Indian J Ophthalmol. 2019 Sep; 67(9): 1417–1423.

doi: 10.4103/ijo.IJO_1353_18

PMCID: PMC6727703

PMID: 31436184

Ocular biometry characteristics and corneal astigmatisms in

cataract surgery candidates at a tertiary care center in North-
East India
Tanie Natung, Wakaru Shullai, Benjamin Nongrum, Lanalyn Thangkhiew, Prasenjit
Baruah,1 and Mary L Phiamphu1

Author information Article notes Copyright and License information Disclaimer

Abstract
Cataract surgery is rapidly becoming a lens-based refractive surgery by correcting the
refractive errors including astigmatisms and presbyopia, while at the same time
replacing the cataractous lens with a premium intraocular lens (IOL).[1] Therefore, very
precise assessment of axial length (AL), corneal power, and anterior chamber depth
(ACD) is very important to calculate the exact IOL power to achieve the desired
refractive power and to minimize the postoperative astigmatism.[2,3] This is especially
required in patients opting for premium IOLs such as trifocal or toric or trifocal-toric
IOLs. This will reduce spectacle dependence of the patients undergoing cataract
surgery.
Partial coherence interferometry (PCI) is the gold standard for measuring the ocular
biometry characteristics.[4] Using the PCI, few studies have been done to find the
ocular biometry characteristics in the Asian eyes.[3,5,6,7,8,9,10,11] However, there is
no data available, to the best of our knowledge, on the pattern of ocular biometric values
and astigmatisms of Indian subjects undergoing cataract surgery by using PCI. Using
the ultrasonography (USG) contact method, only one study from Central India has tried
to find the association of AL with other ocular and systemic parameters in an adult
Indian population.[11] Hence, the biometry pattern using the PCI in Indian eyes is not
known.
Therefore, the aim of our study was to determine the distribution of ocular biometric
parameters and corneal astigmatisms in Indian patients undergoing cataract surgery at
this medical college of North-East India.
Go to:

Methods
It was a prospective, cross-sectional, hospital-based study. The study was conducted at
the Department of Ophthalmology of a medical college in North-East India between
January 2015 and December 2017. Institute's ethics clearance was taken for the study
and we adhered to the tenets of Declaration of Helsinki. Written informed consent was
taken from every patient undergoing cataract surgery.
We included patients 40 years or above undergoing cataract surgery were included in
the study. Dense cataract interfering with the measurement with PCI, cataract surgery
for secondary IOL-like scleral fixated IOL, corneal diseases, and ocular surface
disorders and post-traumatic cataract patients were excluded from the study.
The place of study was a hill station with an altitude of approximately 550 m above sea
level. Because of higher altitude of the place and low population, the prevalence of
cataract is low in this place. During the study period 641 consecutive cataract candidates
were enrolled. The ocular biometry before the cataract surgery was performed using
PCI with an infrared diode laser at a 780 nm wavelength (IOL Master, Carl Zeiss
Meditec AG, 07745 Jena, Germany, 2014). The parameters measured were keratometry,
AL, ACD, white-to-white (WTW), and the IOL formulas of SRK II, SRK/T, Holladay,
Hoffer Q and Haegis formulas, and IOL power. The place of study has many central
government establishments such as the eastern headquarters of Indian Army, Indian Air
Command, Border Security Force, Assam rifle, Indo-Tibetan Border Police, Geological
and Botanical Survey of India, a central university, and many science and humanity
colleges. These centers have many central government officers from different states of
India posted at this place. So, apart from the patients from the state and the nearby
states, this medical college caters to many patients from all over India.
Because IOL master is a noncontact biometer, the AL was measured as the distance
from the tear film to the retinal pigment epithelium. Similarly, the ACD was measured
as the distance from the anterior corneal surface to the anterior lens surface. Corneal
power (keratometry – K) was measured in both the flat (K1) and steep K (K2). The final
K value was taken as the mean of K1 and K2. For calculation of astigmatism, difference
between K1 and K2 were taken and for the axis of astigmatism the axis of the steeper
power, i.e., K2 was taken. The refractive index value used by PCI was 1.3375. The SRK
T formula (as per the AL) was used for the statistical analysis of the theoretical IOL
powers, and the target refraction was set as 0.00 diopter (D). The A constant was set as
per the IOL chosen. The IOL master was calibrated every Monday of the week.
Apart from the patients' details, height and weight were also measured using standard
instruments. The height was measured using a standard height measuring device (Floor
Model Height Scale Model No: WS0011, Prestige Weighing Scales, Hardik Meditech,
New Delhi). Similarly, weight was measured using a standard weighing machine
(Microgene Bathroom weighing scale, BR9201, Ghaziabad, India). These equipments
were calibrated every Monday.

