Distribution characteristics and influencing factors of three-dimensional lens parameters in patients with age-related cataracts

Abstract Background To characterize the three-dimensional lens parameters in age-related cataract patients and examine their associations with age, sex, and ocular biometrics. Methods In this retrospective cohort study, we consecutively enrolled patients aged ≥ 40 years who underwent cataract surgery at the Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital) between January 2023 and December 2024. Three-dimensional lens parameters were acquired using swept-source anterior segment optical coherence tomography (SS-AS-OCT), including: anterior lens surface curvature radius (RAL), lens posterior surface curvature radius (RPL), lens thickness (LT), anterior lens thickness (LT a ), lens diameter (LD), and lens volume (LV). Correlations with age, sex, and ocular biometrics were analyzed. Results The study included 356 patients (140 males and 216 females) with a mean ± SD age of 66.48 ± 9.60 years. No significant sex-related differences were found in any lens parameters (all p > 0.05). RAL demonstrated a significant negative linear correlation with age ( r = -0.142, p = 0.007), decreasing at a rate of 0.019 mm/year. In contrast, LT, LT a , and LV showed positive linear correlations with age, increasing at rates of 0.013 mm/year, 0.007 mm/year, and 1.052 mm³/year, respectively (all p < 0.05). Age stratification showed LT increased faster in ≤ 60 years (0.022 mm/year vs. 0.010 mm/year). RAL was negatively correlated with LT and LT a , but positively with RPL and LD. RPL, LT, LT a , LD, and LV were positively intercorrelated. Ocular biometrics showed that RAL correlated positively with ACD, AL, and WTW but negatively with K m . RPL positively correlated only with AL. LT, LT a , LD, and LV exhibited negative correlations with ACD, while LD and LV positively correlated with AL (all p < 0.05). Conclusions In cataract patients aged ≥ 40 years, the anterior lens surface convexity, LT, and LV increased significantly with age, with more rapid progression rates before age 60 than thereafter. Multivariable analysis revealed that smaller ACD was associated with more pronounced anterior lens surface convexity and greater lens thickness. LT, LT a , and RAL showed nonlinear relationships with AL, where RAL was maximal and LT was thinnest at approximately 25 mm AL.