Ocular biometry parameters in mobile cataract surgery camp: a large-scale report from Nigeria
Medical hypothesis, discovery & innovation in optometry,
Vol. 5 No. 2 (2024),
1 September 2024
,
Page 51-56
https://doi.org/10.51329/mehdioptometry197
Abstract
Background: Humanitarian missions and mobile camp surgeries have pivotal roles in the uptake of cataract surgery in areas with limited resources. Ocular biometry is an important preoperative evaluation tool for cataract surgery candidates. Herein, we report the distributions of ocular biometric values among cataract surgery candidates in camp settings in southern Nigeria.Methods: In this cross-sectional study, we retrieved data from consecutive patients scheduled for cataract surgery. All patients underwent a full ophthalmic examination using a slit-lamp biomicroscope. Age, sex, and preoperative biometric values, including anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD), and axial length (AL), together with intraocular lens (IOL) power, were documented. Biometric values were obtained using A-mode ultrasonography.
Results: Records of 567 patients with a mean (standard deviation) age of 66.0 (13.4) years revealed a male-to-female sex ratio of 1:1.24. Most participants were in the 66–70-year age group. Mean IOL power was significantly different between males and females (P < 0.001). However, the biometric values were comparable between sexes (all P > 0.05). There were significant differences in the mean IOL power (P < 0.001) and ACD (P < 0.05) between the age groups, indicating a decrease in ACD with age. However, the other biometric parameters were comparable between the age groups (all P > 0.05). ACD had a significant weak negative correlation with LT (r = - 0.16; P < 0.001) and IOL power (r = - 0.22; P < 0.001) and a positive correlation with AL (r = + 0.24; P < 0.001). LT had a significant weak negative correlation with VCD (r = - 0.16; P < 0.001) and a positive correlation with AL (r = + 0.09; P < 0.05). VCD had significant moderate positive and negative correlations with AL (r = + 0.39; P < 0.001) and IOL power (r = - 0.34; P < 0.001), respectively. AL had a significant strong negative correlation with IOL power (r = - 0.78; P < 0.001).
Conclusions: This study presents the mean distributions of ocular biometric parameters among cataract surgery candidates in camp settings in southern Nigeria. Age and sex were important determinants of IOL power and should be considered when planning eye camp supplies. AL had a strong inverse correlation with IOL power. Further multicenter national studies are required to verify these preliminary findings.
Keywords:
- ocular biometry
- cataract
- axial length
- anterior chamber depth
- keratometry
- lens thickness
- age group
- resource-limited setting
References
1. Cataracts in adults: management. London: National Institute for Health and Care Excellence (NICE); 2017 Oct. PMID: 29106797.
2. Gupta V, Pal H, Sawhney S, Aggarwal A, Vanathi M, Luthra G. Optimization of biometry for best refractive outcome in cataract surgery. Indian J Ophthalmol. 2024 Jan 1;72(1):29-43. doi: 10.4103/IJO.IJO_1219_23. Epub 2023 Dec 22. PMID: 38131567; PMCID: PMC10841781.
3. Song AL, Rizzuti A. Optical Biometry. 2023 Apr 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 35593856.
4. Khorrami-Nejad M, Moradi R, Akbarzadeh Baghban A, Khosravi B. Effect of axial length and anterior chamber depth on the peripheral refraction profile. Int J Ophthalmol. 2021 Feb 18;14(2):292-298. doi: 10.18240/ijo.2021.02.17. PMID: 33614460; PMCID: PMC7840374.
5. Bian L, Li W, Qin R, Sun Z, Zhao L, Zhou Y, Liu D, Liu Y, Sun T, Qi H. Ocular Biometry Features and Their Relationship with Anterior and Posterior Segment Lengths among a Myopia Population in Northern China. J Clin Med. 2024 Feb 9;13(4):1001. doi: 10.3390/jcm13041001. PMID: 38398313; PMCID: PMC10888956.
6. Lee KE, Klein BE, Klein R, Quandt Z, Wong TY. Association of age, stature, and education with ocular dimensions in an older white population. Arch Ophthalmol. 2009 Jan;127(1):88-93. doi: 10.1001/archophthalmol.2008.521. PMID: 19139346; PMCID: PMC2725427.
