Technical failure rates for biometry between swept-source and older-generation optical coherence methods: a review and meta-analysis

PURPOSE: Precise ocular measurements are fundamental for achieving excellent target refraction following both cataract surgery and refractive lens exchange. Biometry devices with swept-source optical coherence tomography (SS-OCT) employ longer wavelengths (1055–1300 nm) in order to have better penetration through opaque lenses than those with partial coherence interferometry (PCI) or low-coherence optical reflectometry (LCOR) methods. However, to date a pooled analysis showing the technical failure rate (TFR) between the methods has not been published. The aim of this study was to compare the TFR in SS-OCT and in PCI/LCOR biometry. METHODS: PubMed and Scopus were used to search the medical literature as of Feb 1, 2022. The following keywords were used in various combinations: optical biometry, partial coherence interferometry, low-coherence optical reflectometry, swept-source optical coherence tomography. Only clinical studies referring to patients undergoing routine cataract surgery, and employing at least two (PCI or LCOR vs. SS-OCT) optical methods for optical biometry in the same cohort of patients were included. RESULTS: Fourteen studies were included in the final analysis, which presented results of 2,459 eyes of at least 1,853 patients. The overall TFR of all included studies was 5.47% (95% confidence interval [CI]: 3.66–8.08%; overall I(2) = 91.49%). The TFR was significantly different among the three methods (p < 0.001): 15.72% for PCI (95% CI: 10.73–22.46%; I(2) = 99.62%), 6.88% for LCOR (95% CI: 3.26–13.92%; I(2) = 86.44%), and 1.51% for SS-OCT (95% CI: 0.94–2.41%; I(2) = 24.64%). The pooled TFR for infrared methods (PCI and LCOR) was 11.12% (95% CI: 8.45–14.52%; I(2) = 78.28%), and was also significantly different to that of SS-OCT: 1.51% (95% CI: 0.94–2.41%; I(2) = 24.64%; p < 0.001). CONCLUSIONS: A meta-analysis of the TFR of different biometry methods highlighted that SS-OCT biometry resulted in significantly decreased TFR compared to PCI/LCOR devices. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12886-023-02926-0.