power was calculated using SRK-T, SRK-T TK, Haigis, Haigis TK, Barrett Universal II, and Barrett Universal II TK formulas. Results:The results showed significantly higher differences between two measurements in Kf, K, KCA, TKf, TK, and TCA, as well as the vector variability of corneal astigmatism in the tear film instability group (all P ​< ​0.05). Of all formulas, only the SRK-T formula displayed significantly higher variability in IOL power calculations in the tear film instability group compared to the control group (P ​< ​0.05). Conclusions:This study highlights that tear film instability can lead to deviations in corneal refractive power and astigmatism measurements, contributing to increased prediction errors in IOL power calculation, particularly with the SRK-T formula.

PURPOSE: To evaluate the predictive accuracy of 18 intraocular lens (IOL) power calculation formulas across diverse biometric parameters using a modified formula performance index (FPI) and prediction error (PE) variability metrics. DESIGN: Prospective, comparative, accuracy, and reliability analysis of IOL power calculations. METHODS: This study included 213 cataract patients who underwent phacoemulsification with SN60WF IOL implantation. Preoperative biometry was obtained using the IOLMaster 700. Eighteen IOL power calculation formulas, including Barrett TK, Barrett Universal II, Castrop, Cooke K6, EVO 2.0, Haigis, Hoffer Q, Hoffer QST, Holladay 1, Holladay 2, Kane, Karmona, Ladas Super Formula, Nallasamy, PEARL-DGS, RBF 3.0, SRK/T, and T2, were evaluated. Predictive accuracy was assessed using FPI and standard deviation (SD) for overall performance, while root mean square error (RMSE) and subgroup-specific FPI (FPI_sub) were used for biometric subgroup analysis. Additional metrics included mean absolute error, median absolute error, and the percentage of eyes within +/- 0.25 D, +/- 0.50 D, +/- 0.75 D, and +/- 1.00 D. RESULTS: Cooke K6 achieved the highest FPI (0.724) and lowest SD (0.394), followed by PEARLDGS (FPI = 0.714, SD = 0.399) and Barrett TK (FPI = 0.710, SD = 0.411). Barrett TK had the highest percentage of eyes within +/- 0.25 D (54.5%). Subgroup analysis revealed that PEARL-DGS exhibited the highest accuracy in short eyes (axial length <22 mm, FPI_sub = 0.838, RMSE = 0.271), while Haigis performed best in long eyes (axial length >26 mm, FPI_sub = 0.826, RMSE = 0.336) and steep corneas ( K > 46 D, FPI_sub = 0.765, RMSE = 0.350). Barrett TK ranked highest in medium-long eyes (24.5-26 mm, FPI_sub = 0.700, RMSE = 0.400) and flatter corneas ( K < 42 D, FPI_sub = 0.639, RMSE = 0.382). Cooke K6 was most accurate in shallow anterior chambers (anterior chamber depth < 3.0 mm, FPI_sub = 0.737, RMSE = 0.383). Traditional formulas, including Hoffer Q, Holladay 1, and SRK/T, exhibited lower accuracy and higher PE variability. CONCLUSIONS: Modern formulas, particularly Cooke K6, PEARL-DGS, and Barrett TK, demonstrated superior accuracy with lower PE variability than traditional formulas. Subgroup analysis highlighted the importance of biometric-driven formula selection to optimize refractive outcomes, providing a clinically reference for personalized IOL power selection. (c) 2025 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/))

OBJECTIVE:To analyze the effect of gentamicin in the irrigating solution on endophthalmitis caused by methicillin-resistant Staphylococcus epidermidis after phacoemulsification with intraocular lens implantation. METHODS:Fifteen rabbits were randomly assigned into three groups. During surgery, group A was irrigated with gentamicin-free solution and injected with 100 μL of normal saline postoperatively, group B was irrigated with 80 μg/mL gentamicin and injected with 100 μl of MRSE suspension, group C was irrigated with gentamicin-free solution and injected with 100 μl of MRSE suspension. At different times, corneal endothelial cell count (CEC), inflammation grading，B-scan ultrasonography and histological examination were analyzed. RESULTS:No endophthalmitis occurred in groups A and B. Group C developed severe endophthalmitis, with massive inflammatory exudation in the vitreous cavity. CONCLUSION:Irrigating solution containing gentamicin is favorable to reduce the incidence of MRSE endophthalmitis after phacoemulsification with IOL in rabbits.