7. Lam BC, Weiss M, Jing F, Zhu C, Johnson DA, Kheirkhah A. Comparison of Ocular Biometric Parameters Between Hispanic and Non-Hispanic Ethnicities in White Adults Undergoing Cataract Surgery. Eye Contact Lens. 2022 Sep 1;48(9):391-395. doi: 10.1097/ICL.0000000000000907. Epub 2022 Jul 8. PMID: 36002944.
8. Cao X, Hou X, Bao Y. The Ocular Biometry of Adult Cataract Patients on Lifeline Express Hospital Eye-Train in Rural China. J Ophthalmol. 2015;2015:171564. doi: 10.1155/2015/171564. Epub 2015 Oct 5. PMID: 26509076; PMCID: PMC4609820.
9. Richdale K, Bullimore MA, Zadnik K. Lens thickness with age and accommodation by optical coherence tomography. Ophthalmic Physiol Opt. 2008 Sep;28(5):441-7. doi: 10.1111/j.1475-1313.2008.00594.x. PMID: 18761481; PMCID: PMC2857534.
10. Roters S, Hellmich M, Szurman P. Prediction of axial length on the basis of vitreous body length and lens thickness: retrospective echobiometric study. J Cataract Refract Surg. 2002 May;28(5):853-9. doi: 10.1016/s0886-3350(01)01169-5. PMID: 11978468.
11. Wong TY, Foster PJ, Ng TP, Tielsch JM, Johnson GJ, Seah SK. Variations in ocular biometry in an adult Chinese population in Singapore: the Tanjong Pagar Survey. Invest Ophthalmol Vis Sci. 2001 Jan;42(1):73-80. PMID: 11133850.
12. Augusteyn RC, Nankivil D, Mohamed A, Maceo B, Pierre F, Parel JM. Human ocular biometry. Exp Eye Res. 2012 Sep;102:70-5. doi: 10.1016/j.exer.2012.06.009. Epub 2012 Jul 20. PMID: 22819768; PMCID: PMC3432692.
13. Eysteinsson T, Jonasson F, Arnarsson A, Sasaki H, Sasaki K. Relationships between ocular dimensions and adult stature among participants in the Reykjavik Eye Study. Acta Ophthalmol Scand. 2005 Dec;83(6):734-8. doi: 10.1111/j.1600-0420.2005.00540.x. PMID: 16396653.
14. Shufelt C, Fraser-Bell S, Ying-Lai M, Torres M, Varma R; 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 Dec;46(12):4450-60. doi: 10.1167/iovs.05-0435. PMID: 16303933.
15. Foster PJ, Broadway DC, Hayat S, Luben R, Dalzell N, Bingham S, Wareham NJ, Khaw KT. Refractive error, axial length and anterior chamber depth of the eye in British adults: the EPIC-Norfolk Eye Study. Br J Ophthalmol. 2010 Jul;94(7):827-30. doi: 10.1136/bjo.2009.163899. PMID: 20606021.
16. Ojaimi E, Rose KA, Morgan IG, Smith W, Martin FJ, Kifley A, Robaei D, Mitchell P. Distribution of ocular biometric parameters and refraction in a population-based study of Australian children. Invest Ophthalmol Vis Sci. 2005 Aug;46(8):2748-54. doi: 10.1167/iovs.04-1324. PMID: 16043846.
17. Urbinati F, Jiménez-Siles L, Rocha-de-Lossada C, Valvecchia G, Barraquer-Compte E, Fernández J. Humanitarian missions and visual outcomes in cataract surgery: A literature review. Arch Soc Esp Oftalmol (Engl Ed). 2024 Jul;99(7):288-295. doi: 10.1016/j.oftale.2024.01.008. Epub 2024 Feb 1. PMID: 38309656.
18. Jivrajka R, Shammas MC, Boenzi T, Swearingen M, Shammas HJ. Variability of axial length, anterior chamber depth, and lens thickness in the cataractous eye. J Cataract Refract Surg. 2008 Feb;34(2):289-94. doi: 10.1016/j.jcrs.2007.10.015. PMID: 18242456.
19. Wu HM, Gupta A, Newland HS, Selva D, Aung T, Casson RJ. Association between stature, ocular biometry and refraction in an adult population in rural Myanmar: the Meiktila eye study. Clin Exp Ophthalmol. 2007 Dec;35(9):834-9. doi: 10.1111/j.1442-9071.2007.01638.x. PMID: 18173412.
