Search Results (156)

Lipid keratopathy is an uncommon corneal disorder characterized by stromal lipid deposition that may cause progressive corneal opacity and visual impairment. We report a case of advanced bilateral lipid keratopathy with severe visual-axis involvement. At presentation, best-corrected visual acuity (BCVA) was counting fingers in the right eye and 0.1 Snellen (1.0 logMAR) in the left eye. Slit-lamp examination and anterior segment optical coherence tomography (AS-OCT) demonstrated dense stromal lipid deposits involving the visual axis in both eyes. The patient underwent staged bilateral penetrating keratoplasty, with procedures performed three months apart. Postoperatively, corneal transparency improved in both eyes. At 6 months, BCVA was 0.5 Snellen (0.3 logMAR) in the right eye and 0.7 Snellen (0.15 logMAR) in the left eye. Residual visual limitation was attributed mainly to coexisting cataract, and sequential cataract surgery was planned. Together, the clinical photographs and AS-OCT scans illustrate an uncommon presentation of visually disabling bilateral lipid keratopathy, characterized by dense central stromal lipid deposition involving both visual axes and profound preoperative visual loss. The case is clinically noteworthy because it combines severe bilateral disease, close clinical–tomographic correlation, and sequential penetrating keratoplasty performed as a staged visual rehabilitation strategy, resulting in restoration of graft clarity and meaningful visual improvement during postoperative follow-up. Full article

The aim of this study is to determine the optimal functional size of laser peripheral iridotomy (LPI) for anterior chamber parameter improvement in primary angle-closure disease (PACD). This study evaluated 109 eyes from 62 consecutive phakic patients. Baseline and one-week post-LPI anterior segment OCT were utilized to measure anterior chamber volume (ACV), anterior chamber angle (ACA), and iridotomy dimensions. Data was analyzed using linear mixed-effects models (LMMs), generalized additive models (GAMs), and receiver operating characteristic (ROC) curves. Post-LPI, significant increases occurred in ACA 500 (+7.54°), ACV (+11.09 mm³), and gonioscopic grade. LMMs confirmed a positive association between iridotomy size and anatomical expansion. GAMs demonstrated a saturation effect for ACV improvement, plateauing at 0.1 mm² (narrow area) and 0.25–0.30 mm² (superficial area), while the ACA relationship remained predominantly linear. ROC analysis identified preliminary superficial area cutoffs of 0.14 mm² and 0.12 mm² as discriminators of above-median volumetric and angular response, respectively. These findings suggest that LPI size is an independent determinant of anatomical response, beyond simple patency. As a preliminary, hypothesis-generating target, a superficial iridotomy area of approximately 0.12–0.14 mm² was associated with above-median volumetric and angular response in this cohort. Prospective validation is required before these thresholds can be incorporated into clinical practice. Full article

Descemet stripping automated endothelial keratoplasty (DSAEK) is a well-established surgical technique for the treatment of endothelial dysfunction, in which intracameral gas tamponade plays a critical role in graft adherence. We report the case of a 67-year-old pseudophakic woman with advanced Fuchs endothelial corneal dystrophy and symptomatic pseudophakic bullous keratopathy in the right eye, who presented with progressive visual deterioration and underwent DSAEK using an 8.25 mm donor graft inserted with a Busin glide and tamponaded with a 25% sulfur hexafluoride (SF6) gas–air mixture. On the first postoperative day, slit-lamp examination suggested an appropriate anterior chamber configuration and satisfactory graft attachment. However, detailed multiplanar anterior segment optical coherence tomography (AS-OCT), defined here as assessment using vertical, horizontal, and rotational scan orientations, revealed subtle posterior migration of the gas bubble beneath the iris plane. This clinically occult finding indicated altered anterior segment anatomy associated with a risk of secondary angle-closure mechanisms and raised concern for malignant glaucoma. Prompt surgical re-intervention was undertaken on postoperative day one, involving decompression of the misdirected gas bubble and reinjection of a centrally positioned tamponade. This resulted in restoration of normal anterior chamber configuration and stable graft adherence. Best-corrected visual acuity (BCVA) improved from 0.1 Snellen (1.0 logMAR) preoperatively to 0.7 Snellen (0.15 logMAR) at 2 weeks following surgery. This case highlights the added value of multiplanar AS-OCT in detecting clinically occult posterior gas migration after DSAEK, particularly when the abnormality is scan-orientation-dependent and not apparent on slit-lamp examination, thereby enabling timely intervention in the presence of a potentially sight-threatening postoperative configuration. Full article

