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Introduction <p>Accurate intraocular lens (IOL) selection in cataract surgery relies on precise ocular biometry, yet variability between patients remains a challenge in achieving optimal refractive outcomes. Sex-related differences in biometric parameters and age-related changes in corneal astigmatism may contribute to this variability. This study aimed to evaluate sex-related differences in ocular biometry and age-related astigmatic changes in Greek cataract candidates using swept-source optical coherence tomography (SS-OCT).</p> Methods <p>This retrospective observational study included 6258 eyes from 3726 adult patients. Patients were scheduled for cataract surgery between July 2024 and July 2025 at a tertiary eye hospital in Athens, Greece. Axial length (AL), anterior chamber depth (ACD), lens thickness (LT), keratometry (K1, K2), corneal astigmatism (CA), and white-to-white (WTW) were measured using the Argos SS-OCT biometer. Predicted IOL power distribution was evaluated using the Hoffer Q formula for descriptive purposes, targeting emmetropia. Sex- and age-stratified analyses were performed<b>.</b></p> Results <p>Male eyes demonstrated longer AL (by 0.46&#xa0;mm), deeper ACD (by 0.13&#xa0;mm), and larger WTW (by 0.20&#xa0;mm) (<i>p</i> &lt; 0.01), whereas female eyes had steeper K1 (by 0.78&#xa0;D) and K2 (by 0.70&#xa0;D) (<i>p</i> &lt; 0.01). An age-related shift from with-the-rule (WTR) to against-the-rule (ATR) astigmatism was observed in both sexes, occurring approximately one decade earlier in male eyes. Female eyes were overrepresented below the 5th (5.54% vs. 4.00%, <i>p</i> &lt; 0.01) and above the 95th (4.42% vs. 2.88%, <i>p</i> &lt; 0.01) percentiles of the predicted IOL power distribution.</p> Conclusion <p>Sex-related differences in ocular biometry and age-related changes in corneal astigmatism were observed in this cohort. These findings provide population-specific data and highlight variability in biometric characteristics among patients with cataracts which may be relevant for preoperative assessment and surgery planning.</p>

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The Role of Sex in Ocular Biometry: A Large-Scale Study of Cataract Candidates in Greece

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月16日

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  • Dimitra Sakka,
  • Athanasios Zisimopoulos,
  • Efthymia Kalogera,
  • Efstathios Athanasopoulos,
  • Kalliopi Diamantopoulou,
  • Ioannis Halkiadakis,
  • Kalliroi Konstantopoulou,
  • Christina Kourentis,
  • Ioannis Markopoulos,
  • Iakovos Michail,
  • Efstratios Paroikakis,
  • Vasileios Peponis,
  • Michael Karampelas

摘要

Introduction

Accurate intraocular lens (IOL) selection in cataract surgery relies on precise ocular biometry, yet variability between patients remains a challenge in achieving optimal refractive outcomes. Sex-related differences in biometric parameters and age-related changes in corneal astigmatism may contribute to this variability. This study aimed to evaluate sex-related differences in ocular biometry and age-related astigmatic changes in Greek cataract candidates using swept-source optical coherence tomography (SS-OCT).

Methods

This retrospective observational study included 6258 eyes from 3726 adult patients. Patients were scheduled for cataract surgery between July 2024 and July 2025 at a tertiary eye hospital in Athens, Greece. Axial length (AL), anterior chamber depth (ACD), lens thickness (LT), keratometry (K1, K2), corneal astigmatism (CA), and white-to-white (WTW) were measured using the Argos SS-OCT biometer. Predicted IOL power distribution was evaluated using the Hoffer Q formula for descriptive purposes, targeting emmetropia. Sex- and age-stratified analyses were performed.

Results

Male eyes demonstrated longer AL (by 0.46 mm), deeper ACD (by 0.13 mm), and larger WTW (by 0.20 mm) (p < 0.01), whereas female eyes had steeper K1 (by 0.78 D) and K2 (by 0.70 D) (p < 0.01). An age-related shift from with-the-rule (WTR) to against-the-rule (ATR) astigmatism was observed in both sexes, occurring approximately one decade earlier in male eyes. Female eyes were overrepresented below the 5th (5.54% vs. 4.00%, p < 0.01) and above the 95th (4.42% vs. 2.88%, p < 0.01) percentiles of the predicted IOL power distribution.

Conclusion

Sex-related differences in ocular biometry and age-related changes in corneal astigmatism were observed in this cohort. These findings provide population-specific data and highlight variability in biometric characteristics among patients with cataracts which may be relevant for preoperative assessment and surgery planning.