20. Hashemi H, Khabazkhoob M, Miraftab M, Emamian MH, Shariati M, Abdolahinia T, Fotouhi A. The distribution of axial length, anterior chamber depth, lens thickness, and vitreous chamber depth in an adult population of Shahroud, Iran. BMC Ophthalmol. 2012 Sep 18;12:50. doi: 10.1186/1471-2415-12-50. PMID: 22988958; PMCID: PMC3500253.
21. Adio AO, Onua DO, Arowolo D. Ocular axial length and keratometry readings of normal eyes in Southern Nigeria. Nigerian Journal of Ophthalmology. 2010;18(1): 12-14. doi: 10.4314/njo.v18i1.61367.
22. Jagun OA, Onabolu OO, Ajibode HA. Normative Ocular Biometric Dimensions and its Variation in a Nigerian Population. West Afr J Med. 2015 Jul-Sep;34(3):162-166. PMID: 28276040.
23. Chinawa EN, Ezeh EI. The distribution of ocular biometrics among patients undergoing cataract surgery. Nigerian Journal of Ophthalmology. 2018;26(1): 40-45.doi: 10.4103/njo.njo_7_18
24. Atchison DA, Markwell EL, Kasthurirangan S, Pope JM, Smith G, Swann PG. Age-related changes in optical and biometric characteristics of emmetropic eyes. J Vis. 2008 Apr 28;8(4):29.1-20. doi: 10.1167/8.4.29. PMID: 18484868.
25. Ibeneche HO, Ekpenyong BN, Ebri A. Barriers to accessing eye care services in the Federal Capital Territory, Abuja, Nigeria. Journal of the Nigerian Optometric Association. 2018;20(1):64-9. Link
26. Doyal L, Das-Bhaumik RG. Sex, gender and blindness: a new framework for equity. BMJ Open Ophthalmol. 2018 Sep 1;3(1):e000135. doi: 10.1136/bmjophth-2017-000135. PMID: 30246151; PMCID: PMC6146307.
27. Ramke J, Kyari F, Mwangi N, Piyasena M, Murthy G, Gilbert CE. Cataract Services are Leaving Widows Behind: Examples from National Cross-Sectional Surveys in Nigeria and Sri Lanka. Int J Environ Res Public Health. 2019 Oct 12;16(20):3854. doi: 10.3390/ijerph16203854. PMID: 31614715; PMCID: PMC6843674.
28. Knox Cartwright NE, Johnston RL, Jaycock PD, Tole DM, Sparrow JM. The Cataract National Dataset electronic multicentre audit of 55,567 operations: when should IOLMaster biometric measurements be rechecked? Eye (Lond). 2010 May;24(5):894-900. doi: 10.1038/eye.2009.196. Epub 2009 Aug 14. PMID: 19680278.
29. Badmus SA, Ajaiyeoba AI, Adegbehingbe BO, Onakpoya OH, Adeoye AO. Associations between ocular biometry and anthropometric measurements in a Nigerian population. Niger Postgrad Med J. 2016 Jul-Sep;23(3):127-31. doi: 10.4103/1117-1936.190341. PMID: 27623723.
30. Fotedar R, Mitchell P, Burlutsky G, Wang JJ. Relationship of 10-year change in refraction to nuclear cataract and axial length findings from an older population. Ophthalmology. 2008 Aug;115(8):1273-8, 1278.e1. doi: 10.1016/j.ophtha.2007.11.003. Epub 2008 Jan 25. PMID: 18222002.
2. Gupta V, Pal H, Sawhney S, Aggarwal A, Vanathi M, Luthra G. Optimization of biometry for best refractive outcome in cataract surgery. Indian J Ophthalmol. 2024 Jan 1;72(1):29-43. doi: 10.4103/IJO.IJO_1219_23. Epub 2023 Dec 22. PMID: 38131567; PMCID: PMC10841781.
3. Song AL, Rizzuti A. Optical Biometry. 2023 Apr 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 35593856.
4. Khorrami-Nejad M, Moradi R, Akbarzadeh Baghban A, Khosravi B. Effect of axial length and anterior chamber depth on the peripheral refraction profile. Int J Ophthalmol. 2021 Feb 18;14(2):292-298. doi: 10.18240/ijo.2021.02.17. PMID: 33614460; PMCID: PMC7840374.
