Crystalline lens geometry from a clinical OCT-based biometer in pre-cataract surgery patients

Abstract Understanding relationships between crystalline lens geometry, eye’s refractive error and aging will be insightful to inspire new intraocular lenses (IOLs) and improve selection methods of the IOLs implanted in refractive lens exchange and cataract surgery. In this study we evaluated the relationships between the full geometry of the crystalline lens and age, axial length (AL), and refractive error in patients scheduled for cataract surgery. Optical Coherence Tomography (IOLMaster700, Zeiss) combined with custom-developed full crystalline lens shape reconstruction algorithms were applied to image 327 eyes from 327 participants and quantify lens geometrical parameters, including thickness (LT), radii of curvature of the anterior and posterior lens surfaces (RAL, RPL), volume (LV), surface area (LSA), diameter (DIA) and equatorial plane position (EPP). Correlation and partial correlation analysis (controlling for age, AL, and refractive error) were performed. Multiple linear regression models evaluated whether age and AL predicted LT, DIA, LV and LSA. Age was significantly correlated with LT, LV, LSA, DIA, EPP, and these associations persisted after controlling for AL or refractive error. AL was correlated with RAL, RPL, DIA and refractive error, and with RAL, RPL, LV, LSA, DIA, and refractive error after adjusting for age. Overall, the lens expands axially and meridionally with age, increasing in thickness, diameter, volume and surface area, accompanied by a hyperopic shift. Longer eyes exhibited lenses with larger diameters and flatter anterior and posterior surfaces, partially offsetting myopia. These findings suggest that age- and growth-related lens remodeling contributes to refractive shifts.