Background/Objectives: To evaluate the associations between corneal topographic irregularity, higher-order aberrations (HOAs), and posterior segment structural and microvascular parameters in keratoconus using optical coherence tomography (OCT) and OCT angiography (OCTA). Methods: In this cross-sectional study, 81 eyes with keratoconus and 60 healthy control eyes underwent corneal topography and wavefront analysis, spectral-domain OCT with enhanced depth imaging, and OCTA. Retinal layer thicknesses, choroidal thickness and area metrics, choroidal vascularity index (CVI), and OCTA-derived vascular parameters were analyzed. Associations were assessed using Spearman correlation analysis with false discovery rate (FDR) correction. Results: Compared with controls, keratoconus eyes showed significantly increased corneal curvature, corneal irregularity indices, and HOAs (all p < 0.001). Structural OCT analysis demonstrated preserved inner retinal layers, whereas outer nuclear layer thickness was reduced (p < 0.001) and overall outer retinal layer thickness was increased (p = 0.005). Choroidal thickness and both total and luminal choroidal areas were significantly greater in keratoconus eyes (all p ≤ 0.011), while CVI did not differ between groups (p > 0.05). OCTA revealed reduced superficial capillary plexus vessel density at the whole image and perifoveal regions (all p < 0.001), whereas deep capillary plexus and foveal avascular zone metrics were largely preserved. Correlation analyses identified only weak and inconsistent associations between corneal parameters, HOAs, and posterior segment measurements, none of which remained statistically significant after FDR correction. Conclusions: Despite pronounced anterior segment deformation and optical degradation, posterior segment structural and microvascular alterations in keratoconus are limited and weakly related to corneal disease severity. These findings support a predominantly anterior segment centered pathophysiology of keratoconus and highlight the importance of stringent multiple-comparison control in multimodal imaging studies. Full article

Lamellar ichthyosis is a rare congenital disorder of keratinization frequently associated with ocular complications, most commonly cicatricial ectropion and exposure keratopathy. We present a case of severe mixed exposure-related and neurotrophic keratopathy with marked corneal thinning in a 61-year-old man with genetically confirmed lamellar ichthyosis. At presentation, the best-corrected visual acuity (BCVA) in the right eye was limited to hand motion (logMAR 2.3). Slit-lamp examination revealed a large central to inferocentral corneal ulcer measuring approximately 3 × 4 mm with severe stromal thinning in the setting of marked lower eyelid ectropion, incomplete eyelid closure, and chronic ocular surface exposure, while anterior segment optical coherence tomography (AS-OCT) demonstrated a minimal corneal thickness of approximately 165 µm. Microbiological swabs obtained from the conjunctival sac were negative, and no purulent discharge, hypopyon, or anterior chamber inflammatory reaction was present, making active infectious keratitis unlikely. Corneal sensitivity measured with Cochet–Bonnet esthesiometry at presentation, centrally and in all four peripheral quadrants of both eyes, was markedly reduced, more severely in the affected right eye, supporting the presence of a severe neurotrophic component contributing to impaired corneal healing. Intensive conservative therapy including preservative-free lubricants, dexpanthenol gel, autologous serum eye drops, topical insulin, prophylactic antibiotics, and systemic doxycycline was initiated. Serial AS-OCT imaging demonstrated progressive structural recovery, with corneal thickness increasing to 438 µm after one month of treatment and complete corneal epithelialization. The BCVA improved to 0.2 Snellen (0.7 logMAR). This case highlights the diagnostic value of multimodal anterior segment imaging in monitoring severe mixed keratopathy with advanced corneal thinning and demonstrates that intensive conservative therapy may stabilize the ocular surface and prevent corneal perforation in patients with lamellar ichthyosis. Full article

