Advertisement

Distribution of Axial Length and Ocular Biometry Measured Using Partial Coherence Laser Interferometry (IOL Master) in an Older White Population

Published:December 24, 2009DOI:https://doi.org/10.1016/j.ophtha.2009.07.028

      Purpose

      We aimed to describe norms for the distribution of axial length (AL) and other ocular biometric parameters in an older Caucasian population, measured using partial coherence laser interferometry (Zeiss IOL Master; Carl Zeiss AG, Oberkochen, Germany), a technique now routinely used in measuring AL before cataract surgery. We also aimed to assess age and gender relationships with these parameters and their correlations with spherical equivalent refraction (SER).

      Design

      Cross-sectional analysis of the Blue Mountains Eye Study (BMES) cohort at the examinations (10-year follow-up examination).

      Participants

      From 2002 to 2004, 1952 persons (76% of surviving baseline BMES participants) aged 59 years or older had ocular biometry measured at the 10-year examinations.

      Methods

      Spherical equivalent refraction was calculated as the sum of sphere +0.5 cylinder power, after protocol refraction. Measurements of AL, corneal curvature (K1), anterior chamber depth (ACD), and corneal diameter (WTW) were performed using the IOL Master. Only right phakic eyes (n = 1335) with biometry data were included.

      Main Outcome Measures

      Axial length distribution.

      Results

      Mean AL was 23.44 mm (95% confidence interval [CI], 23.38–23.50) and was greater in men, 23.76 mm (CI, 23.68–23.84), than in women, 23.19 mm (CI, 23.11–23.27). The mean K1, ACD, and WTW were 43.42 diopters (D), 3.10 mm, and 12.06 mm, respectively. The AL and ACD distributions were both positively skewed and peaked, whereas the WTW and K1 distributions were near normal. From age 59 years or older, a mean reduction in AL with age was observed (P for trend = 0.005), 0.12 mm per decade (P = 0.0176) in women but only 0.02 mm per decade (P = 0.6319) in men. Mean SER was 0.58 D, and the distribution was peaked with a negative skew. The SER was negatively correlated with both AL (beta coefficient –0.688) and ACD (beta coefficient −0.222), but not with K1 or WTW.

      Conclusions

      These data provide normative values in the older general population for AL measured using the IOL Master. Axial length distribution was peaked and skewed, suggesting an active modulation process.

      Financial Disclosure(s)

