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Conventional AL measured with the composite method used the mean refractive index. The segmented-AL method used individual refractive indices for each ocular medium. The composite AL (24.52\u2009\u00b1\u20092.03\u2009mm) was significantly longer (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) than the segmented AL (24.49\u2009\u00b1\u20091.97\u2009mm) among a total of 374 eyes of 374 patients. Bland\u2013Altman analysis revealed a negative proportional bias for the differences between composite and segmented ALs. Although there was no significant difference in the RE obtained by the composite and segmental methods (0.42\u2009\u00b1\u20090.38 D vs 0.41\u2009\u00b1\u20090.36 D, respectively, <jats:italic>P<\/jats:italic>\u2009=\u20090.35), subgroup analysis of extremely long eyes implanted with a low power intraocular lens indicated that predicted RE was significantly smaller with the segmental method (0.45\u2009\u00b1\u20090.86 D) than that with the composite method (0.80\u2009\u00b1\u20090.86 D, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Segmented AL with SS-OCT is more accurate than composite AL in eyes with extremely long AL and can improve post-operative hyperopic shifts in such eyes.<\/jats:p>","DOI":"10.1038\/s41598-020-61391-7","type":"journal-article","created":{"date-parts":[[2020,3,11]],"date-time":"2020-03-11T11:03:11Z","timestamp":1583924591000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Comparison of composite and segmental methods for acquiring optical axial length with swept-source optical coherence tomography"],"prefix":"10.1038","volume":"10","author":[{"given":"So","family":"Goto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Noda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Ohnuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizuka","family":"Koh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikko","family":"Iehisa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohji","family":"Nishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,11]]},"reference":[{"key":"61391_CR1","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1016\/j.jcrs.2007.10.031","volume":"34","author":"S Norrby","year":"2008","unstructured":"Norrby, S. 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Goto, Maeda, Noda, and Nishida received fees from TOMEY CORPORATION for a sponsored seminar not related to this study. No conflicting relationship exists for any other author.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"4474"}}