{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T18:22:41Z","timestamp":1787595761010,"version":"build-2736575974"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    Accurate keratometry is essential for toric intraocular lens (IOL) planning, yet most prior studies evaluated inter-device agreement under standardized research conditions that may not reflect everyday practice. This retrospective study evaluated keratometry agreement among the KR-800, IOLMaster 500, and Pentacam HR under real-world clinical conditions in 227 eyes of cataract surgery candidates. Corneal astigmatism was converted to power vector components: J0 (with\/against-the-rule astigmatism) and J45 (oblique astigmatism). Population-level agreement was assessed using linear mixed-effects models and intraclass correlation coefficients (ICC), while individual-level agreement was evaluated using Bland-Altman analysis. Agreement in toric IOL candidacy and the predicted residual astigmatism arising from inter-device differences were also examined. No significant population-level differences were observed among devices (J0:\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.138; J45:\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.233), with ICC values of 0.894 for J0 and 0.748 for J45, respectively. However, the 95% limits of agreement were wide (0.80\u20131.21 D). When any device pair was considered, the predicted residual astigmatism exceeded 0.50 D in 64.8% of patients, and the Pentacam HR classified fewer eyes as toric IOL candidates than the reflection-based devices. Among toric IOL candidates (\u22651.0 D astigmatism), 21\u201333% demonstrated axis differences exceeding 10\u00b0, a threshold associated with clinically relevant reduction in astigmatic correction. Axis differences were inversely correlated with astigmatism magnitude (Spearman\u2019s rho\u2009= \u22120.220 to \u22120.272, all\n                    <jats:italic>p<\/jats:italic>\n                    -values\u2009&lt;\u2009.001). The three devices showed acceptable agreement at the population level, and notably, the average magnitude of disagreement was limited. At the individual level, however, differences exceeded clinically relevant thresholds in a meaningful proportion of patients, including some toric IOL candidates. Using a single device consistently throughout surgical planning may be prudent, although the clinical impact of these differences was not directly assessed and warrants prospective validation.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0356995","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T17:25:01Z","timestamp":1787592301000},"page":"e0356995","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Agreement of keratometry measurements for toric IOL planning in routine clinical practice: KR-800, IOLMaster 500, and Pentacam HR"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1991-2336","authenticated-orcid":true,"given":"Yeoeun","family":"Lim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6287-5529","authenticated-orcid":true,"given":"Moonwon","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"issue":"2","key":"pone.0356995.ref001","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.ophtha.2015.10.002","article-title":"Toric Intraocular Lenses in the Correction of Astigmatism During Cataract Surgery: A Systematic Review and Meta-analysis","volume":"123","author":"L Kessel","year":"2016","journal-title":"Ophthalmology"},{"issue":"5","key":"pone.0356995.ref002","doi-asserted-by":"crossref","DOI":"10.1111\/aos.12584","article-title":"The 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