5. Bian L, Li W, Qin R, Sun Z, Zhao L, Zhou Y, Liu D, Liu Y, Sun T, Qi H. Ocular Biometry Features and Their Relationship with Anterior and Posterior Segment Lengths among a Myopia Population in Northern China. J Clin Med. 2024 Feb 9;13(4):1001. doi: 10.3390/jcm13041001. PMID: 38398313; PMCID: PMC10888956.
6. Lee KE, Klein BE, Klein R, Quandt Z, Wong TY. Association of age, stature, and education with ocular dimensions in an older white population. Arch Ophthalmol. 2009 Jan;127(1):88-93. doi: 10.1001/archophthalmol.2008.521. PMID: 19139346; PMCID: PMC2725427.
7. Lam BC, Weiss M, Jing F, Zhu C, Johnson DA, Kheirkhah A. Comparison of Ocular Biometric Parameters Between Hispanic and Non-Hispanic Ethnicities in White Adults Undergoing Cataract Surgery. Eye Contact Lens. 2022 Sep 1;48(9):391-395. doi: 10.1097/ICL.0000000000000907. Epub 2022 Jul 8. PMID: 36002944.
8. Cao X, Hou X, Bao Y. The Ocular Biometry of Adult Cataract Patients on Lifeline Express Hospital Eye-Train in Rural China. J Ophthalmol. 2015;2015:171564. doi: 10.1155/2015/171564. Epub 2015 Oct 5. PMID: 26509076; PMCID: PMC4609820.
9. Richdale K, Bullimore MA, Zadnik K. Lens thickness with age and accommodation by optical coherence tomography. Ophthalmic Physiol Opt. 2008 Sep;28(5):441-7. doi: 10.1111/j.1475-1313.2008.00594.x. PMID: 18761481; PMCID: PMC2857534.
10. Roters S, Hellmich M, Szurman P. Prediction of axial length on the basis of vitreous body length and lens thickness: retrospective echobiometric study. J Cataract Refract Surg. 2002 May;28(5):853-9. doi: 10.1016/s0886-3350(01)01169-5. PMID: 11978468.
11. Wong TY, Foster PJ, Ng TP, Tielsch JM, Johnson GJ, Seah SK. Variations in ocular biometry in an adult Chinese population in Singapore: the Tanjong Pagar Survey. Invest Ophthalmol Vis Sci. 2001 Jan;42(1):73-80. PMID: 11133850.
12. Augusteyn RC, Nankivil D, Mohamed A, Maceo B, Pierre F, Parel JM. Human ocular biometry. Exp Eye Res. 2012 Sep;102:70-5. doi: 10.1016/j.exer.2012.06.009. Epub 2012 Jul 20. PMID: 22819768; PMCID: PMC3432692.
13. Eysteinsson T, Jonasson F, Arnarsson A, Sasaki H, Sasaki K. Relationships between ocular dimensions and adult stature among participants in the Reykjavik Eye Study. Acta Ophthalmol Scand. 2005 Dec;83(6):734-8. doi: 10.1111/j.1600-0420.2005.00540.x. PMID: 16396653.
14. Shufelt C, Fraser-Bell S, Ying-Lai M, Torres M, Varma R; 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 Dec;46(12):4450-60. doi: 10.1167/iovs.05-0435. PMID: 16303933.
15. Foster PJ, Broadway DC, Hayat S, Luben R, Dalzell N, Bingham S, Wareham NJ, Khaw KT. Refractive error, axial length and anterior chamber depth of the eye in British adults: the EPIC-Norfolk Eye Study. Br J Ophthalmol. 2010 Jul;94(7):827-30. doi: 10.1136/bjo.2009.163899. PMID: 20606021.
16. Ojaimi E, Rose KA, Morgan IG, Smith W, Martin FJ, Kifley A, Robaei D, Mitchell P. Distribution of ocular biometric parameters and refraction in a population-based study of Australian children. Invest Ophthalmol Vis Sci. 2005 Aug;46(8):2748-54. doi: 10.1167/iovs.04-1324. PMID: 16043846.
17. Urbinati F, Jiménez-Siles L, Rocha-de-Lossada C, Valvecchia G, Barraquer-Compte E, Fernández J. Humanitarian missions and visual outcomes in cataract surgery: A literature review. Arch Soc Esp Oftalmol (Engl Ed). 2024 Jul;99(7):288-295. doi: 10.1016/j.oftale.2024.01.008. Epub 2024 Feb 1. PMID: 38309656.