Background/Objectives: Corneal epithelial thickness (CET) alterations reflect distinct mechanisms in aqueous-deficient and evaporative dry eye disease (DED) subtypes. In this study, we compare the CET profiles between patients with Sjögren’s syndrome (SS) and those with meibomian gland dysfunction (MGD) to elucidate the underlying mechanisms. Methods: We retrospectively analyzed 30 patients with SS and 30 age- and sex-matched with MGD. Assessments included corneal staining, Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), non-invasive breakup time, lipid layer thickness (LLT), and anterior segment optical coherence tomography (AS-OCT) CET mapping. Regional CET and superior–inferior asymmetry were compared. Results: The SS group exhibited higher corneal staining scores (2.18 ± 1.23 vs. 1.03 ± 1.18, p = 0.001) and lower TMHs (0.14 ± 0.06 vs. 0.18 ± 0.07 mm, p = 0.013), while the MGD group reported greater OSDI scores (40.39 ± 22.49 vs. 31.25 ± 22.81, p = 0.029). A significantly thinner central epithelium (p = 0.043) and localized inferior paracentral thinning (2–5 mm zone, p = 0.008) were noted in SS. Corneal staining was identified as the primary independent predictor of central and inferior CET reduction in both groups. In the MGD group, LLT was associated with the preserved inferior CET (p = 0.045) and superior–inferior thickness difference (p = 0.015). Conclusions: Distinct structural signatures are observed between DED subtypes. SS features central/inferior thinning from aqueous deficiency-mediated friction, whereas MGD shows a relatively preserved epithelial thickness influenced by LLT. Regional CET analysis may provide mechanistic insights into DED subtyping. Full article

Rapidly progressive infectious keratitis may involve the anterior uveal tract and lead to anterior segment inflammation, resulting in severe structural damage of the cornea and potentially causing corneal perforation or endophthalmitis if not promptly treated. We report the case of a 63-year-old male admitted to the Emergency Ophthalmology Department of the University Clinical Center in Katowice, Poland, with a rapidly progressive corneal ulcer of the left eye that had not responded to two weeks of outpatient topical antibiotic therapy. The condition developed after ocular trauma sustained while chopping wood. At presentation, visual acuity was limited to light perception with preserved projection. Multimodal imaging, including slit-lamp examination, anterior segment optical coherence tomography (AS-OCT), and in vivo confocal microscopy, revealed extensive corneal ulceration with severe stromal destruction, progressive corneal melting, and marked anterior segment inflammation, with an imminent risk of perforation. Microbiological cultures identified Pseudomonas aeruginosa. Despite intensive empiric topical antimicrobial therapy targeting both bacterial infection and a possible fungal component related to trauma with organic material, rapid clinical deterioration necessitated emergency therapeutic penetrating keratoplasty (PK). The procedure resulted in rapid resolution of inflammation and improvement in visual acuity, with best-corrected visual acuity (BCVA) reaching 0.3 logMAR during follow-up. At the three-month follow-up, the corneal graft remained clear with stable visual acuity and no recurrence of infection. The patient remains under regular long-term follow-up, with ongoing monitoring of graft clarity, intraocular pressure (IOP), and visual function. This case differs from routine presentations of infectious keratitis by demonstrating exceptionally rapid stromal melting despite promptly initiated empiric topical therapy. Multimodal imaging, particularly AS-OCT provided clinically meaningful information by revealing structural instability and an imminent risk of perforation not fully appreciable on slit-lamp examination, thereby supporting timely urgent keratoplasty. These findings highlight the practical diagnostic value of imaging-based assessment in advanced infectious keratitis and underscore its role in guiding surgical decision-making in eyes at high risk of corneal perforation. Full article

Introduction: Although anterior non-infectious uveitis affects the structures of the anterior segment of the eye, (inflammatory) disruption of the hemato–ocular barrier may lead to changes in the structures of the posterior segment of the eye. Objective: To evaluate functional retinal changes using multifocal electroretinography (mfERG) and their relationship with structural optical coherence tomography (OCT) parameters in patients with acute anterior non-infectious uveitis (AANU). Methods: This prospective study included 38 eyes of 19 patients diagnosed with unilateral AANU and age-matched healthy fellow eyes as controls. All subjects underwent comprehensive ophthalmological examination, including best-corrected visual acuity (BCVA), spectral-domain OCT, and mfERG testing at baseline, 3 months, and 6 months. mfERG parameters (amplitude and implicit times) were analyzed alongside central field thickness (CFT), macular volume (MV), and average macular thickness (AMT). Results: Eyes affected by AANU demonstrated a significant reduction in mfERG response amplitude in the central retinal region compared with control eyes, particularly during the acute phase. Although OCT parameters showed partial structural normalization during follow-up, functional recovery was less pronounced in selected retinal regions. Latency values showed minimal variation over time. These findings indicate a potential dissociation between electrophysiological function and structural morphology during disease resolution. Conclusions: Acute anterior uveitis is associated with measurable macular functional impairment detectable by mfERG, even when structural OCT parameters appear relatively stable. These results suggest that inflammatory processes in AAU may extend beyond the anterior segment and transiently affect retinal function. mfERG may therefore serve as a sensitive adjunct tool for detecting and monitoring subclinical macular dysfunction in AANU. Clinical Relevance: Functional retinal impairment may persist despite apparent structural recovery in acute anterior uveitis. Incorporating mfERG into clinical evaluation may improve the detection of subtle macular involvement and enhance understanding of disease dynamics beyond conventional imaging findings. Full article

