The Current State of Ocular Biometry

Practical considerations for the use of biometry in cataract surgery planning, recent technological advances, and the current landscape of commercially available biometers.

By: Mitchell P. Weikert, MD, Melody Ziari, MD

Ophthalmology Management July 20, 2026

Clinical Report: The Current State of Ocular Biometry

Background

Ocular biometry is essential for accurate intraocular lens (IOL) power calculation, which directly impacts surgical outcomes in cataract surgery. The transition from ultrasound to optical biometry has marked a significant advancement in the precision of ocular measurements. Understanding the current landscape of biometry technologies is crucial for optimizing patient care in ophthalmology.

Data Highlights

Qualitative data highlights the transition from ultrasound to optical biometry and the advancements in measurement techniques.

Key Findings

Ultrasound biometry was the original method for measuring axial length, anterior chamber depth, and lens thickness.
Optical biometry has largely replaced ultrasound biometry due to its higher resolution and ability to provide fixation targets.
Recent advancements in optical biometry, particularly swept-source optical coherence tomography (SS-OCT), have improved measurement success rates.
Despite advancements, ultrasound biometry remains necessary for certain cases, particularly with dense cataracts.
Auto-keratometry is now integrated into optical biometers, providing comparable resolution to manual keratometry.
Attention to measurement quality is critical for maximizing refractive outcomes in cataract surgery.

Clinical Implications

Surgeons should be familiar with both optical and ultrasound biometry techniques to ensure accurate IOL power calculations.

Conclusion

The evolution of ocular biometry has significantly enhanced the accuracy of cataract surgery planning.

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