Comment on - The effect of age on lens parameters and axial length among wide age range of Saudis: A prospective, cross-sectional study

Dear Editor, We read an interesting article in the April–June 2024 issue of Saudi Journal of Ophthalmology on the effect of age on lens parameters and axial length in Saudi population. It was a well-conducted study, and the authors should be congratulated for their effort to establish the normative value for these parameters. However, the following points should be taken into consideration before using the published results in clinical practice: The measurement of these parameters has vital clinical implications in cataract surgery, as mentioned in the introduction section. However, out of 125 participants, only 14 were above 40 years of age and just 6 were above 50 years old – the age when senile cataract develops “The correlation coefficient of r = −0.216 indicates a weak negative of association. In other words, as age increases by 1 year, the average LT measurement decreases by 0.216 mm. The correlation coefficient of r = −0.291 indicates a moderate negative of association. In other words, as age increases by 1 year, the average LD measurement decreases by 0.291 mm.” The interpretation of Pearson’s correlation coefficients needs re-evaluation. Does this negative correlation indicate a corresponding change in magnitude of LT and LD? The authors have reported decrease in lens thickness (LT) and lens density (LD) with age. Another study published from the same geographical region has reported a significant positive correlation between LD and age, for a group of 370 individuals between 20 and 65 years of age, with equal age distribution across all age groups.[1] They reported a variable density change in the nuclear and cortical region of lens with age. A similar nonlinear change in LD and LT with age has been documented in other studies also.[2,3] We believe that this negative correlation of LD and LT with age in this article may be attributed to uneven distribution of study participants in different age groups. LT is a significant variable in the calculation of effective lens position and final visual outcome of cataract surgery.[4] As developing a normative database is a significant scientific contribution, a larger population-based study encompassing individuals of all age groups in equal distribution can provide clearer evidence. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.