目的：探讨IOL Master 700在不同散光程度分组测量白内障患者角膜散光及相关生物参数的重复性，并评估其与IOL Master 500的一致性。

方法：横断面研究，选取2024年2月至2025年9月医院收治的白内障术前患者为研究对象，分为低度散光组(散光度数<0.75 D)、中度散光组(0.75 D≤散光度数≤1.50 D)和高度散光组(散光度数>1.50 D)。由同一名检查者分别采用IOL Master 700和IOL Master 500生物测量仪，在相同环境、头位及操作标准下，每眼用每台仪器连续测量2次(间隔3-5 min)，记录眼轴长度(AL)、前房深度(ACD)、晶状体厚度(LT)、角膜横径(WTW)、角膜前表面平坦曲率(Kf)、陡峭曲率(Ks)、平均曲率(Km)、角膜前表面散光(Kly)、全角膜散光(TK)、虹膜水平中心距(IBD-Ix)、虹膜垂直中心距(IBD-Iy)以及散光矢量J0和J45。采用组内相关系数(ICC)评价IOL Master 700两次测量的重复性，采用Bland-Altman 95%一致性界限(LoA)评价IOL Master 700与IOL Master 500测量结果的一致性，采用相关性散点图评价IOL Master 700与IOL Master 500测量结果的相关性。

结果：选取白内障术前患者238例238眼为研究对象，低度散光组88例，男47例，女41例，平均年龄68.14±6.25岁； 中度散光组80例，男42例，女38例，平均年龄68.13±6.98岁； 高度散光组70例，男38例，女32例，平均年龄69.11±6.79岁； 三组患者一般资料具有可比性。在低、中、高度散光三组中，IOL Master 700测量AL、ACD、LT、WTW、Kf、Ks、Km、Kly、TK、IBD-Ix的ICC均>0.90，IBD-Iy的ICC>0.85。不同散光度数患者J0和J45的ICC比较，低度散光组<中度散光组<高度散光组。两台设备间Bland-Altman分析显示，AL、ACD、LT、WTW、Kf、Ks、Km、Kly、TK、IBD-Ix、IBD-Iy的95% LoA宽度均较窄，提示两台仪器一致性良好。对于散光矢量J0和J45，两台设备间的Bland-Altman 95% LoA宽度随散光度数增加而减小。绘制相关性散点图，结果显示AL、ACD、LT、WTW、Kf、Ks、Km、Kly、TK、IBD-Ix及IBD-Iy的散点紧密聚集于对角线两侧，无明显离群值，提示相关性较高； J0、J45散点仍沿对角线分布，但离散程度明显大于上述参数，提示相关性略低。

结论：IOL Master 700在测量白内障患者AL、ACD、LT、WTW、角膜曲率、Kly、TK及IBD-Ix等参数时，在不同散光程度分组中均具有良好至极好的重复性，且与IOL Master 500间一致性好。但对于散光矢量J0和J45，IOL Master 700自身重复性及与IOL Master 500的一致性均随散光度数降低而下降，在低度散光患者中差异尤为明显。因此，对于低度散光患者，应谨慎解读单次测量的散光矢量结果。

METHODS: A cross-sectional study was conducted on preoperative cataract patientsadmitted to the hospital from February 2024 to September 2025. The patients were divided into three groups: low astigmatism group(astigmatism<0.75 D), moderate astigmatism group(0.75 D≤astigmatism≤1.50 D), and high astigmatism group(astigmatism>1.50 D). The IOL Master 700 and IOL Master 500 biometers were used by the same examiner respectively. Under the same environment, head position, and operating standards, each eye was continuously measured twice(with an interval of 3-5 min)with each instrument. Axial length(AL), anterior chamber depth(ACD), lens thickness(LT), corneal transverse diameter(WTW), flat curvature(Kf), steep curvature(Ks), mean curvature(Km), anterior corneal astigmatism(Kly), total corneal astigmatism(TK), iris-based diameter-vertical component(IBD-Ix), iris-based diameter-horizontal component(IBD-Iy)and astigmatism vectors J0 and J45 were recorded. Intraclass correlation coefficient(ICC)was used to evaluate the repeatability of IOL Master 700 measurements. Bland-Altman 95% limits of agreement(LoA)was used to evaluate the consistency of IOL Master 700 and IOL Master 500 measurements. Correlation scatter plots were used to evaluate the correlation between IOL Master 700 and IOL Master 500 measurements.

RESULTS:Totally 238 preoperative cataract patients(238 eyes)were selected as the research subjects and divided into a low astigmatism group of 88 cases, including 47 males and 41 females, with an average age of 68.14±6.25 y. The moderate astigmatism group consisted of 80 eyes, with 42 males and 38 females, with an average age of 68.13±6.98 y. The high astigmatism group consisted of 70 eyes, with 38 males and 32 females, with an average age of 69.11±6.79 y. The general information of the three groups of patients was comparable. In the low, medium, and high astigmatism groups, the ICC measured by IOL Master 700 for AL, ACD, LT, WTW, Kf, Ks, Km, Kly, TK, and IBD-Ix were all>0.90, and the ICC for IBD-Iy was>0.85. The ICC comparison of J0 and J45 patients with different degrees of astigmatism showed that the low astigmatism group was less than the moderate astigmatism group and less than the high astigmatism group. Bland Altman analysis between two devices showed that the 95% LoA width of AL, ACD, LT, WTW, Kf, Ks, Km, Kly, TK, and IBD-Ix was narrow, indicating good consistency between the two instruments. For the astigmatism vectors J0 and J45, the Bland Altman 95% LoA width between the two devices decreased with increasing astigmatism. A correlation scatter plot was drawn, which showed that the scatter points of AL, ACD, LT, WTW, Kf, Ks, Km, Kly, TK, IBD-Ix, and IBD-Iy were closely clustered on both sides of the diagonal without obvious outliers, indicating high correlation. J0 and J45 scatter points were still distributed along the diagonal, but the degree of dispersion was significantly greater than the above parameters, indicating slightly lower correlation.

CONCLUSION:IOL Master 700 exhibits goodtoexcellent repeatability in measuring parameters such as AL, ACD, LT, WTW, corneal curvature, Kly, TK, IBD-Ix,and IBD-Iy in cataract patients with different degrees of astigmatism, and shows good agreement with the IOL Master 500. However, for the astigmatism vectors J0 and J45, the repeatability of IOL Master 700 and its consistency with IOL Master 500 both decrease with decreasing astigmatism, and the difference is particularly significant in patients with low astigmatism. Therefore, astigmatism vector outcomes obtained from a single measurement should be interpreted with caution in patients with low astigmatism.