Comparison of corneal aberrations from anterior segment swept source OCT versus Placido-topography combined spectral domain OCT in cataract patients

Background To comprehensively evaluate the agreement of component corneal aberrations from the newly updated wavefront analysis software of a swept-source optical coherence tomographer (SS-OCT) and a referential Placido-topography combined OCT device in elderly cataract patients. Methods Retrospective study including 103 eyes from 103 elderly patients scheduled for cataract surgery that were measured on the same day with a SS-OCT (Heidelberg Engineering, Germany) device and a Placido-topography combined OCT device (CSO, Italy). Anterior, total, and posterior corneal wavefront aberrations were evaluated for their mean differences and limits of agreement (LoA) via Bland-Altman plots. Vector analysis was additionally employed to compare corneal astigmatism measurements in dioptric vector space. Results Mean differences of all corneal aberrometric parameters did not exceed 0.05 μm. Total corneal aberrations were not significantly different from 0 except for vertical coma (− 0.04 μm; P = 0.003), spherical aberration (− 0.01 μm, P < 0.001), and root mean square (RMS) higher-order aberration (HOA) (0.03 μm, P = 0.04). The 95% LoA for total corneal aberration parameters between both devices were − 0.46 to 0.42 μm for horizontal astigmatism, − 0.37 to 0.41 μm for oblique astigmatism, − 0.19 to 0.17 μm for oblique trefoil, − 0.33 to 0.25 μm for vertical coma, − 0.20 to 0.22 μm for horizontal coma, − 0.22 to 0.20 μm for horizontal trefoil, − 0.11 to 0.08 μm for spherical aberration, and − 0.22 to 0.28 μm for RMS HOA. Vector analysis revealed no statistically significant mean differences for anterior, total, and posterior corneal astigmatism in dioptric vector space. Conclusion In eyes undergoing cataract surgery with a regular elderly cornea, corneal wavefront analysis from the SS-OCT device showed functional equivalency to the reference device. Nevertheless, clinically relevant higher order aberration parameters should be interpreted with caution for surgical decision-making.