18. Jivrajka R, Shammas MC, Boenzi T, Swearingen M, Shammas HJ. Variability of axial length, anterior chamber depth, and lens thickness in the cataractous eye. J Cataract Refract Surg. 2008 Feb;34(2):289-94. doi: 10.1016/j.jcrs.2007.10.015. PMID: 18242456.
19. Wu HM, Gupta A, Newland HS, Selva D, Aung T, Casson RJ. Association between stature, ocular biometry and refraction in an adult population in rural Myanmar: the Meiktila eye study. Clin Exp Ophthalmol. 2007 Dec;35(9):834-9. doi: 10.1111/j.1442-9071.2007.01638.x. PMID: 18173412.
20. Hashemi H, Khabazkhoob M, Miraftab M, Emamian MH, Shariati M, Abdolahinia T, Fotouhi A. The distribution of axial length, anterior chamber depth, lens thickness, and vitreous chamber depth in an adult population of Shahroud, Iran. BMC Ophthalmol. 2012 Sep 18;12:50. doi: 10.1186/1471-2415-12-50. PMID: 22988958; PMCID: PMC3500253.
21. Adio AO, Onua DO, Arowolo D. Ocular axial length and keratometry readings of normal eyes in Southern Nigeria. Nigerian Journal of Ophthalmology. 2010;18(1): 12-14. doi: 10.4314/njo.v18i1.61367.
22. Jagun OA, Onabolu OO, Ajibode HA. Normative Ocular Biometric Dimensions and its Variation in a Nigerian Population. West Afr J Med. 2015 Jul-Sep;34(3):162-166. PMID: 28276040.
23. Chinawa EN, Ezeh EI. The distribution of ocular biometrics among patients undergoing cataract surgery. Nigerian Journal of Ophthalmology. 2018;26(1): 40-45.doi: 10.4103/njo.njo_7_18
24. Atchison DA, Markwell EL, Kasthurirangan S, Pope JM, Smith G, Swann PG. Age-related changes in optical and biometric characteristics of emmetropic eyes. J Vis. 2008 Apr 28;8(4):29.1-20. doi: 10.1167/8.4.29. PMID: 18484868.
25. Ibeneche HO, Ekpenyong BN, Ebri A. Barriers to accessing eye care services in the Federal Capital Territory, Abuja, Nigeria. Journal of the Nigerian Optometric Association. 2018;20(1):64-9. Link
26. Doyal L, Das-Bhaumik RG. Sex, gender and blindness: a new framework for equity. BMJ Open Ophthalmol. 2018 Sep 1;3(1):e000135. doi: 10.1136/bmjophth-2017-000135. PMID: 30246151; PMCID: PMC6146307.
27. Ramke J, Kyari F, Mwangi N, Piyasena M, Murthy G, Gilbert CE. Cataract Services are Leaving Widows Behind: Examples from National Cross-Sectional Surveys in Nigeria and Sri Lanka. Int J Environ Res Public Health. 2019 Oct 12;16(20):3854. doi: 10.3390/ijerph16203854. PMID: 31614715; PMCID: PMC6843674.
28. Knox Cartwright NE, Johnston RL, Jaycock PD, Tole DM, Sparrow JM. The Cataract National Dataset electronic multicentre audit of 55,567 operations: when should IOLMaster biometric measurements be rechecked? Eye (Lond). 2010 May;24(5):894-900. doi: 10.1038/eye.2009.196. Epub 2009 Aug 14. PMID: 19680278.
29. Badmus SA, Ajaiyeoba AI, Adegbehingbe BO, Onakpoya OH, Adeoye AO. Associations between ocular biometry and anthropometric measurements in a Nigerian population. Niger Postgrad Med J. 2016 Jul-Sep;23(3):127-31. doi: 10.4103/1117-1936.190341. PMID: 27623723.
30. Fotedar R, Mitchell P, Burlutsky G, Wang JJ. Relationship of 10-year change in refraction to nuclear cataract and axial length findings from an older population. Ophthalmology. 2008 Aug;115(8):1273-8, 1278.e1. doi: 10.1016/j.ophtha.2007.11.003. Epub 2008 Jan 25. PMID: 18222002.
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