Abstract
Accurate ocular biometry is crucial for the success of refractive cataract surgery. This study aims to assess the consistency and differences of a new biometer, the ZW-30, compared with the mainstream devices IOLMaster 700 and Sirius in patients with cataracts. A total of 307 patients with cataracts (603 eyes) were included. The anterior chamber depth (ACD), central corneal thickness (CCT), white-to-white (WTW) distance, pupil diameter (PD), flat K (K1), steep K (K2), corneal astigmatism (ΔK), total keratometry (TK), total corneal astigmatism (TCA), astigmatism axis, kappa angle (κ), axial length (AL), and lens thickness (LT) were measured using the ZW-30, IOLMaster 700, and Sirius. The consistency between devices was evaluated using Bland-Altman analysis, the correlation of parameters was assessed using Spearman correlation analysis, and inter-device agreement equations were established. Strong correlations (r ≥ 0.7) and no statistically significant differences in mean values (p > 0.05) were found for ACD, CCT, AL, LT, and anterior corneal curvature (K1/K2) among the three devices, but the 95% limits of agreement (LoA) exceeded the clinical threshold. Total corneal parameters (TK/TCA) and κ angle showed strong correlations (r ≥ 0.5) among the three devices, with significant inter-device differences in mean values (p < 0.05) and 95%LoA exceeding the clinical threshold. Corneal diameter (WTW) had a weak correlation (r = 0.48) between the ZW-30 and Sirius, and differences in PD measurement methods led to systematic bias. The ZW-30 is consistent with the IOLMaster 700 and Sirius in terms of group trends for basic biometric parameters (ACD/CCT/anterior corneal curvature), but significant individual differences exist (95%LoA exceeding the threshold). Total corneal parameters (TK/TCA) and κ angle require cross-validation with Sirius. WTW and PD are not interchangeable between devices due to differences in measurement principles. Cross-device parameter conversion should be avoided in clinical practice to ensure the accuracy of refractive surgery.
Similar content being viewed by others
Data availability
The original contributions presented in this study are included in the article/supplementary material, further inquiries can be directed to the corresponding authors.
Abbreviations
- SS-OCT:
-
Swept-source optical coherence tomography
- IOL:
-
Intraocular lens
- LoA:
-
Limits of agreement
- GAM:
-
Generalized additive model
- AL:
-
Axial length
- TK:
-
Total keratometry
- TCA:
-
Total corneal astigmatism
- CCT:
-
Central corneal thickness
- WTW:
-
White-to-White
- ACD:
-
Anterior chamber depth
- LT:
-
Lens thickness
- PD:
-
Pupil diameter
- κ:
-
Kappa
- SD:
-
Standard deviation
- BA analysis:
-
Bland-Altman analysis
References
Huang, J. et al. Reliability of a new swept-source optical coherence tomography biometer in healthy children, adults, and cataract patients. J. Ophthalmol. 2020, 8946364. https://doi.org/10.1155/2020/8946364 (2020).
Fişuş, A. D. et al. Repeatability of 2 swept-source OCT biometers and 1 optical low-coherence reflectometry biometer. J. Cataract Refract. Surg. 47, 1302–1307. https://doi.org/10.1097/j.jcrs.0000000000000633 (2021).
Calvo-Sanz, J. A., Portero-Benito, A. & Arias-Puente, A. Efficiency and measurements agreement between swept-source OCT and low -coherence interferometry biometry systems. Graefes Arch. Clin. Exp. Ophthalmol. 256, 559–566. https://doi.org/10.1007/s00417-018-3909-9 (2018).
Pathak, M., Sahu, V., Kumar, A., Kaur, K. & Gurnani, B. Current concepts and recent updates of optical biometry- a comprehensive review. Clin. Ophthalmol. 18, 1191–1206. https://doi.org/10.2147/OPTH.S464538 (2024).
Henriquez, M. A. et al. Effectiveness and agreement of 3 optical biometers in measuring axial length in the eyes of patients with mature cataracts. J. Cataract Refract. Surg. 46, 1222–1228. https://doi.org/10.1097/j.jcrs.0000000000000237 (2020).
Li, X., Cao, X. & Bao, Y. Comparison of total corneal astigmatism between IOLMaster and pentacam. Biomed. Res. Int. 2022, 9236006. https://doi.org/10.1155/2022/9236006 (2022).
Jin, Y. et al. Sirius Scheimpflug-Placido versus ultrasound pachymetry for central corneal thickness: meta-analysis. Eye Vis. (Lond) 8, 5. https://doi.org/10.1186/s40662-021-00227-5 (2021).
Namkung, S. et al. Repeatability and agreement of horizontal corneal diameter measurements between scanning-slit topography, dual rotating scheimpflug camera with placido disc tomography, placido disc topography, and optical cohe rence tomography. Cornea 41, 1392–1397. https://doi.org/10.1097/ICO.0000000000002964 (2022).