Statistical analysis
Data were recorded in Microsoft Excel spreadsheets and then transferred to SPSS
software for analysis. Continuous variables were expressed as the mean ± standard
deviation for the data showing normal distribution. Data were analyzed using the
Kolmogorov–Smirnov test to see whether they were normally distributed or not.
Student's t-test was used to compare the means of characteristics between the male and
female groups. Univariate analyses of the associations between AL and other ocular
parameters were determined. Then, multivariate regression analyses of the associations
between AL and other parameters were performed. One-way analysis of variance and
the Kruskal–Wallis test were applied for the comparison of variance for normally and
non-normally distributed data among the different age groups, respectively. Statistical
analysis was performed using the SPSS software package (SPSS for Windows, version
22.0; SPSS, Inc., Chicago, IL, USA). P values <0.05 were considered statistically
significant.
For statistical purpose, the patients were divided into six subgroups on the basis of age
as: 40–50, 51–60, 61–70, 71–80, and ≥81 years. All the eyes were subdivided into four
groups based on AL measurements as shorter than 22.0, 22.0–24.5, 24.51–26.0, and
longer than 26.0 mm. Type of astigmatism was defined as with-the-rule (WTR) if the
steeper meridian lies between 60 and 120; against-the-rule (ATR) if it lies between 0
and 30 or 150 and 180; and oblique astigmatism if it lies between 30.01 and 59.99 or
120.01 and 149.99. ACD was divided into ≤2.8, 2.81–3.5, and ≥3.51 mm. The amount
of corneal astigmatism was divided into 0–1, 1.01–2.00, 2.01–3.00, 3.01–4.00, 4.01–
5.00, 5.01–6.00, and ≥6.01.
Go to:

Results
Data were analyzed from a total of 641 eligible patients. The distribution of age, ocular
biometric parameters, and BMI by sex is given in Table 1. The distribution of ocular
biometric parameters by age group and sex are given in Table 2 and in the Figs.
Figs.11--4.4. State-wise distribution of participants from different Indian states is given
in Table 3.

Table 1
Distribution of age, ocular biometric parameters, and BMI in males and females
 Mean±SD

Sex Age AL ACD WTW Corneal power (D) IOL BMI

(Eyes power
)

K1 K2 K

Male 64.07±11 23.58±0 3.18±0 11.99±0 43.56±1 44.81±1 44.19±1 20.34±2 25.98±4
(334) .15 .99 .39 .53 .46 .65 .46 .35 .05

Fem 64.01±10 23.07±1 3.05±0 11.84±0 44.01±1 45.29±1 44.65±1 20.73±3 26.29±4
ale .45 .19 .39 .54 .62 .65 .52 .20 .61
(307)

All 64.04±10 23.34±1 3.12±0 11.92±0 43.78±1 45.04±1 44.41±1 20.53±2 26.13±4
(641) .81 .12 .39 .54 .55 .67 .50 .79 .33

Open in a separate window

Table 2
Distribution of ocular biometric parameters by age group and sex
 Mean±SD

Age Eye AL (mm) ACD WTW Keratometry IOL

(years)/S s (mm) (mm) power
ex (n)

K1 K2 K

40-50

Male 51 23.76±1. 3.38±0. 12.21±0. 43.69±1. 45.07±1. 44.38±1.62 20.08±2.

12 32 50 55 88 56

Female 38 23.17±1. 3.25±0. 11.94±0. 43.54±1. 45.12±1. 44.3334±1.15 20.38±3.

06 39 60 38 64 383 07

51-60

Male 75 23.53±1. 3.22±0. 12.01±0. 43.58±1. 44.83±1. 44.21±1.48 20.25±2.