Objective: To develop and validate an artificial intelligence (AI) system for automated lens opacities classification system III (LOCS III)-based grading of all three major cataract subtypes using anterior segment optical coherence tomography (AS-OCT). Methods: This is a single-center cross-sectional study. AS-OCT images were collected and manually graded by ophthalmologists according to LOCS III. The dataset was randomly split into training, validation, and test sets. We propose a novel multi-granularity mask-guided network (MMNet) that jointly performs lens substructure segmentation and severity grading. The model’s performance was assessed on an independent test set for automatic grading of cortical cataract (CC), nuclear cataract (NC), and posterior subcapsular cataract (PSC) and the grading performance of the proposed method against ophthalmologists was also evaluated. The model’s interpretability was assessed via attention heatmaps and feature visualization. Results: The proposed MMNet exhibited high agreement with ground truth conducted through gold standard. The proportions of predictions with an absolute error < 1.0 for three subtypes range from 83.02% to 89.94%. The model’s grading accuracy for cataract subtypes was between 82.20 ± 1.41% and 89.76 ± 1.31% among the three subtypes, the Area Under the Curve (AUC) was between 0.954 (95% CI, 0.952–0.969; p < 0.001) and 0.973 (95% CI, 0.964–0.985; p < 0.001). The MMNet shows a satisfactory mean absolute error (MAE) of 0.14 ± 0.35 in CC, 0.10 ± 0.30 in NC, and 0.17 ± 0.38 in PSC grading. It also achieved a fast grading speed of 0.0178 s/image against manual grading. Conclusions: The proposed AI model presented advanced performance on AS-OCT images in automated LOCS III-based cataract grading for CC and NC, and also showed feasibility in PSC assessment. Full article

Background: Mirvetuximab soravtansine (MIRV) improves outcomes in FRα-positive, platinum-resistant ovarian cancer; however ocular adverse events (OAEs), particularly corneal epithelial toxicity, are frequent and warrant structured ophthalmologic monitoring. Methods: In this retrospective observational study, 31 consecutive patients receiving MIRV for FRα-positive gynecologic malignancies underwent standardized ophthalmic assessments at baseline and prior to each treatment cycle (every 21 days). The protocol included best corrected visual acuity (BCVA), slit-lamp biomicroscopy, anterior-segment optical coherence tomography (AS-OCT), corneal topography, and tear film analysis. OAEs were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0, based on symptom severity and functional impairment. Results: OAEs occurred in all patients (31/31, 100%), predominantly grade 1–2. Corneal epithelial toxicity was documented in 28/31 patients (90.3%), while no grade ≥ 3 events were observed. Symptoms typically developed 7–14 days after the second infusion. AS-OCT and corneal topography consistently revealed epithelial microcysts and surface irregularities, which were usually detected during scheduled pre-cycle ophthalmologic evaluations. Tear-film instability (break-up time ≤ 5 s) developed in 19/31 patients (61.3%), generally within 10 days after the second infusion, and improved in all but 2 patients (6.5%) following prophylactic lubrication. Transient refractive changes occurred in 28/31 patients (90.3%) and were associated with a temporary BCVA reduction (mean nadir ~20/32 Snellen), followed by recovery during follow-up. Conclusions: MIRV-related ocular alterations are frequent but reversible and clinically manageable. Multimodal imaging combined with functional and refractive assessment provides sensitive markers of corneal epithelial toxicity and supports integrated ophthalmologic monitoring to preserve visual function and maintain oncologic treatment continuity. Full article