Ethnopharmacological relevanceQiju Dihuang Pill (QDP) is a traditional Chinese medicine prescription for the treatment of eye diseases. Novel literature reports that copper-induced cell death, called as cuproptosis, is a copper-dependent and differs distinctly from other types of cell death.Aim of the studyThe present study aims to investigate whether QDP could protect lens epithelial cells via alleviating copper-induced death in diabetic cataract.Materials and methodsThe different concentration of QDP medicated serum was administrated on high glucose (HG)-induced human lens epithelial cells (HLECs). The copper concentration was tested using Elabscience Copper Assay kit. The proliferation was detected using CCK-8 and EdU assays. The molecular binding was identified using RIP-PCR and luciferase reporter assay.ResultsResults indicated that HG culture condition triggered the copper concentration and repressed the proliferation of HLECs. Then, the elesclomol-Cu (Es-Cu) administration up-regulated the copper concentration and inhibited the proliferation, and cuproptosis inhibitor tetrathiomolybdate (TTM) could specifically reverse the consequence. QDP treatment reduced the copper concentration and cuproptosis-related genes (SLC31A1, FDX1). MeRIP-Seq and RIP-PCR confirmed that QDP reduced the stability of SLC31A1 mRNA through m6A modified site, and copper actually synergized the molecular binding efficiency. Rescue assay verified the role of QDP and SLC31A1 on HLECs’ cuproptosis characteristic.ConclusionThis research identified the protective role of QDP on HG-induced HLECs in DC through decreasing m6A/SLC31A1-mediated cuproptosis in DC. This finding provides novel insights into mechanisms for QDP and sheds light on the multifaceted role of traditional prescription on DC.

A retrospective cohort study was conducted to observe the correction effect of Toric intraocular lens (IOL) implantation in cataract eyes with specific types of irregular corneal astigmatism. Thirty-four eyes with either the "asymmetric bow-tie" pattern (Type I) or the "angled bow-tie" pattern (Type II) were included. Corneal topography was assessed using Pentacam HR, and changes in preoperative corneal astigmatism, visual acuity, manifest refraction, and objective visual quality were measured and compared. The average uncorrected distance visual acuity improved significantly from 0.86 ± 0.40 logMAR to 0.22 ± 0.15 logMAR (P < 0.001). Preoperative corneal astigmatism of 2.05 ± 0.90 D was corrected to a postoperative residual astigmatism of 0.78 ± 0.57 D (P < 0.001), with 32% of eyes within 0.50 D. The residual astigmatism prediction errors in Type I and Type II cases were (0.97 ± 0.68 D) and (0.66 ± 0.37 D), respectively (P = 0.100). The mean spherical equivalent prediction error in Type II cases (0.07 ± 0.36 D) was significantly smaller than that in Type I cases (− 0.29 ± 0.52 D) (P = 0.030). This study concludes that Toric IOL implantation effectively corrects specific types of irregular corneal astigmatism in cataract surgery. Eyes with the "angled bow-tie" pattern show higher accuracy in refractive predictions compared to eyes with the "asymmetric bow-tie" pattern.

Intraocular irrigating solution is extensively applied in cataract surgery. This paper explored the difference and relationship between optical coherence tomography (OCT) and optical quality analysis system (OQAS) parameters induced by compound electrolyte intraocular irrigating solution (CEIIS) or Ringer lactate (RL) solution during uncomplicated cataract surgery. Totally 200 senior cataract patients were randomly divided into the CEIIS and RL groups (N = 100 patients/group). The anterior chamber was irrigated by CEIIS or RL during phacoemulsification. Patients were subdivided into diabetes mellitus (DM)+ and DM− groups. The central macular thickness (CMT), hyper reflective foci (HF), modulation transfer function cutoff frequency (MTF cutoff), Strehl ratio (SR), objective scatter index (OSI), and OQAS values (OVs) at 100

