Abstract
BACKGROUND: The lens thickness-to-anterior chamber depth (LT/ACD) ratio remains underexplored, despite its significance in optimizing cataract surgical outcomes and stratifying the risk of potential complications in aging populations. AIM: This study aimed to investigate the distribution patterns and determinants of the LT/ACD ratio in cataract patients. METHODS: Bilateral ocular biometrics of 715 cataract patients were measured using Lenstar LS-900. The LT/ACD ratios of the right and left eyes were analyzed separately, with the results for the left eyes used to validate those for the right eyes. The LT/ACD ratio was compared using the Mann-Whitney or Kruskal-Wallis test. Spearman's correlation coefficients were used to evaluate its correlation with other biometrics. Univariable and multivariable linear regression analyses were performed to identify the determinants of the LT/ACD ratio. RESULTS: The LT/ACD ratio was higher in women, in patients with shorter axial length (AL), and in older patients (all p < 0.0001). In both eyes, the LT/ACD ratio correlated with iris center distance, pupil size (PS), angle kappa, AL, and white-to-white corneal diameter (WTW) (all p < 0.05). Determinants of the LT/ACD ratio in the right eyes included age (β = 0.01), sex (β = -0.08), anterior corneal astigmatism (ACA) (β = 0.06), angle kappa (β = 0.30), and AL (β = -0.09). In the left eyes, determinants included age (β = 0.01), sex (β = -0.08), corneal curvature (CR) (β = -0.05), angle kappa (β = 0.20), AL (β = -0.12), and WTW (β = -0.12). CONCLUSION: The distribution patterns of the LT/ACD ratio varied with sex, AL, and age, and the LT/ACD ratio correlated with similar but distinct determinants in both eyes. These findings help us better understand the interaction between LT and ACD in the eyes of cataract patients.