PurposeTo determine the keratometric indices calculated based on parameters obtained by Fourier-domain optical coherence tomography (FD-OCT).MethodsThe ratio of anterior corneal curvature to posterior corneal curvature (Ratio) and keratometric index (N) were calculated within central 3 mm zone with the RTVue FD-OCT (RTVue, Optovue, Inc.) in 186 untreated eyes, 60 post-LASIK/PRK eyes, and 39 keratoconus eyes. The total corneal powers were calculated using different keratometric indices: Kcal based on the mean calculated keratometric index, K1.3315 calculated by the keratometric index of 1.3315, and K1.3375 calculated by the keratometric index of 1.3375. In addition, the total corneal powers based on Gaussian optics formula (Kactual) were calculated.ResultsThe means for Ratio in untreated controls, post-LASIK/PRK group and keratoconus group were 1.176 ± 0.022 (95% confidence interval (CI), 1.172–1.179), 1.314 ± 0.042 (95%CI, 1.303–1.325) and 1.229 ± 0.118 (95%CI, 1.191–1.267), respectively. And the mean calculated keratometric index in untreated controls, post-LASIK/PRK group and keratoconus group were 1.3299 ± 0.00085 (95%CI, 1.3272–1.3308), 1.3242 ± 0.00171 (95%CI, 1.3238–1.3246) and 1.3277 ± 0.0046 (95%CI, 1.3263–1.3292), respectively. All the parameters were normally distributed. The differences between Kcal and Kactual, K1.3315 and Kactual, and K1.3375 and Kactual were 0.00 ± 0.11 D, 0.21 ± 0.11 D and 0.99 ± 0.12 D, respectively, in untreated controls; -0.01 ± 0.20 D, 0.85 ± 0.18 D and 1.56 ± 0.16 D, respectively, in post-LASIK/PRK group; and 0.03 ± 0.67 D, 0.56 ± 0.70 D and 1.40 ± 0.76 D, respectively, in keratoconus group.ConclusionThe calculated keratometric index is negatively related to the ratio of anterior corneal curvature to posterior corneal curvature in untreated, post-LASIK/PRK, and keratoconus eyes, respectively. Using the calculated keratometric index may improve the prediction accuracies of total corneal powers in untreated controls, but not in post-LASIK/PRK and keratoconus eyes.