06 36 50 58 58 84
 Mean±SD

Age Eye AL (mm) ACD WTW Keratometry IOL

(years)/S s (mm) (mm) power
ex (n)

K1 K2 K

Female 69 23.33±2. 3.15±0. 11.90±0. 43.96±1. 45.34±1. 44.65±1.78 19.86±5.

01 46 56 92 91 17

61-70

Male 123 23.57±0. 3.19±0. 11.97±0. 43.59±1. 44.68±1. 44.11±1.33 20.61±1.

87 40 56 30 56 89

Female 120 22.95±0. 2.99±0. 11.76±0. 44.18±1. 45.36±1. 44.77±1.47 20.87±2.

77 33 47 48 59 25

71-80
 Mean±SD

Age Eye AL (mm) ACD WTW Keratometry IOL

(years)/S s (mm) (mm) power
ex (n)

K1 K2 K

Male 65 23.33±0. 3.04±0. 11.84±0. 43.54±1. 44.86±1. 44.20±1.52 20.44±1.

71 33 48 54 65 88

Female 69 22.93±0. 2.96±0. 11.84±0. 44.20±1. 45.40±1. 44.80±1.41 21.41±1.

73 36 56 51 49 76

81-90

Male 20 24.17±1. 2.99±0. 12.00±0. 43.30±1. 44.68±1. 43.99±1.56 19.27±3.

49 48 60 4 77 27

Female 11 23.28±0. 2.86±0. 11.96±0. 42.84±1. 44.14±1. 43.49±1.49 21.72±2.

79 19 71 75 41 12
 Mean±SD

Age Eye AL (mm) ACD WTW Keratometry IOL

(years)/S s (mm) (mm) power
ex (n)

K1 K2 K

Total 641 23.34±1. 3.12±0. 11.92±0. 43.78±1. 45.04±1. 44.41±1.50 20.53±2.

12 39 54 55 67 79

Open in a separate window

Figure 1

Relationship of mean AL with increasing age in males and females

 Open in a separate window

Figure 4

Relationship of mean keratometry with increasing age in males and females

Table 3
State-wise distribution of participants

States Number Percentage

Meghalaya 207 32.3

Assam 195 30.4

States Number Percentage

Manipur 67 10.5

Nagaland 42 6.6

Bihar 32 5

Arunachal Pradesh 29 4.5

Mizoram 24 3.7

Uttar Pradesh 8 1.2

Punjab 6 0.9

Tripura 5 0.8

West Bengal 4 0.6

Rajasthan 3 0.5

Himachal Pradesh 3 0.5

States Number Percentage

Sikkim 3 0.5

Uttarakhand 3 0.5

New Delhi 2 0.3

Orissa 2 0.3

Haryana 2 0.3

Andhra Pradesh 2 0.3

Tamil Nadu 1 0.2

Kerala 1 0.2

Total 641 100

Open in a separate window

The mean age of the participants was 64.04 ± 10.81 years. There were 334 males and
307 females in the study. There was no statistically significant difference in age
between the male and female (P = 0.951).
The mean AL of the participants was 23.34 ± 1.12 mm. The mean AL in males (23.58 ±
0.99 mm) was longer than the females (23.07 ± 1.19 mm) and was statistically
significant (P = 0.00). Fifty-seven participants (8.9%) had AL <22 mm, 521 (81.3%)
had between 22 and 24.5 mm, 48 (7.5%) had between 24.51 and 26 mm, and 15 (2.3%)
had >26 mm [Table 1]. The mean AL decreased initially and then increased with the
increase in age (P for trend = 0.004) [Fig. 1].
The mean ACD was 3.12 ± 0.39 mm. The mean ACD in males (3.18 ± 0.39 mm) was
deeper than the females (3.05 ± 0.39 mm) and was statistically significant (P = 0.00). A
total of 138 (21.5%) patients had ACD ≤2.8 mm, 403 (62.9%) had between 2.81 and 3.5
mm, and 100 (15.6%) had >3.5 mm [Table 1]. The mean ACD decreased with the
increase in the age (P for trend = 0.00) [Fig. 2].