Cytomegalovirus (CMV) infection of the anterior segment is increasingly recognized as an important cause of corneal endotheliitis and secondary glaucoma, even in immunocompetent individuals. CMV corneal endotheliitis typically presents with coin-shaped or linear keratic precipitates (KPs), corneal edema, mild anterior chamber inflammation, and recurrent intraocular pressure (IOP) elevation; persistent or episodic ocular hypertension may progress to glaucomatous optic neuropathy if inadequately treated. Definitive diagnosis relies on aqueous humor polymerase chain reaction (PCR) testing for CMV DNA, supported by adjunctive imaging including specular microscopy, anterior segment optical coherence tomography (AS-OCT), and in vivo confocal microscopy (IVCM). Management requires a comprehensive strategy integrating antiviral therapy, anti-inflammatory treatment, and appropriate IOP control. Topical or systemic ganciclovir remains the cornerstone, while refractory disease may necessitate surgical intervention. Older age and male sex, host immune status, prolonged or recurrent CMV infection, and pre-existing ocular conditions are major risk factors for progression and poor outcomes. The pathogenesis of secondary glaucoma is thought to involve both direct viral cytopathic effects and inflammation-mediated damage to the trabecular meshwork (TM), resulting in impaired aqueous outflow. Therefore, early recognition, accurate diagnosis, and effective treatment are essential to prevent corneal decompensation and permanent vision loss. Full article

Background/Objectives: Anterior segment optical coherence tomography (AS-OCT) and optical coherence tomography angiography (AS-OCTA) have enhanced the evaluation of the cornea, ocular surface, and ocular surface diseases (OSD), offering high-resolution structural and anterior segment vascular imaging. This review summarizes recent advances in these modalities and their clinical applications. Methods: A comprehensive literature search was conducted using PubMed, Web of Science, and Google Scholar with the terms OCT, OCTA, anterior segment, and ocular surface disease. Studies published in the past five years were included, emphasizing more recent developments such as ultra-high-resolution AS-OCT (UHR-AS-OCT) and swept-source AS-OCTA technologies. Results: UHR-AS-OCT provides non-invasive, sub-micron imaging of the cornea and the ocular surface, including tear film morphology and epithelial thickness to correlate with clinical tests such as tear break-up time, and fluorescein staining. Advances in AS-OCTA allow dye-free, depth-resolved imaging of corneal and conjunctival vasculature. These vascular biomarkers have shown promising utility in conditions such as limbal stem cell deficiency, chemical ocular injury, and ocular surface squamous neoplasia. Improvements in image acquisition, motion correction, and segmentation algorithms have enhanced accuracy and repeatability, supporting broader clinical translation. Conclusions: AS-OCT and AS-OCTA have become useful adjunctive imaging tools for the cornea and ocular surface evaluation. Their non-invasive, quantitative, and reproducible metrics may enable earlier diagnosis, objective staging, and longitudinal monitoring of OSD. Integration of OCT-based imaging with artificial intelligence and multimodal data, including tear proteomics and meibography, may optimize personalized treatment for ocular surface disorders. Full article

Background/Objectives: During cataract surgery, topical anesthesia is routinely achieved through the instillation of topical anesthetic eye drops, while different agents may be applied to the corneal surface during the procedure to support lubrication and protection. The impact of these intraoperative strategies on corneal integrity and postoperative ocular surface recovery remains an area of clinical interest. This study aimed to compare the intraoperative and postoperative effects of applying a topical anesthetic gel (Ophtesic, Horus Pharma) on the corneal surface versus the use of balanced salt solution (BSS) during cataract surgery. Methods: In this longitudinal, observational prospective study, 24 eyes of 24 patients undergoing phacoemulsification received either topical anesthetic gel (n = 15) or BSS irrigation (n = 9). Central corneal thickness (CCT) and epithelial thickness were measured preoperatively and on postoperative days 1, 5, and 15 using anterior segment optical coherence tomography (AS-OCT). Basal epithelial cell (BEC) density was assessed by in vivo confocal microscopy (IVCM), while OSDI score, non-invasive breakup time (NI-BUT), and Schirmer test I values were evaluated preoperatively and on postoperative days 5 and 15. Patient and surgeon satisfaction were rated using a Likert-like scale. Results: Both groups showed increased CCT and epithelial thickness at day 1. In the gel group, CCT returned to baseline by day 15 (p = 0.361), and epithelial thickness normalized by day 5 (p = 0.066). In the BSS group, CCT remained elevated at day 15 (p < 0.05), and epithelial thickness decreased at day 5 (p < 0.05) before returning to baseline. BEC density normalized at day 15 in the gel group (p = 0.107) but remained altered in the BSS group (p < 0.05). NI-BUT Schirmer I, and OSDI showed a trend toward faster recovery in the gel group than in the BSS group. Conclusions: In this exploratory study, intraoperative application of a topical anesthetic gel appeared to support early normalization of corneal and tear film parameters while providing effective anesthesia. Further studies are warranted to confirm these observations and evaluate potential long-term benefits. Full article

