Abstract
<title>Abstract</title> <p>Purpose To compare different keratometry measurements for intraocular lens (IOL) power calculation in patients undergoing IOL implantation after keratoplasty (penetrating keratoplasty [PKP] or deep anterior lamellar keratoplasty [DALK]) and to determine the most clinically appropriate keratometric value. Setting: Department of Ophthalmology, Adana City Training and Research Hospital, Adana, Turkey. Design: Retrospective comparative study. Methods Clinical records of patients who underwent PKP and subsequent IOL power calculation were reviewed. Keratometric values were obtained using an autorefractor, Nidek AL-Scan, and Pentacam topographer. Holladay Equivalent Keratometry Readings (EKR) and anterior corneal surface keratometry values were compared. Statistical analyses assessed agreement and repeatability between devices. Results A total of 24 eyes of 24 patients were included. Pre-cataract biometry (IOL Master 500) was repeated using autorefractor K, Pentacam topographic K, and Holladay EKR. No significant differences were found between the actual refractive error and the predicted error among these three methods (P > .05). Bland–Altman analysis showed repeatability coefficients of 9.32 for autorefractor, 9.37 for topography, and 14.33 for EKR. Although not statistically significant, the lower repeatability coefficient with the autorefractor suggests more consistent measurements. Absolute refractive error differences were also smallest with the autorefractor. Conclusions In post-keratoplasty patients undergoing cataract surgery, IOL power calculations based on autorefractor and topographic keratometry values demonstrated more consistent outcomes. Although no statistically significant differences were observed among the evaluated methods, EKR measurements exhibited greater variability. These findings suggest that caution may be warranted when relying on EKR for IOL power calculation in this patient population.</p>