      The authors have no proprietary or commercial interest in any materials discussed in this article.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Ophthalmology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bhatt A.B.
        • Schefler A.C.
        • Feuer W.J.
        • et al.
        Comparison of predictions made by the Intraocular Lens Master and ultrasound biometry.
        Arch Ophthalmol. 2008; 126: 929-933
        • Wong T.Y.
        • Foster P.J.
        • Ng T.P.
        • et al.
        Variations in ocular biometry in an adult Chinese population in Singapore: the Tanjong Pagar Survey.
        Invest Ophthalmol Vis Sci. 2001; 42: 73-80
        • Francois J.
        • Goes F.
        Ultrasonographic study of 100 emmetropic eyes.
        Ophthalmologica. 1977; 175: 321-327
        • Villarreal M.G.
        • Ohlsson J.
        • Abrahamsson M.
        • et al.
        Myopisation: the refractive tendency in teenagers.
        Acta Ophthalmol Scand. 2000; 78: 177-181
        • Haigis W.
        • Lege B.
        • Miller N.
        • Schneider B.
        Comparison of immersion ultrasound biometry and partial coherence interferometry for intraocular lens calculation according to Haigis.
        Graefes Arch Clin Exp Ophthalmol. 2000; 238: 765-773
        • Kiss B.
        • Findl O.
        • Menapace R.
        • et al.
        Biometry of cataractous eyes using partial coherence interferometry: clinical feasibility study of a commercial prototype I.
        J Cataract Refract Surg. 2002; 28: 224-229
        • Kiss B.
        • Findl O.
        • Menapace R.
        • et al.
        Refractive outcome of cataract surgery using partial coherence interferometry and ultrasound biometry: clinical feasibility study of a commercial prototype II.
        J Cataract Refract Surg. 2002; 28: 230-234
        • Packer M.
        • Fine I.H.
        • Hoffman R.S.
        • et al.
        Immersion A-scan compared with partial coherence interferometry: outcomes analysis.
        J Cataract Refract Surg. 2002; 28: 239-242
        • Eleftheriadis H.
        IOLMaster biometry: refractive results of 100 consecutive cases.
        Br J Ophthalmol. 2003; 87: 960-963
        • Connors III, R.
        • Boseman III, P.
        • Olson R.J.
        Accuracy and reproducibility of biometry using partial coherence interferometry.
        J Cataract Refract Surg. 2002; 28: 235-238
        • Tron E.
        Uber die optischen Grundlagen der Ametropie.
        Albrecht Von Graefes Arch Ophthalmol. 1934; 132: 182-223
        • Benjamin B.
        • Davey J.B.
        • Sheridan M.
        • et al.
        Emmetropia and its aberrations: a study in the correlation of the optical components of the eye.
        Spec Rep Ser Med Res Counc (G B). 1957; 11: 1-69
        • Brown N.P.
        • Koretz J.F.
        • Bron A.J.
        The development and maintenance of emmetropia.
        Eye. 1999; 13: 83-92
        • Lyhne N.
        • Sjolie A.K.
        • Kyvik K.O.
        • Green A.
        The importance of genes and environment for ocular refraction and its determiners: a population based study among 20-45 year old twins.
        Br J Ophthalmol. 2001; 85: 1470-1476
        • Attebo K.
        • Ivers R.Q.
        • Mitchell P.
        Refractive errors in an older population: the Blue Mountains Eye Study.
        Ophthalmology. 1999; 106: 1066-1072
        • Attebo K.
        • Mitchell P.
        • Smith W.
        Visual acuity and the causes of visual loss in Australia: the Blue Mountains Eye Study.
        Ophthalmology. 1996; 103: 357-364
        • Hill W.E.
        The IOLMaster.
        Tech Ophthalmol. 2003; 1: 62-67
        • Olsen T.
        Sources of error in intraocular lens power calculation.
        J Cataract Refract Surg. 1992; 18: 125-129
        • Holladay J.T.
        • Prager T.C.
        • Ruiz R.S.
        • et al.
        Improving the predictability of intraocular lens power calculations.
        Arch Ophthalmol. 1986; 104: 539-541
        • Deller J.F.
        • O'Connor A.D.
        • Sorsby A.
        X-ray measurement of the diameters of the living eye.
        Proc R Soc Lond B Biol Sci. 1947; 134: 456-467
        • Saw S.M.
        • Carkeet A.
        • Chia K.S.
        • et al.
        Component dependent risk factors for ocular parameters in Singapore Chinese children.
        Ophthalmology. 2002; 109: 2065-2071
        • Larsen J.S.
