Axial Length, Myopia, and the Severity of Lens Opacity at the Time of Cataract Surgery

Abstract

To investigate the relationship between axial length, myopia of the eye, and the severity of lens opacity at the time of cataract surgery. Methods: We retrospectively reviewed a consecutive series of 198 eyes of patients aged older than 50 years at Fukui University Hospital (Fukui, Japan) from June 2004 to December 2005. Patient age at the time of surgery, axial length, spherical equivalent, and the subtypes and severity of cataract (as classified according to the modification of the Lens Opacities Classification System, version III) were recorded. Results: Axial length was significantly associated with age at the time of cataract surgery (PϽ.001). Regarding the severity of nuclear cataract, a significant correlation was seen between a higher score of nuclear cataract and longer axial length (PϽ.001). The relationship between the severity of nuclear cataract and spherical equivalent at the time of surgery showed a significant association between grading nuclear color and nuclear opalescence 4-6 and higher myopia (PϽ.001). Conclusion: An increase in axial length or myopia of the eye was associated with a lower mean age at the time of surgery and higher grade of nuclear cataract.

Variability of axial length, anterior chamber depth, and lens thickness in the cataractous eye

“…1993, Hoffer 1,9 statistically proved that cataracts requiring surgery occur earlier in eyes with longer ALs. This was also noted by Kubo et al 10 In another study of cataractous eyes with high axial myopia (AL over 25.0 mm), Tsang et al 11 found that 46.6% of patients were younger than 65 years (versus 12.0% in our study). Shammas and Milkie 12 report 7 patients with unsuspected unilateral axial myopia who developed cataract in the longer eye.…”

The Royal College of Ophthalmologists’ National Ophthalmology Database Study of cataract surgery: report 2, relationships of axial length with ocular copathology, preoperative visual acuity, and posterior capsule rupture

“…30 Certainly, as seen in Figure 1c, there is no apparent increase in PCR rates as axial length increases above 26.0 mm as would be expected based on previous studies, however consultant surgeons did perform more cases at the extremes of axial length and in the first NOD cataract analysis we found intraoperative complication rates to be lower for consultant surgeons than other surgeon grades. 10 Interestingly, increasing axial length has also been associated with more advanced levels of nuclear cataract and lower age at time of cataract surgery, 31 however we found no association between axial length and age at cataract surgery in this series. Eyes with brunescent/ white cataract were more common at both axial length extremes, suggesting that surgeons were presumably more reluctant to operate on these cases until there was more advanced cataract, perhaps due to expected poorer visual outcomes as a result of higher ocular co-pathology rates or anticipated higher PCR rates in eyes at axial length extremes.…”

Age-related cataracts and Prdx6: correlation between severity of lens opacity, age and the level of Prdx 6 expression

“…Prevalence of nuclear and cortical cataracts increased significantly with age among patients in our present study, as in our previous study 22. The decreased level of Prdx6 that comes with ageing may increase oxidative stress in the lens, thus promoting the formation of cortical or nuclear cataracts, especially in patients under 70 years.…”