ArticleOphthalmology and therapy2026
The Role of Sex in Ocular Biometry: A Large-Scale Study of Cataract Candidates in Greece.
Article in Ophthalmology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAccurate 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).
methodsThis 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.
resultsMale 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.
conclusionSex-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.
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