Abstract
Purpose :
Determining the structural changes of the human crystalline lens with age and refraction is important in the management of cataracts. We performed a retrospective analysis of anterior segment Optical Coherence Tomography (OCT) images to assess the relationship between crystalline lens geometry, age, and preoperative refraction.
Methods :
Preoperative OCT images from the IOLMaster700 (Zeiss, swept source-OCT, six radial images per measurement) were obtained in 41 eyes from 21 subjects undergoing cataract surgery at a single institution. Surface segmentation and distortion correction with custom-developed algorithms were performed to obtain preoperative 3-D models of the eye and the following parameters: radius of curvature of the anterior lens surface (RAL), radius of curvature of the posterior lens surface (RPL), lens thickness (LT), and pupil diameter. A manifest refraction in spherical equivalent (SE) was obtained preoperatively. Eyes were separated into three age groups (ages≤65 years (n=18), >65 to ≤72 years (n=12), and >72 years (n=11)) and three preoperative refraction groups (SE≤-3 (n=17), -3 to 0 (n=15), and >0 (n=9)). Pearson correlation coefficient and two-way ANOVA were performed to analyze crystalline lens geometry as a function of preoperative refraction and age.
Results :
LT negatively correlated with refraction between ages 65 and 72 (Rho=-0.76, p=0.004), increased with age in the refraction group with SE≤-3 (Rho=0.75, p=0.001), positively correlated with age across all ages combined (Rho=0.53, p<0.05), and negatively correlated with pupil size (Rho=-0.52, p<0.05). RAL decreased with age in refraction groups with SE≤-3 and -3 to 0 (Rho=-0.61, p = 0.008; Rho=-0.69, p=0.004, respectively). RPL decreased with age overall (Rho=-0.46, p<0.05), negatively correlated with refraction across all ages (Rho=-0.34, p<0.05), and positively correlated with pupil size (Rho=0.68, p<0.05). Two-way ANOVA showed RAL depends on age while RPL does not (F(2,4)=4.25, p=0.023) and F(2,4)=3.09, p=0.059, respectively).
Conclusions :
The crystalline lens thickness increased with age while the anterior and posterior lens surfaces steepened. Posterior lens surface flattening was observed with increasing myopia. A deeper understanding of crystalline lens geometry in a presbyopic/cataract population and the interactions of age and refraction are critical in IOL selection, sizing, and customization of IOLs.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.