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Original Article
Abstract
Background: To investigate the difference of ocular biometric and corneal topographic characteristics between the two eyes in high anisometropes with difference of 4 D or more in spherical component.
Methods: Fifty-one young anisometropic men were collected. Detailed ocular examinations, including cycloplegic autorefraction, best-corrected
visual acuity, intraocular pressure, A-scan, and Orbscan topography were done and recorded. The comparisons between two eyes were performed and the correlations between different ocular parameters were evaluated.
Results: The mean axial length in the more myopic/less hyperopic eye was longer than that in the less myopic/more hyperopic eye [difference
1.8 mm, 95% confidence interval (CI) 1.6e2.0 mm, p < 0.001]. The mean thinnest corneal thickness in the more myopic/less hyperopic eye was
an average of 4.0 mm thicker than that in the other eye (95% CI 1.2e6.8 mm, p 0.007). The mean anterior chamber depth in the more myopic/
less hyperopic eye was an average of 0.05 mm (95% CI 0.02e0.07 mm, p < 0.001) more than that in the other eye. The curvature and size of
cornea were not significantly different.
Conclusion: The anterior chamber depth is deeper, axial length is longer, and thinnest corneal thickness is thicker in the more myopic/less
hyperopic eye of high-anisometropic patients. Anisometropic eyes provide the chance to understand the biometric changes of eyeball with
different refractive statuses in the same person. Such information is helpful for us to calculate the intraocular lenses power in cataract surgery
and to do the surgical planning for corneal refractive surgery in eyes of different refractive power.
Copyright 2011 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.
Keywords: Anisometropia; Corneal topography; Intraocular pressure
1. Introduction
Ocular biometric and topographic characteristics are
important measurements in different fields in ophthalmology.
Corneal thickness is an important guiding parameter in corneal
refractive surgery, allowing determination of the extent of safe
stromal ablation.1 The central corneal thickness (CCT) and the
anterior chamber depth (ACD) are considered as the screening
risk factors for glaucoma.2e5 Recently, ACD was used as an
* Corresponding author. Dr. Ni-Wen Kuo, Department of Ophthalmology,
Kaohsiung Veterans General Hospital, 386, Ta-Chung First Road, Kaohsiung
813, Taiwan, ROC.
E-mail address: nwkuo@vghks.gov.tw (N.-W. Kuo).
1726-4901/$ - see front matter Copyright 2011 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.
doi:10.1016/j.jcma.2011.05.007
N.-W. Kuo et al. / Journal of the Chinese Medical Association 74 (2011) 310e315
311
Table 1
Cycloplegic refraction, IOP, ACD, and AL between the two eyes of high anisometropia (n 51)
More myopic/less hyperopic eye
SE (D)
IOP (mmHg)
ACD (mm)
AL (mm)
a
Mean
SD
Mean
SD
5.66
17.4
3.15
26.1
2.70
3.1
0.26
1.2
0.79
16.8
3.10
24.3
3.04
3.2
0.27
1.3
Difference
95% CI
4.87
0.6
0.05
1.8
5.24 to 4.50
0.05e1.1
0.02e0.07
1.6e2.0
26.54
2.23
3.71
17.57
<0.001a
0.03a
<0.001a
<0.001a
Statistical significance.
AL axial length; ACD anterior chamber depth; CI confidence interval; IOP intraocular pressure; SD standard deviation; SE cycloplegic spherical
equivalent.
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N.-W. Kuo et al. / Journal of the Chinese Medical Association 74 (2011) 310e315
for the difference of IOP between the two eyes of high anisometropes. The TCT was thicker, the ACD was deeper, and
the AL was longer in the more myopic eye than that in the less
myopic eye in the high-anisomyopic patients ( p 0.02, 0.02,
and <0.001, respectively). And in high-antimetropic patients,
the results were similar in the more myopic eye than in the
more hyperopic eye ( p 0.047, 0.03, and <0.001, respectively). The difference of IOP between the paired eyes was
different in high-anisomyopic and in high-antimetropic
patients. In the high-anisomyopic group, the mean IOP in
the more myopic eye was an average of 1.0 mmHg (95% CI
0.3e1.9 mmHg, p 0.004) higher than that in the less myopic
eye. But there was no statistically significant difference of IOP
between the two eyes in high-antimetropic group (mean
16.6 mmHg, SD 2.9 mmHg in the more myopic eye and mean
16.5 mmHg, SD 3.1 mmHg in the more hyperopic eye,
p 0.81) (Table 4).
4. Discussion
Fig. 1. Relation between the percentages of anterior chamber depth and axial
length in more myopic/less hyperopic eyes and the difference of cycloplegic
spherical equivalent.
Table 2
Corneal characteristics between the two eyes of high anisometropes (n 51)
Curvature
Ant BFS (D)
Post BFS (D)
Mean SimK (D)
Thickness
TCT (mm)
Size
WTW (mm)
a
Mean
Mean
41.92
51.59
42.76
533.3
11.69
SD
1.24
1.78
1.36
32.0
0.45
41.87
51.71
42.65
529.3
11.72
Difference
95% CI
0.05
0.12
0.11
0.07e0.18
0.33e0.10
0.04e0.27
0.85
1.08
1.47
0.40
0.28
0.15
SD
1.31
1.82
1.44
31.7
0.39
4.0
1.2e6.8
0.02
1.46e1.03
2.84
0.34
0.007a
0.73
Statistical significance.
Ant BFS anterior best-fit sphere; CI confidence interval; Post BFS posterior best-fit sphere; SD standard deviation; SimK simulated keratometry;
TCT thinnest corneal thickness; WTW white to white horizontal corneal diameter.
N.-W. Kuo et al. / Journal of the Chinese Medical Association 74 (2011) 310e315
313
Table 3
Correlation between the IOP, TCT, ACD, and AL in each eye of high anisometropes
TCT
ACD
IOP
0.31
0.31
0.03*
0.03*
TCT
0.06
0.02
ACD
AL
p
0.35
0.26
0.02*
0.07
0.68
0.91
p
0.28
0.27
0.06
0.07
0.02
0.07
0.87
0.64
0.47
0.52
0.001*
<0.001*
*A p value <0.05.
ACD anterior chamber depth; AL axial length; IOP intraocular pressure; TCT thinnest corneal thickness.
Table 4
Subgroup analyses of difference of cycloplegic refraction, IOP, TCT, ACD, and AL between the two eyes of high anisomyopia and high antimetropia
Anisomyopia (n 29)
SE (D)
TCT (mm)
IOP (mmHg)
ACD (mm)
AL (mm)
a
Antimetropia (n 20)
Difference
95% CI
4.59
4.5
1.0
0.05
1.6
5.00 to 4.17
0.7e8.2
0.3e1.9
0.02e0.07
1.4e1.9
<0.001
0.02a
0.004a
0.02a
<0.001a
a
Difference
95% CI
5.28
3.6
0.1
0.06
2.0
6.01 to 4.56
0.7e9.1
0.8e1.0
0.008e0.12
1.7e2.5
<0.001a
0.047a
0.81
0.03a
<0.001a
Statistical significance.
ACD anterior chamber depth; AL axial length; CI confidence interval; IOP intraocular pressure; SD standard deviation; SE cycloplegic spherical
equivalent; TCT thinnest corneal thickness.
314
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