Aims: The aim of this study is to characterise corneal epithelial thickness profiles after Descemet membrane endothelial keratoplasty (DMEK) and compare it with healthy controls, focusing on inferior–superior (I–S) epithelial thickness differences and their relationship with age. Methods: This single-centre observational study included 36 post-DMEK eyes with at least 6 months’ follow-up and 36 healthy control eyes. High-resolution spectral-domain anterior segment OCT maps were analysed for central epithelial thickness (CET, defined as the mean epithelial thickness within the central 2 mm zone [E2.0]) and peripheral sectors to derive inferior (E–I) and superior (E–S) values (between 2 and 7 mm), with the I–S difference computed at a 3 mm radius; group comparisons used t-tests and correlations used Pearson’s r (α = 0.05). Central corneal thickness (CCT) was also compared between groups. Results: Post-DMEK eyes had significantly lower mean CCT than controls (525.7 ± 98.4 μm vs. 544.71 ± 27.8 μm, p = 0.04). Central epithelial thickness did not differ between groups (post-DMEK 53.7 ± 5.5 μm vs. controls 52.7 ± 3.3 μm, p = 0.62), but the I–S epithelial difference was greater after DMEK (5.9 ± 4.3 μm) than controls (3.0 ± 2.2 μm, p < 0.01), indicating a more pronounced inferior thickening pattern. Age showed no significant relationship with epithelial thickness in controls, and only very weak or non-significant correlations with central thickness and I–S difference in post-DMEK eyes, indicating no clinically meaningful age effect postoperatively. Conclusions: DMEK restores central epithelial thickness to values comparable to normal eyes, while accentuating the physiologic inferior–superior epithelial gradient, consistent with localised postoperative epithelial remodelling rather than global epithelial thickening or thinning. Corneal stromal remodelling may result in lower CCT post-DMEK versus controls, and age does not meaningfully influence epithelial distribution after surgery. Full article

Background and Objectives: Accurate anterior segment measurements are central to intraocular lens (IOL) power calculation and toric planning, yet different optical platforms may yield non-interchangeable values. This study compared keratometry, astigmatism metrics, and ocular biometry obtained with a swept-source OCT biometer (Argos), an optical low-coherence interferometry biometer (Aladdin), and a combined Scheimpflug–Placido topographer (Schwind Sirius). Methods: This is a retrospective observational study (January 2022–June 2024) including eyes undergoing uncomplicated cataract surgery. All eyes were measured in a single session by one examiner. Outcomes included K1, K2, cylinder, astigmatism axis (degrees; device-reported corneal cylinder axis, labeled “Powerful Angle” in the Sirius export), vector components (J0 and J45), and—where available—lens thickness (LT), axial length (AL), anterior chamber depth (ACD), white-to-white (WTW) distance, and central corneal thickness (CCT). Friedman tests assessed 3-device differences, and pairwise comparisons were evaluated using Wilcoxon signed-rank tests (paired data). Results: A total of 170 eyes (102 patients) were analyzed (mean age: 69.12 ± 10.26 years). Significant inter-device differences were detected for K1 (Argos: 43.45 ± 1.64 D; Aladdin: 43.41 ± 1.70 D; overall: p < 0.001; Argos vs. Aladdin: p = 0.019), K2 (Argos: 44.45 ± 1.67 D; Aladdin: 44.34 ± 1.71 D; overall and pairwise: p < 0.001), and cylinder (Argos: −0.83 ± 0.74 D, Aladdin: −0.77 ± 0.76 D; Sirius: −0.68 ± 0.75 D; overall: p < 0.001). “Powerful Angle” differed across devices (p = 0.003) but not between Argos and Aladdin (p = 0.512). J0 (p = 0.277) and J45 (p = 0.084) did not differ significantly. Argos reported higher ACD (3.19 ± 0.42 vs. 3.13 ± 0.41 mm, p < 0.001) and WTW (11.95 ± 0.42 vs. 11.65 ± 0.39 mm, p < 0.001) values than Aladdin. CCT was similar between Aladdin and Sirius (540.27 ± 33.44 vs. 540.47 ± 33.78 µm, p = 0.169). Conclusions: Several keratometric and biometric parameters differed significantly by device, indicating limited interchangeability—particularly relevant for toric and premium IOL planning—while vector astigmatism components and CCT showed better agreement. Full article