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This study aimed to evaluate the intra-examiner repeatability and inter-examiner reproducibility in lens zonular length measurements using very high-frequency digital ultrasound (Insight 100). Two examiners performed ultrasound imaging independently in each subject. The length of temporal and nasal zonules were then measured with a built-in software. Coefficient of variations (CVs) of the three repeated measurements were used to determine intra-examiner variances. Inter-examiner reproducibility was evaluated using intraclass correlation coefficients (ICCs) and the Bland-Altman method. 40 eyes of 40 subjects (14male and 26female; mean age 23.9 ± 2.4 years) were included in the study. The CVs for intra-examiner measurement were 2.74% temporally and 4.32% nasally for Examiner 1, and were 1.96% temporally and 1.75% nasally for Examiner 2. For inter-examiner reproducibility, all ICCs were above 0.9. However, there were significant differences between the two examiners in temporal zonular length measurements ( p  = 0.001), and the differences mainly came from measuring the zonular length manually ( p  = 0.001) rather than recording images ( p  = 0.480). No significant differences were found between two measurements by the same examiner after one month (all  p  &gt; 0.05, all ICCs &gt; 0.8). The Insight 100 device can be used to measure the length of anterior lens zonule with relatively good repeatability and reproducibility. www.clinicaltrials.gov  identifier is NCT05657951

Repeatability and reproducibility of anterior lens zonule length measurement using ArcScan insight 100 very high-frequency ultrasound