Objective To investigate the reproducibility and agreement between Lenstar and IOLMaster when measuring axial length （AL）， anterior chamber depth （ACD）， keratometry for the flattest meridian （Kf）， keratometry for the steepest meridian （Ks）， mean keratometry （Km） and corneal diameter （WTW） of children after dilation. Methods In this prospective clinical study， 75 eligible children were recruited. One eye of each subject was randomly selected and all subjects were dilated with 1% cyclopentolate. All subjects were examined by two examiners for all parameters （AL， Kf， Ks， Km， WTW， ACD）. Within-subject standard deviation （Sw）， test-retest repeatability （TRT）， the within-subject coefficient of variation （CV） and the interclass correlation coefficient （ICC） were used to analyze reproducibility. The differences between these ocular parameters were analyzed using a paired t-test. Bland-Altman was used to assess the agreement of the instruments. Results The reproducibility results of AL， Kf， Ks， Km and ACD measured by the two examiners using Lenstar were good. The TRT values were 0.03 mm， 0.33 D， 0.22 D， 0.03 D and 0.23 mm， respectively. All the ICC values were over 0.99. The mean ACD， WTW， Ks and Km obtained by Lenstar and IOLMaster were 3.77±0.20 mm and 3.66±0.20 mm （t=16.194， P<0.01）， 12.11±0.43 mm and 12.41±0.53 mm （t=-5.973， P<0.01）， 43.62±1.49 D and 43.66±1.49 D （t=-2.277， P<0.05）， and 43.08±1.36 D and 43.12±1.35 D （t=-2.673， P<0.01）， respectively. All these values showed significant differences between the two methods. Bland-Altman analysis showed that the two instruments had comparable results for ACD， AL， Kf， Ks， and Km. The maximum absolute values of the 95% limits of agreement （LoA） were 0.23 mm， 0.07 mm， 0.29 D， 0.35 D and 0.29 D. But the 95% LoA of WTW was large （-1.17~0.57 mm）， indicating the agreement of WTW between these two instruments was poor. Conclusion The reproducibility is good for Lenstar. The WTW difference between Lenstar and IOLMaster is statistically significant， and the consistency is poor， but Lenstar is much better. Otherwise， the consistency of ACD， AL， Kf， Ks and Km between Lenstar and IOLMaster is good and could be regarded as clinically interchangeable.
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