Crystalline Lens Power and Associated Factors in Highly Myopic Children and Adolescents Aged 4 to 19 Years

Abstract

To investigate the distribution characteristics of lens power in highly myopic Chinese children and adolescents and its association with age, axial length (AL), and spherical equivalent (SE). Cross-sectional study. A total of 459 highly myopic (SE ≤-5 diopter [D]) children and adolescents aged 4-19 years were included in the study. Participants underwent a series of ophthalmic examinations, which included AL, cycloplegic refraction, and Pentacam measurements. Lens power was calculated using Bennett's formula with its distribution described by age, AL, and SE. Multiple regression was conducted to analyze the associated factors of lens power. Greater lens power was independently associated with younger age, girls, shorter AL, and thicker lens thickness (standardized β=-0.203, 0.214,-0.379 and 0.492, respectively; all P < .001). However, a significant difference in lens power with age was only found in participants younger than 9 years, after which it reached a plateau (mean difference of 1.23 and 0.084 D per age group, respectively). Lens power was negatively associated with AL only in participants with AL <27mm. No correlation was observed between lens power and SE. Among highly myopic children and adolescents, differences in lens power with age declined significantly after 9 years of age, which was 1 year earlier than non-high myopic patients in previous studies, which implied differences in pathophysiological process between non-high myopia and high myopia. The decoupling of lens power and AL in eyes >27mm might represent the limited influence of AL on lens power.