Figure 2

Relationship of mean ACD with increasing age in males and females

The mean WTW was 11.92 ± 0.54 mm. The difference in the mean WTW (P = 0.00)
between the males and females was statistically significant. It was more for males
(11.99 ± 0.53 mm) than females (11.84 ± 0.54 mm). The mean WTW increased initially
and then decreased with the increase in the age (P for trend = 0.007) [Fig. 3].
Figure 3

Relationship of mean WTW with increasing age in males and females

The mean K was 44.41 ± 1.50 D. The mean K in females (44.01 ± 1.62 D) was higher
than the males (43.56 ± 1.46 D) [Table 1], and the difference was statistically
significant (P = 0.00). The mean K increased initially and then decreased with the
increase in age but the change was not statistically significant (P = 0.074) [Fig. 4].

Astigmatism Types
The proportion of WTR was more in the younger age group. However, with the increase
in age, the proportion of ATR increased more than the WTR [Fig. 5] The amount of
astigmatism decreased initially and then increased with age but the trend was
statistically not significant (P for trend = 0.249). ATR, WTR, and oblique astigmatisms
were 48.4, 33.2, and 18.4%, respectively. Corneal astigmatism of ≥1 D was found in
45.55% and >1.5 D in 28.39%. A total of 353 (55.1%) had astigmatism ≤1 D, 174
(27.1%) had between 1.01 and 2 D, 61 (9.5%) had between 2.01 and 3 D, 32 (5%) had
between 3.01 and 4 D, 7 (1.1%) had between 4.01 and 5 D, 7 (1.1%) had between 5.01
and 6 D, and 3 (0.5%) had ≥6 D.
Figure 5

Distribution of astigmatism types with increasing age

The mean IOL power in our study was 20.53 ± 2.79 D and the mean BMI was 26.12 ±
4.32. Male eyes had longer AL, deeper ACD, wider WTW, flatter K, greater height and
weight (P = 0.00).

Correlations
Age had statistically significant correlation with ACD, WTW, and BMI (P = 0.00) but
not with AL and K. AL had statistically significant correlation with K, ACD, WTW,
IOL power (P = 0.00) but not with age. AL, ACD, WTW, and K had statistically
significant correlations with each other (P = 0.00), while IOL power had statistically
significant correlation with AL, ACD, and BMI (P = 0.00). BMI had statistically
significant correlation with age, ACD, and IOL power (P = 0.00).

Regression analysis
In the first step univariate analysis was performed where the association of AL, as the
dependent variable, was tested with each of the rest of other variables taken individually
as an independent variable. It was found that AL had statistically significant association
with K, ACD, WTW, IOL Power, height and weight individually but not with Age,
Corneal Astigmatism and BMI [Table 4]. In the next step, multivariate regression
analysis was performed with AL as the dependent variable and all other variables that
were significantly associated with AL in the univariate analysis were taken together as
the dependent variables. It was seen that only K, ACD, WTW and IOL power had
statistically significant association but not height and weight [Table 4]. The mean AL
was negatively correlated with the mean K (R-square linear 0.138) [Fig. 6].

Table 4
Univariate and multivariate regression analysis of ocular biometry parameters, corneal
astigmatisms, and systemic parameters with AL

Variables With Univariate regression analysis Multivariate regression analysis

Correlation 95% CI of P Correlation 95% CI of P

coefficient β coefficient coefficient β coefficient

AL Age −0.044 −0.013- 0.267

0.004

K −0.372 −0.331- 0.000 −0.294 −0.257- 0.000

−0.224 −0.182

ACD 0.298 0.639-1.061 0.000 0.116 0.182-0.480 0.000

WTW 0.205 0.266-0.580 0.000 0.090 0.080-0.292 0.001

Corneal −0.048 −0.122- 0.228

Astigmatism 0.029
Variables With Univariate regression analysis Multivariate regression analysis

Correlation 95% CI of P Correlation 95% CI of P

coefficient β coefficient coefficient β coefficient

IOL Power −0.682 −0.297- 0.000 −0.644 −0.279- 0.000

−0.252 −0.239

BMI 0.069 −0.002- 0.080

0.038

Height 0.207 0.015-0.032 0.000 0.085 −0.026- 0.595

0.046

Weight 0.203 0.013-0.028 0.000 0.056 −0.040- 0.809

0.052
Figure 6

Scatter plots of mean ACD, WTW, keratometry, and corneal astigmatism in relation to mean
AL
Go to:

Discussion
Our study could determine the ocular biometry characteristics and astigmatisms in the
candidates of 40 years and above, undergoing cataract surgery in a medical college in
North-East India. We could find the association of AL with other ocular parameters, and
IOL power.
PCI is currently the gold standard for ocular biometry and IOL power calculations.[4]
Because it is a noncontact technique, it is more accurate than the contact biometry
measurement techniques and has less chance of corneal abrasions and infections.
Moreover, it is easier to use and is reproducible. It can also predict the postoperative
target refraction better than the manual biometer. However, it cannot be carried out in
patients with very dense cataracts such as matured cataracts or dense posterior
subcapsular cataract.
On comparing the studies for AL measurement, the mean AL in our study (23.34) was
longer than the AL of Chinese population from Singapore and rural China,[5,6]
Indians,[11] and Iranians.[12] It was shorter than the AL of
Whites,[2,7,13,14,15,16,17,18,19,20] Chinese of Southern China,[3] Malay,[8]
Singaporean Indians,[9] and Hispanics[21] [Table 5]. The mean AL in males was longer
than the females and was statistically significant (P = 0.00). The AL decreased initially
and then increased with the increase in age, which was statistically significant (P for
trend = 0.004). The AL in our study was longer than that found in the Central India Eye
and Medical study (22.6 ± 0.91), which, however, was done by USG method contact
method.[11] It could be because the population in that study was mainly rural, whereas
in our study the population was mainly from the urban area. Therefore, there could be a
greater degree of axial myopia.[5,7,11,21]

Table 5
Comparison of ocular biometry characteristics of the present study with some other
studies of the world

Author Count Race Measure AL (mm) ACD (mm) K (D)

ry ment
method

Tot Mal Fema Tot Mal Fema Tot Mal Fema

al es les al es les al es les

Nangia India Indian USG 22. - - 3.2 - - - - -

et al. contact 60 1
method

Cao et China Chines USG 23. - - 3.0 - - 44. - -

al. e contact 04 3 24
method

Hashe Iran Irania Lenstar 23. 23. 23.95 2.6 2.6 2.58
mi et n 14 41 2 6
al.
Author Count Race Measure AL (mm) ACD (mm) K (D)
ry ment
method

Tot Mal Fema Tot Mal Fema Tot Mal Fema

al es les al es les al es les

Wong e Singap Chines USG 23. 23. 22.98 2.9 2.9 2.81 44. 43. 44.47
t al. ore e contact 23 54 9 12 66
method

Shufelt USA Hispan USG 23. 23. 23.18 3.4 3.4 3.36 43. 43. 43.95
et al. ic contact 38 65 1 8 72 35
method

Knox et United Caucas IOL 23. 23. 23.2 - - - 43. 43. 44.18
al. Kingdo ian Master 40 76 9 45
m

Hoffma Germa Caucas IOL 23. 23. 23.23 3.1 3.1 3.02 43. 43. 44.12
n et al. ny ian Master 43 77 1 2 89 44

Fotedar Austra Caucas IOL 23. 23. 23.2 3.1 3.1 3.06 43. 43. 43.74
lia ian Master 44 75 6 42 01
Author Count Race Measure AL (mm) ACD (mm) K (D)
ry ment
method

Tot Mal Fema Tot Mal Fema Tot Mal Fema

al es les al es les al es les

Olsen Denm Caucas IOL 23. - - - - - - - -

ark ian Master 45

Pan et Singap Indian 23. 23. 23.23 3.1 3.1 3.1

al. ore 45 68 5 9

Jivrajka USA Caucas USG 23. 23. 23.27 2.9 3.0 2.9 - - -
et al. ian contact 46 76 6 5
method

Siahme France Caucas IOL 23. - - - - - 43. - -

d et al. ian Master 46 97

Lim et Singap Malay IOL 23. - - 3.1 - - 44. - -

al. ore Master 55 12

Hoffer USA Caucas USG 23. - - 3.2 - - 43. - -

ian Immersio 65 4 81
n
Author Count Race Measure AL (mm) ACD (mm) K (D)
ry ment
method

