Inter-ocular and inter-visit differences in ocular biometry and refractive outcomes after cataract surgery

This study aimed to determine whether inter-ocular differences in axial length (AL), corneal power (K), and adjusted emmetropic intraocular lens power (EIOLP) and inter-visit differences in these ocular biometric values, measured on different days, are related to refractive outcomes after cataract surgery. We retrospectively reviewed 279 patients who underwent phacoemulsification. Patients underwent ocular biometry twice (1–4 weeks before and on the day of surgery). Patients were divided into three groups: group S (similar inter-ocular biometry in different measurements; n = 201), group P (inter-ocular differences persisted in the second measurement; n = 37), and group D (inter-ocular difference diminished in the second measurement; n = 41). Postoperative refractive outcomes (mean absolute errors [MAEs]) were compared among the groups. Postoperative MAE2, based on second measurement with reduced inter-ocular biometry difference, was smaller than that calculated using the first measurement (MAE1) with borderline significance in group D (MAE1, 0.49 ± 0.45 diopters vs. MAE2, 0.41 ± 0.33 diopters, p = 0.062). Postoperative MAE2 was greater in group P compared to the other two groups (p = 0.034). Large inter-ocular biometry differences were associated with poor refractive outcomes after cataract surgery. These results indicate that measurements with smaller inter-ocular differences were associated with better refractive outcomes in cases with inter-visit biometry differences.