Updated study on demographic and ocular biometric characteristics of cataract patients indicates new trends in cataract surgery

Abstract

To assess changes in the demographics and ocular biometric characteristics of cataract patients over the past decade to identify trends that may impact cataract surgery as well as design and selection of intraocular lenses. Retrospective study. Clinicodemographic and ocular biometric data from swept-source optical coherence tomography were retrospectively analyzed for 25,192 eyes of 25,192 patients aged 40 and older who underwent cataract surgery between 2020 and 2023 at West China Hospital of Sichuan University. As patient age increased, axial length, anterior chamber depth, aqueous depth, and white-to-white tended to decrease, whereas corneal refractive power and lens thickness tended to increase. Among all patients, 19.66% had axial lengths exceeding 26 mm, and 1.72% had a history of refractive surgery; the incidence of such surgery increased significantly from 2020 to 2023. Compared to patients without a history of refractive surgery, those with such a history were 12 years younger and larger proportions had axial lengths exceeding 26 mm or corneal refractive power below 38 D. The frequencies of high myopia and of previous refractive surgery among cataract patients increased between the 2010s and the 2020s, and the age of cataract patients at the time of surgery fell during that interval. These changes in ocular and demographic characteristics may necessitate updates in preparations before cataract surgery, procedures during surgery, management after surgery, as well as design and selection of intraocular lenses.

Keywords: Biometry; Cataract; Demography; Myopia; Ocular; Refractive surgery.

Fig. 1

Distribution of numbers and sex of individuals across different age ranges in the cohort.

Fig. 2

Age distribution of patients with a history of refractive surgery (RS) or not (NRS), in terms of (A) absolute numbers and (B) percentages. The solid lines represent Gaussian modeling.

Fig. 3

Axial length and age in our cohort. (A) Prevalence of different ranges of axial length in different age groups. (B) Prevalence of axial length > 26 mm in different age groups.

Fig. 4

Corneal astigmatism and age in our cohort. (A) Prevalence of “with-the-rule” (WTR), “against-the-rule” (ATR) and “oblique” (OBL) astigmatism in different age groups. (B) Comparison of the three types of astigmatism between patients aged 40 to 60 with a history of refractive surgery (RS) and those in the same age range without such a history (NRS).

Fig. 5

Flowchart of patient selection and stratification.