Refractive outcomes after cataract surgery using swept-source OCT biometry and image-guided toric IOL alignment: a prospective comparative study in normal versus long axial length eyes.

This prospective comparative study evaluated the refractive accuracy of the ARGOS® swept-source OCT biometer combined with the VERION™ Image-Guided System in cataract surgery using the Barrett Universal II formula. Ninety eyes were divided into Normal Axial Length (AL) (22.5–26.0 mm, n = 50) and Long AL (≥ 26.0 mm, n = 40) groups. All underwent phacoemulsification with PanOptix® Toric IOL implantation. The primary outcome was mean refractive prediction error (RPE) at 1 month. The mean RPE was − 0.07 ± 0.18 D in the Normal AL Group and − 0.05 ± 0.23 D in the Long AL Group (P = 0.375). The percentage of eyes achieving an absolute RPE within ± 0.50 D was 98.0% and 95.0%, respectively (P = 0.574). Mean absolute residual refractive astigmatism was 0.56 ± 0.32 D in the Normal AL Group and 0.47 ± 0.25 D in the Long AL Group (P = 0.110). Visual acuity outcomes were comparable between groups. In conclusion, the combination of ARGOS® segmental biometry and VERION™ digital image guidance yielded high-precision refractive outcomes in long AL eyes that were comparable to normal AL eyes.