Ophthalmology and Therapy · Published 2026-05-16 · DOI 10.1007/s40123-026-01402-4
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
Abstract 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.
Abstract from DOAJ. Public domain (CC0 1.0).
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Sakka, D., Zisimopoulos, A., Kalogera, E., et al. (2026). The Role of Sex in Ocular Biometry: A Large-Scale Study of Cataract Candidates in Greece. Ophthalmology and Therapy. https://doi.org/10.1007/s40123-026-01402-4