Purpose: To investigate the characteristics and factors associated with crystalline lens tilt and decentration measured by CASIA2 anterior segment optical coherence tomography. Setting: Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Design: Cross-sectional study. Methods: 1097 eyes of 1097 patients who planned to undergo cataract surgery were enrolled. All patients underwent a general ophthalmologic examination. Lens thickness (LT), front curvature radius (FCR), back curvature radius, lens equator diameter (LED), tilt, and decentration of preoperative crystalline lenses were measured by CASIA2. Univariate and multivariate regression analyses were performed to evaluate the relationships between the tilt and decentration of crystalline lens with related factors. Results: The natural crystalline lenses showed a mean tilt of 5.16 degrees toward the inferotemporal direction and a mean decentration of 0.22 mm toward the temporal direction. Of the total 1097 eyes, 119 eyes (10.85%) had a tilt greater than 7 degrees, and 89 eyes (8.11%) had a decentration more than 0.4 mm. Multivariate regression analysis showed that larger decentration, thicker LT, shorter axial length (AL), and FCR were associated with greater lens tilt (P < .001, P = .007, P = .006, and P = .003, respectively). In addition, greater tilt, older and thinner LT were correlated with larger decentration (all P < .001). Conclusions: Preoperative crystalline lens had a certain degree of tilt and decentration in age-related cataract. The greater tilt of the crystalline lens was, the larger decentration of it was. In addition, AL, FCR, LT, and age also correlated with tilt and decentration.

Purpose: To explore the risk factors and construct nomogram models to predict the risks of clinically significant intraocular lens (IOL) tilt and decentration after cataract surgery in patients with age-related cataract. Setting: Zhongshan Ophthalmic Center, Guangzhou, China. Design: Prospective cohort study. Methods: 207 patients (207 eyes) who underwent phacoemulsification combined with IOL implantation were enrolled in the study. Casia2 was used to measure the tilt and decentration of crystalline lenses and IOLs before and 3 months after surgery. Univariate and multivariate logistic regression analyses were used to determine the risk factors of clinically significant IOL tilt and decentration, and nomogram prediction models were constructed according to the results of the multivariate logistic regression analysis. Results: Two hundred and seven patients were included in analysis. 24 eyes (11.59%) and 16 eyes (7.73%) had clinically significant IOL tilt and decentration at 3 months after cataract surgery. Multivariate logistic regression analysis revealed that preoperative crystalline lens tilt and decentration were the risk factors for clinically significant IOL tilt (odds ratio [OR], 3.519, P < .001) and decentration (OR, 410.22, P = .001), respectively. Axial length was another association factor for clinically significant IOL decentration (OR, 2.155, P = .019). The risk models demonstrated good calibrations and discriminations for the predictions of clinically significant IOL tilt (receiver operating characteristic [ROC] area = 0.833, cutoff value = 6.5) and decentration (ROC area = 0.757, cutoff value = 0.08). Conclusions: The good performances of our models suggested that they may be useful risk prediction tools for postoperative IOL tilt and decentration. The measurement of preoperative crystalline lens tilt and decentration should be one of the routine examinations before cataract surgery, especially for toric and multifocal IOLs.

Purpose: To explore the distribution of lens volume (VOL) and its associated factors in noncataract adolescents and adults and patients with cataract in a Chinese population. Setting: Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Design: Cross-sectional study. Methods: 1674 eyes from 1674 Chinese participants (690 adolescents and 363 adults without cataract, and 621 patients with cataract) aged from 7 to 90 years were included. Lens thickness (LT) and lens diameter (LD) were measured using swept-source anterior segment optical coherence tomography (SS-AS OCT) to calculate VOL. Axial length (AL) was measured by IOL-Master 700. Pearson correlation analysis and multivariate linear regression models were used to evaluate the potential associated factors of lens dimensions. Results: The mean VOL was 167.74 ± 12.18 mm³ in noncataract adolescents, 185.20 ± 14.95 mm³ in noncataract adults, and 226.10 ± 49.25 mm³ in patients with cataract. VOL had no significant correlation with AL in patients with cataract (P > .05), neither in noncataract adolescents nor noncataract adults, when adjusted with LT, LD, age, and sex (P > .05). On the other hand, eyes with longer ALs tended to have smaller LTs and larger LDs in all groups (all P-trend < .05). Larger VOL was associated with older age in all groups (all P < .001). Conclusions: A data set of VOLs in Chinese eyes over a wide age range was presented. It is inaccurate to predict VOL, LT, and LD solely according to AL. The direct measurement and calculation of VOL in vivo and the establishment of the normal range of VOL could help predict the size of lens capsular bag and plan cataract surgery.

Limited evidence has shown the relationship between systemic inflammation and high myopia. Thus, we conducted this study to explore this issue. A total of 2891 participants (2891 eyes) aged ≤40 years were included in this cross-sectional study. Four systemic inflammation markers were calculated through blood cell counts: systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. Univariate and multivariate logistic regression analyses, as well as restricted cubic spline analyses, were used to assess the relationship between systemic inflammation markers and high myopia. The incidence of mild and moderate myopia was 67.24% (1944 eyes), and the incidence of high myopia was 4.6% (133 eyes) in this US population. After adjusting for covariates, multivariate logistic regression analysis revealed that high myopia was associated with white blood cell counts (odds ratio [OR] = 0.242, P = .027), neutrophils (OR = 4.052, P = .033), lymphocytes (OR = 4.989, P = .021), neutrophil-to-lymphocyte ratio (OR = 0.621, P = .025), and SII (OR = 1.002, P = .011). We also found that lymphocytes and the SII were nonlinearly associated with high myopia (all P < .05). Higher levels of lymphocytes and SII related to high myopia. Thus, the measurement of inflammatory markers should be taken into consideration when assessing high myopia.