Busool Abu-Eta, Y. et al. Outcomes of photorefractive keratectomy in patients with posterior cor neal steepening. Eye (Lond). 35, 2016–2023. https://doi.org/10.1038/s41433-020-01213-2 (2021).
de Rojas Silva, M. V., Tobío Ruibal, A., Suanzes Hernández, J. & Darriba Folgar, H. Assessing the predictability of five intraocular lens calculation methods in eyes with prior myopic keratorefractive lenticule extraction. Graefes Arch. Clin. Exp. Ophthalmol. 263, 873–881. https://doi.org/10.1007/s00417-024-06661-0 (2025).
Goto, S. & Maeda, N. Corneal topography for intraocular lens selection in refractive cataract surgery. Ophthalmology 128, e142–e. https://doi.org/10.1016/j.ophtha.2020.11.016 (2021).
Song, H., Liu, C., Yang, W., Yang, C. & Cheng, X. Comparison of central corneal thickness measured in myopic eyes by Pentacam, Sirius and IOLMaster 700. Photodiagnosis Photodyn. Ther. 49, 104302. https://doi.org/10.1016/j.pdpdt.2024.104302 (2024).
Song, H., Yang, W., Yang, C. & Sun, Q. Comparison of anterior chamber depth measured by three different anter ior segment analysis systems. Photodiagnosis Photodyn. Ther. 51, 104471. https://doi.org/10.1016/j.pdpdt.2025.104471 (2025).
Saad, A., Steinberg, J. & Frings, A. Repeatability of pupil diameter measurements using three different topography devices. PLoS One. 18, e0290417. https://doi.org/10.1371/journal.pone.0290417 (2023).
Yu, C. et al. Analysis of differences between keratometric astigmatism and total corneal astigmatism measured by IOLMaster 700. Int. Ophthalmol. 45, 66. https://doi.org/10.1007/s10792-024-03394-1 (2025).
Kane, J. X., LaHood, B. R. & Goggin, M. Analysis of posterior corneal surgically induced astigmatism following cataract surgery with a 1.8-mm temporal clear corneal incision. J. Refract. Surg. 39, 381–386. https://doi.org/10.3928/1081597X-20230426-01 (2023).
Yu, J. et al. Evaluation of a new dynamic real-time visualization 25 kHz swept-source optical coherence tomography based biometer. Eye Vis. (Lond.) 11, 9. https://doi.org/10.1186/s40662-024-00377-2 (2024).
Lei, C. S. et al. Comparison of anterior segment measurements with a new swept-source op tical coherence tomography biometer and a Scheimpflug-Placido Topographer. J. Refract. Surg. 41, e413–e420. https://doi.org/10.3928/1081597X-20250317-03 (2025).
Ma, S. et al. Comparison of ocular biometric parameters between two swept-source optical coherence tomography devices and Scheimpflug tomography in patients with cataract. Int. J. Ophthalmol. 17, 1437–1446. https://doi.org/10.18240/ijo.2024.08.08 (2024).
Fang, X. et al. Comparison of corneal power assessment methods for true corneal power after myopic small-incision lenticule extractio. Am. J. Ophthalmol. 275, 156–163. https://doi.org/10.1016/j.ajo.2025.03.026 (2025).
Wang, Z. et al. Comparing standard keratometry and total keratometry before and after myopic corneal refractive surgery with a swept-source OCT biometer. Front. Med. (Lausanne). 9, 928027. https://doi.org/10.3389/fmed.2022.928027 (2022).
Muzyka-Woźniak, M., Oleszko, A. & Grzybowski, A. Measurements of anterior and posterior corneal curvatures with OCT and Scheimpflug biometers in patients with low total corneal astigmatism. J. Clin. Med. 11, 6921. https://doi.org/10.3390/jcm11236921 (2022).
Ning, J. & Zhang, L. Comparison of Scheimpflug tomography, Placido disc, and combined Placido Scheimpflug in the measurement of pupil offset in myopic population. Front. Med. (Lausanne). 11, 1490674. https://doi.org/10.3389/fmed.2024.1490674 (2024).
Acknowledgements
The authors thank Mr. G.Z for assistance in data acquisition and Solution (Shanghai) Science and Technology Co., Ltd. for providing the EDC system and statistical consultation. We also acknowledge the support of PubMed.pro for literature retrieval and summarization, which greatly facilitated the research process.
Author information
Authors and Affiliations
Contributions
JY, YH and LJ participated in the study design, data analysis, interpretation and drafted the manuscript. JY, YX, RL, XY and NY collected the imaging data. JY performed the statistical analysis. JY and LJ contributed to the editing and review of the manuscript. All authors read and approved the submitted version.
Corresponding authors
Ethics declarations
Competing interests
The authors declare no competing interests.
Ethical approval
This study was approved by the Human Ethics Committee of Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. The patients/participants provided their written informed consent to participate in this study.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Yang, J., Yang, N., Xiang, Y. et al. Ocular biometry agreement among ZW-30, IOLMaster 700, and sirius in cataract patients. Sci Rep (2026). https://doi.org/10.1038/s41598-026-42451-w
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-42451-w