Tot Mal Fema Tot Mal Fema Tot Mal Fema

al es les al es les al es les

Lee et USA Caucas IOL 23. 23. 23.51 3.1 3.1 3.09 43. 43. 44.12
al. ian Master 69 92 1 4 83 44

Ferreir Portug Caucas Lenstar 23. 23. 23.68 3.2 3.2 3.09 43. 43. 44.2
a et al. al ian 87 99 5 91 46

Cui et China Chines IOL 24. 24. 23.9 3.0 3.0 2.96 44. 43. 44.38
al. e Master 07 28 1 8 13 78

Olsen e Finlan Caucas USG - 23. 23.20 - 3.2 3.08 - 43. 43.73
t al. d ian contact 74 41
method

Present India Indian IOL 23. 23. 23.07 3.1 3.1 3.05 44. 43. 44.01
study Master 34 58 2 8 41 56

Open in a separate window

Similarly, the mean ACD (3.12 ± 0.39) was deeper than the Chinese Mongoloids,[3,5,6]
Whites,[7,12,15,16,17] and Malay Mongoloid.[8] It was less than the ACD found in the
Caucasians,[2,13,14,18,19,20] Singapore Indians,[9] Hispanics and Indians.[22] The
mean ACD in males was deeper than the females, which was statistically significant.
The mean ACD decreased with the increase in the age (P for trend = 0.00).
The mean K was 44.41 ± 1.50 D. There was statistically significant difference in the
mean K between the males and the females (P = 0.00). It was more than all other studies
who have reported the mean K.[3,5,6,7,8,14,15,16,18,19,20,21] The mean K increased
initially and then decreased with the increase in age but the change was not statistically
significant (P = 0.074).
The mean WTW was 11.92 ± 0.54 mm. The mean WTW decreased initially and then
increased with the increase in the age (P for trend = 0.007). Other studies have not
reported the mean WTW. Therefore, we cannot make a comparison of our mean WTW
with other studies.
Age was correlated well with ACD, WTW, and BMI (P = 0.00) but not with AL and K.
As in other studies, the mean AL was negatively correlated with the corneal power (R
square linear 0.138).
Corneal astigmatism of ≥1 D was found in 292 (45.55%) and >1.5 D in 182 (28.39%)
cases. This was similar to that found in the studies by Cui et al.[3] The amount of
astigmatism decreased initially and then increased with age but was not statistically
significant (P for trend = 0.249). ATR, WTR, and oblique astigmatisms were 48.4, 33.2,
and 18.4%, respectively. As the age increases, the proportion of ATR becomes more
than the WTR although initially the WTR is more than the ATR.
Go to:

Conclusion
This study gives the characteristics of ocular biometry and corneal astigmatism using
IOL master in patients undergoing cataract surgery in a medical college in North-East
India. This will serve as the initial normative data for biometry values in Indian adults
undergoing cataract surgery because such data is lacking in the Indian population. This
data will also help the ophthalmologists in choosing the correct IOL and incision
location, thereby improving the surgical outcome in phacoemulsification or
phacorefractive surgeries.

Financial support and sponsorship

Nil.

Conflicts of interest
There are no conflicts of interest.
Go to:

References
1. Donaldson K, Fernandez-Vega-Cueto L, Davidson R, Dhaliwal D, Hamilton R, Jackson M, et al.
Perioperative assessment for refractive cataract surgery. J Cataract Refract Surg. 2018;44:642–
53. [PubMed] [Google Scholar]

2. Olsen T. Improved accuracy of intraocular lens power calculation with the Zeiss IOL
Master. Acta Ophthalmol Scand. 2007;85:84–7. [PubMed] [Google Scholar]
3. Cui Y, Meng Q, Guo H, Zeng J, Zhang H, Zhang G, et al. Biometry and corneal astigmatism in
cataract surgery candidates from Southern China. J Cataract Refract Surg. 2014;40:1661–
9. [PubMed] [Google Scholar]

4. Kaswin G, Rousseau A, Mgarrech M, Barreau E, Labetoulle M. Biometry and intraocular lens

power calculation results with a new optical biometry device: Comparison with the gold
standard. J Cataract Refract Surg. 2014;40:593–600. [PubMed] [Google Scholar]