To compare the performance of Barrett toric calculator incorporated with measured posterior corneal astigmatism (PCA) derived from IOL Master 700 and Pentacam HR versus predicted PCA. The predicted residual astigmatism using Barrett toric IOL calculator with predicted PCA, measured PCA from IOL Master 700 and measured PCA from Pentacam were calculated with the preoperative keratometry and intended IOL axis with modification. The vector analysis was performed to calculate the mean absolute prediction error (MAE), the centroid of the prediction error and the percentage of eyes with a prediction error within ±0.50 D, ±0.75 D, and ±1.00 D. In 57 eyes of 57 patients with mean age of 70.42 ± 10.75 years, the MAE among the three calculation methods were 0.59 ± 0.38 D (Predicted PCA), 0.60 ± 0.38 D (Measured PCA from IOL Master 700) and 0.60 ± 0.36 D (Measured PCA from Pentacam) with no significant difference, either in the whole sample, the WTR eyes and the ATR eyes (F = 0.078, 0.306 and 0.083, p = 0.925, 0.739 and 0.920, respectively). Measured PCA obtained from IOL Master 700 resulted in one level reduction (from Tn to Tn-1) in 49.12% eyes in cylindrical model selection, while measured PCA obtained from Pentacam resulted in one level reduction of toric model selection in 18.18% eyes. The present study suggested that the incorporation of measured PCA values derived from IOL Master 700 and Pentacam produce comparable clinical outcome with the predicted PCA mode in Barrett toric calculator.

AIM: To assess and compare the variations and agreements across different ocular biometric parameters using swept-source optical coherence tomography (SS-OCT) and Scheimpflug tomography in patients diagnosed with cataract. METHODS: This prospective case series was conducted at Tianjin Medical University Eye Hospital. In total, 212 eyes from 212 patients scheduled for phacoemulsification were included. Eyes were evaluated preoperatively using two SS-OCT devices (IOLMaster700 and CASIA2) and Scheimpflug tomography (Pentacam). Central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AQD), white-to-white distance (WTW), flat simulated keratometry (Kf), steep simulated keratometry (Ks), mean keratometry (Km), and total corneal keratometry (TKm) were measured. Intraclass correlation coefficient (ICC), 95% confidence intervals (CI) and limits of agreement (LoA) widths were conducted to assess differences and correlations between devices. RESULTS: All parameters, except for Ks, were significantly different. Pairwise comparison revealed no significant differences between keratometry obtained by IOLMaster 700 and Pentacam. LoA widths of all paired comparisons for Ks were >0.80 D. Except for WTW between IOLMaster 700 and CASIA2 and between CASIA2 and Pentacam, other Pearson's coefficients between devices showed a strong correlation (all r>0.95). The ICC of WTW (ICC=0.438, 95%CI 0.167-0.625) showed poor reliability. The reliability of CCT, ACD, and AQD was excellent (all ICC>0.95), whereas that of TKm was good (ICC=0.827, 95%CI 0.221-0.939). A significant linear correlation was also observed among devices. CONCLUSION: The ocular parameters derived from the use of IOLMaster700, CASIA2, and Pentacam exhibit significant discrepancies; as such, measurements from these devices should not be deemed as interchangeable.

The purpose of the study was to explore the possible correlations between the anterior segment parameters derived from anterior segment swept-source optical coherence tomography (AS-SS-OCT) with the surgically induced corneal astigmatism (CSIA) calculated from total keratometry (TK) measured by AS-SS-OCT. Seventy-one eyes of 67 patients with age-related cataract who underwent phacoemulsification combined with intraocular lens implantation with 2.2-mm incision were included. The CSIA values were calculated from anterior keratometry (CSIAKant) and TK (CSIATK) measured by AS-SS-OCT, respectively. Hotelling’s T2 test was used to evaluate the difference. The correlation of CSIA with various parameters derived from AS-SS-OCT was tested with the Spearman correlation coefficient. The centroid of CSIAKant and of CSIATK were 0.31 ± 0.55 D @ 54° and 0.41 ± 0.59 D @ 51°, with no significant difference (F = 1.283, p = 0.281, Hotelling’s T2). The mean absolute CSIAKant and CSIATK were 0.58 ± 0.24 D and 0.65 ± 0.28 D. Spearman test showed that the magnitude of CSIAKant was negatively correlated with preoperative peripheral corneal thickness (PCT, p = 0.045) and the magnitude of anterior keratometry (p = 0.044). The magnitude of CSIATK was negatively correlated with preoperative central corneal thickness (CCT, p = 0.003) and preoperative PCT (p = 0.015). The increased thickness of the peripheral cornea is correlated with the decrease in the magnitude of the CSIA. The correlation we identified between the corneal thickness and the CSIA indicated that certain preoperative parameters should be considered for the prediction of CSIA for a more precise refractive outcome.

