Overview of the Repeatability, Reproducibility, and Agreement of the Biometry Values Provided by Various Ophthalmic Devices

PURPOSE: To present an overview of the measurement errors for various biometric devices, as well as a meta-analysis of the agreement between biometric devices using the Pentacam, Orbscan, and IOL Master as a reference. DESIGN: Meta-analysis of the literature. METHODS: The meta-analysis is based on data from 216 articles that compare a total of 24 different devices with the reference devices for the following 9 parameters: mean, steep and flat curvature of the anterior and posterior cornea; central corneal thickness; anterior chamber depth; and axial length. After the weighted average difference between devices has been determined, the two one-sided t test was used to test for equivalence between devices within certain thresholds defined by the measurement errors and the influence of these differences on the calculated refraction. RESULTS: In only 17 of the 70 comparisons a device was equivalent with the reference device within the thresholds set by the measurement error. More lenient thresholds, based on a change in calculated refraction of +/- 0.25 diopter, increased this number to a maximum of 25/50 comparisons (excluding pachymetry). High degrees of inconsistency were seen in the reported results, which could partially explain the low agreement between devices. CONCLUSION: As a rule, biometry measurements taken by different devices should not be considered equivalent, although several exceptions could be identified. We therefore recommend that clinical studies involving multiple device types treat this as a within-subject variable to avoid bias. The follow-up of individual patients using different devices should be avoided at all times. (C) 2014 by Elsevier Inc. All rights reserved.