5. 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;42:73–80. [PubMed] [Google Scholar]

6. 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. [PMC free
article] [PubMed] [Google Scholar]

7. Lee KE, Klein BK, Klein R, Quandt Z, Wong TY. Age, stature, and education associations with
ocular dimensions in an older white population. Arch Ophthalmol. 2009;127:88–93. [PMC free
article] [PubMed] [Google Scholar]

8. Lim LS, Saw SM, Jeganathan SE, Tay WT, Aung T, Tong L, et al. Distribution and determinants
of ocular biometric parameters in an Asian population: The Singapore Malay eye study. Invest
Ophthalmol Vis Sci. 2010;51:103–9. [PubMed] [Google Scholar]

9. Pan C-W, Wong T-Y, Chang Lan, Lin X-Y, Lavanya R, Zheng Y-F, et al. Ocular biometry in an
Urban Indian population: The Singapore Indian eye study (SINDI) Invest Ophthalmol Vis
Sci. 2011;52:6636–42. [PubMed] [Google Scholar]

10. Yu J, Zhong J, Mei Z, Zhao F, Tao N, Xiang Y. Evaluation of biometry and corneal
astigmatism in cataract surgery patients from Central China. Invest Ophthalmol Vis
Sci. 2002;43:1408–13. [Google Scholar]

11. Nangia V, Jonas JB, Sinha A, Matin A, Kulkarni M, Panda-Jonas S. Ocular axial length and its
associations in an adult population of central rural India: The Central India eye and medical
study. Ophthalmology. 2010;117:1360–6. [PubMed] [Google Scholar]

12. Hashemi H, Khabazkhoob M, Miraftab M, Emamaian MH, Shariati M, Abdolahinia T, et al.

The distribution of axial length, anterior chamber depth, lens thickness, and vitreous chamber
depth in an adult population of Shahroud, Iran. BMC Ophthalmology. 2012;12:1–8. [PMC free
article] [PubMed] [Google Scholar]

13. Olsen T, Arnarsson A, Sasaki H, Sasaki K, Jonasson F. On the ocular refractive components:
The Reykjavik eye study. Acta Ophthalmol Scand. 2007;85:361–6. [PubMed] [Google Scholar]

14. Knox Cartwright NE, Jonhston RL, Jaycock PD, Tole DM, Sparrow JM. The cataract national
dataset electronic multicentre audit of 55,567 operations: When should IOL Master biometric
measurements be rechecked? Eye (Lond) 2010;24:894–900. [PubMed] [Google Scholar]

15. Hoffmann PC, Hutz WW. Analysis of biometry and prevalence data for corneal astigmatism
in 23,239 eyes. J Cataract Refract Surg. 2010;36:1479–85. [PubMed] [Google Scholar]

16. Fotedar R, Wang JJ, Burlutsky G, Morgan IG, Rose K, Wong TY, et al. Distribution of axial
length and ocular biometry measured using partial coherence laser interferometry (IOL Mater)
in an older white population. Ophthalmology. 2010;117:417–23. [PubMed] [Google Scholar]
17. 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;34:289–94. [PubMed] [Google Scholar]

18. Siahmed K, Muraine M, Brasseur G. Optic biometry in intraocular lens calculation for
cataract surgery. Comparison with usual methods. J Fr Ophthalmol. 2001;24:922–
6. [PubMed] [Google Scholar]

19. Hoffer KJ. Axial dimension of the human cataractous lens. Arch Ophthalmol. 1993;111:914–
8. Erratum 1993; 111-1626. [PubMed] [Google Scholar]

20. Ferreira TG, Hoffer KJ, Ribeiro F, Ribeiro P, O'Neill JG. Ocular biometric measurements in
cataract surgery candidates in Portugal. PLoS One. 2017;10:1–12. [PMC free
article] [PubMed] [Google Scholar]

21. 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;46:4450–60. [PubMed] [Google Scholar]

22. Jonas JB, Nangia V, Gupta R, Khare A, Sinha A, Agarwal S, et al. Anterior chamber depth and
its associations with ocular and general parameters in adults. Clin Exp
Ophthalmol. 2012;40:550–6. [PubMed] [Google Scholar]