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Introduction: This study aims to evaluate the accuracy of the measurement parameters of the new Verion Image Guided System compared with an established standard of care.

Purpose: To compare the keratometry (K) and white-to-white (WTW) measurements obtained from the Lenstar Optical Biometer (LS) with those from the Verion Image-Guided System (VR) and their effect on intraocular lens (IOL) power calculation.

Design: Prospective comparative case series.

Materials and methods: Sixty patients going for cataract surgery had biometry measurements and IOL calculation with the LS. Axial length from LS was used together with K and WTW measurements from VR for IOL calculation as well. IOL selection was done using the Barrett Universal II formula targeting emmetropia. The prediction error (PE) within 0.25 D, 0.5 D, and 1 D of refractive target and the mean absolute error (MAE) were calculated for both the LS and VR.

Results: Keratometry measurements and steep axis from the VR were closely correlated with the LS (Pearson correlation coefficient K1, r = 0.958; K2, r = 0.952; axis, r = 0.950). The WTW measurements were less so (WTW, r = 0.471). The MAE was 0.317 and 0.347 for LS and VR, respectively. PE within 0.25 D was 48.3% and 40%; within 0.5 D was 83.3% and 76.7%; and within 1 D was 98.3% and 96.7% for LS and VR, respectively. There was no statistically significant difference in MAE between the LS and VR (p = 0.74)

Conclusion: Using the K and WTW measurements from the Verion Image-Guided System for IOL power calculation did provide comparable results with the Lenstar. The Lenstar had a higher proportion of eyes within 0.5 D of refractive target but the difference was not statistically significant.