Purpose To assess the differences and similarities in the corneal curvature obtained by two swept-source optical coherence tomography (SS-OCT) devices, Scheimpflug imaging system and one ray tracing aberrometer in patients with cataracts. Moreover, this study aimed to compare the differences in posterior corneal (PK), total corneal (TK) and true net power (TNP) measurements among the IOLMaster 700, CASIA2, and Pentacam. Methods A total of 200 eyes of 200 patients (116 female, 58%) were enrolled in this study, with a mean age of 65.9 ± 9.5 years. The flattest (Kf), steepest (Ks), and mean cornal powers (Km), J 0 , and J 45 were obtained using two SS-OCT-based biometric devices, one rotating camera system and one ray-tracing aberrometer. The PK, TK and TNP values were also measured using these devices. To evaluate the differences and similarities between the devicves, the Friedman test, Pearson correlation coefficient (r), intraclass coefficient correlation (ICC) and Bland‒Altman plots with 95% limits of agreement (LoA) were used, and boxplots and stacked histograms were generated to describe the distributions of the data. Results There were no significant differences between the IOLMaster 700 and Pentacam for any of the keratometry values. Additionally, there were no significant differences between the IOLMaster 700 and iTrace in evaluating J 0 and J 45 . Bland‒Altman plots revealed relatively wide LoA widths, almost larger than 1 diopter for the keratometry values and almost larger than 0.5 diopter for J 0 and J 45 values among the four devices. In terms of PK and TK values, significant differences and low ICCs were found among the three devices. Conclusions Although strong correlations and good agreement were found among the IOLMaster700, CASIA2, Pentacam and iTrace for Kf, Ks, Km and J 0 , J 45 , it seems that the measurements should not be used interchangeably because of the wide LoA widths and the presence of significant differences among the devices. Similarly, due to significant differences and low ICCs, the PK, TK and TNP values obtained by IOLMaster 700, CASIA2, and Pentacam should not be used interchangeably.

Purpose: To evaluate and compare the accuracy of iTrace and CASIA2 in measuring the postoperative orientation of toric intraocular lens (IOL) without mydriasis. Setting: Tianjin Medical University Eye Hospital, Tianjin, China. Design: Prospective cohort study. Methods: Patients with SN6AT toric IOLs implanted after cataract surgery were enrolled. 1 month after surgery, the toric IOL orientation were measured by iTrace and CASIA2 in non-mydriatic, semi-dark conditions. Then, the toric axis was directly reviewed using the slit-lamp under full mydriasis. Axis measurement differences between each of the 2 devices and the slit-lamp, described as their relative differences (RDs), were calculated and compared. The percentage of RDs within 5 degrees, within 10 degrees and greater than 30 degrees were analyzed. Results: 77 eyes of 70 patients were included. Generally, the mean toric axis measurement RDs of CASIA2 and iTrace were 9.24 ± 10.53 degrees and 13.89 ± 15.47 degrees respectively (P = .04). For CASIA2 (72 eyes), 54.17% (39), 72.22% (52), and 4.17% (3) of eyes had RDs within 5 degrees, within 10 degrees and greater than 30 degrees, compared with 40.00% (28), 61.43% (43) and 12.86% (9) for iTrace (70 eyes). The 95% limits of agreements of CASIA2 with slit-lamp was narrower than that of iTrace with slit-lamp. The median RD of CASIA2 was significantly smaller in eyes with pupil ≥4 mm under dark condition compared with eyes with pupil <4 mm (P = .03). Conclusions: CASIA2 demonstrates greater precision in measuring toric IOL orientation under non-mydriatic conditions compared with iTrace. Moreover, the accuracy of CASIA2 is enhanced in cases of pupil >4 mm.