        The sagittal growth of the eye.
        Acta Ophthalmol (Copenh). 1971; 49: 873-886
        • Reddy A.R.
        • Pande M.V.
        • Finn P.
        • El-Gogary H.
        Comparative estimation of anterior chamber depth by ultrasonography, Orbscan II, and IOLMaster.
        J Cataract Refract Surg. 2004; 30: 1268-1271
        • Rose L.T.
        • Moshegov C.N.
        Comparison of the Zeiss IOLMaster and applanation A-scan ultrasound: biometry for intraocular lens calculation.
        Clin Experiment Ophthalmol. 2003; 31: 121-124
        • Vogel A.
        • Dick H.B.
        • Krummenauer F.
        Reproducibility of optical biometry using partial coherence interferometry: intraobserver and interobserver reliability.
        J Cataract Refract Surg. 2001; 27: 1961-1968
        • Lam A.K.
        • Chan R.
        • Pang P.C.
        The repeatability and accuracy of axial length and anterior chamber depth measurements from the IOLMaster.
        Ophthalmic Physiol Opt. 2001; 21: 477-483
        • Olsen T.
        • Arnarsson A.
        • Sasaki H.
        • et al.
        On the ocular refractive components: the Reykjavik Eye Study.
        Acta Ophthalmol Scand. 2007; 85: 361-366
        • Stenstrom S.
        Investigation of the variation and the correlation of the optical elements of human eyes.
        Am J Optom Arch Am Acad Optom. 1948; 25 (passim): 218
        • Ojaimi E.
        • Rose K.A.
        • Morgan I.G.
        • et al.
        Distribution of ocular biometric parameters and refraction in a population-based study of Australian children.
        Invest Ophthalmol Vis Sci. 2005; 46: 2748-2754
        • Fotedar R.
        • Mitchell P.
        • Burlutsky G.
        • Wang J.J.
        Relationship of 10-year change in refraction to nuclear cataract and axial length findings from an older population.
        Ophthalmology. 2008; 115: 1273-1278
        • Eysteinsson T.
        • Jonasson F.
        • Arnarsson A.
        • et al.
        Relationships between ocular dimensions and adult stature among participants in the Reykjavik Eye Study.
        Acta Ophthalmol Scand. 2005; 83: 734-738
        • Shufelt C.
        • Fraser-Bell S.
        • Ying-Lai M.
        • et al.
        • Los Angeles Latino Eye Study Group
        Refractive error, ocular biometry, and lens opalescence in an adult population: the Los Angeles Latino Eye Study.
        Invest Ophthalmol Vis Sci. 2005; 46: 4450-4460
        • Carney L.G.
        • Mainstone J.C.
        • Henderson B.A.
        Corneal topography and myopia: a cross-sectional study.
        Invest Ophthalmol Vis Sci. 1997; 38: 311-320
        • Garner L.F.
        • Meng C.K.
        • Grosvenor T.P.
        • Mohidin N.
        Ocular dimensions and refractive power in Malay and Melanesian children.
        Ophthalmic Physiol Opt. 1990; 10: 234-238
        • Goss D.A.
        • Cox V.D.
        • Herrin-Lawson G.A.
        • et al.
        Refractive error, axial length, and height as a function of age in young myopes.
        Optom Vis Sci. 1990; 67: 332-338
        • Grosvenor T.
        • Scott R.
        Role of the axial length/corneal radius ratio in determining the refractive state of the eye.
        Optom Vis Sci. 1994; 71: 573-579
        • Goh W.S.
        • Lam C.S.
        Changes in refractive trends and optical components of Hong Kong Chinese aged 19–39 years.
        Ophthalmic Physiol Opt. 1994; 14: 378-382
        • Strang N.C.
        • Schmid K.L.
        • Carney L.G.
        Hyperopia is predominantly axial in nature.
        Curr Eye Res. 1998; 17: 380-383
        • Fledelius H.C.
        Corneal curvature radius: oculometric considerations with reference to age and refractive change.
        Acta Ophthalmol Suppl. 1988; 185: 74-77
        • Lam C.S.
        • Goh W.S.
        • Tang Y.K.
        • et al.
        Changes in refractive trends and optical components of Hong Kong Chinese aged over 40 years.
        Ophthalmic Physiol Opt. 1994; 14: 383-388
        • Cook N.R.
        • Rosner B.A.
        Screening rules for determining blood pressure status in clinical trials: application to the trials of hypertension prevention.
        Am J Epidemiol. 1993; 137: 1341-1352
        • Wickremasinghe S.
        • Foster P.J.
        • Uranchimeg D.
        • et al.
        Ocular biometry and refraction in Mongolian adults.
        Invest Ophthalmol Vis Sci. 2004; 45: 776-783