Errors Associated with IOLMaster Biometry as a Function of Internal Ocular Dimensions

Purpose: To evaluate the error in the estimation of axial length (AL) with the IOLMaster partial coherence interferometry (PCI) biometer and obtain a correction factor that varies as a function of AL and crystalline lens thickness (LT). Methods: Optical simulations were produced for theoretical eyes using Zemax-EE software. Thirty-three combinations including eleven different AL (from 20 mm to 30 mm in 1 mm steps) and three different LT (3.6 mm, 4.2 mm and 4.8 mm) were used. Errors were obtained comparing the AL measured for a constant equivalent refractive index of 1.3549 and for the actual combinations of indices and intra-ocular dimensions of LT and AL in each model eye. Results: In the range from 20 mm to 30 mm AL and 3.6–4.8 mm LT, the instrument measurements yielded an error between −0.043 mm and +0.089 mm. Regression analyses for the three LT condition were combined in order to derive a correction factor as a function of the instrument measured AL for each combination of AL and LT in the theoretical eye. Conclusions: The assumption of a single “average” refractive index in the estimation of AL by the IOLMaster PCI biometer only induces very small errors in a wide range of combinations of ocular dimensions. Even so, the accurate estimation of those errors may help to improve accuracy of intra-ocular lens calculations through exact ray tracing, particularly in longer eyes and eyes with thicker or thinner crystalline lenses