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BackgroundTo compare the accuracy of intraoperative wavefront aberrometry using the ORA VLynk system with different biometry-based formulas in short and long eyes after cataract surgery.MethodsThis prospective study considered 48 eyes with axial lengths of <22.1 mm and 48 eyes with axial lengths of >25.0 mm. All eyes were implanted with the monofocal AcrySof IQ IOL, the power being determined using the ORA VLynk. The postoperative spherical equivalent (SE) at 3 months was compared to that predicted preoperatively using the SRK/T, Hoffer Q, Haigis, Holladay 2, Barrett Universal II, and Barrett True K formulas and intraoperatively using the ORA VLynk. Mean numerical and absolute errors and the percentage of eyes within ±0.50 D/1.00 D of their target were obtained.ResultsFor long eyes, the mean absolute error values were 0.35, 0.52, 0.34, 0.30, 0.29, 0.27, and 0.24D for SRK/T, Hoffer Q, Haigis, Holladay 2, Barrett Universal II, Barrett True K, and ORA VLynk, respectively (p < 0.001). These values were 0.55, 0.45, 0.49, 0.40, 0.44, 0.44 and 0.50 D for short eyes, respectively (p < 0.001). The proportions of long eyes within ±0.50 D of the target were 77.08, 50, 75, 85.42, 83.33, 79.17, and 87.50%, respectively; and 50, 66.67, 60.42, 66.67, 60.42, 60.42, and 58.33%, respectively, for short eyes.ConclusionThe ORA VLynk performs better than all biometry-based formulas in long eyes and, in short eyes, it is as effective as SRK/T, Haigis, Barrett Universal II, and Barrett true K, with the Hoffer Q and Holladay 2 being the most accurate; however, the differences between the calculation methods were small.Clinical trial registrationIdentifier DRKS000028106.