International Ophthalmology

, Volume 38, Issue 6, pp 2427–2434 | Cite as

Biometric evaluation of myopic eyes without posterior staphyloma: disproportionate ocular growth

  • Sudarshan Khokhar
  • Brijesh Takkar
  • Esha Agarwal
  • Nripen Gaur
  • Raghav Ravani
  • Pradeep Venkatesh
Original Paper



To evaluate changes in the anterior segment of myopic eyes and assess anterior biometry as a function of axial length (AL).


Retrospective investigational study.


Patients evaluated for phakic intraocular lens surgery at a tertiary eye care centre.


Patients with corrected visual acuity > 20/40 and AL > 24.5 mm were included in the study. Posterior staphyloma and maculopathy were ruled out in all the patients, and 176 eyes were included for analysis. AL was measured with partial coherence interferometry, while keratometry, central corneal thickness (CCT), anterior chamber depth (ACD), and horizontal white to white (WTW) were measured with slit-scanning topography. Group 1 included 55 eyes with AL < 26.5 mm, group 2 had 57 eyes with AL between 26.5 and 28.5 mm while group 3 had 64 eyes with AL > 28.5 mm.

Main outcome measure

Correlation of AL with anterior biometry.


The mean AL of the study eyes was 27.88 + 2.14 mm. The mean values of ACD (2.99 mm), CCT (0.52 mm), WTW (11.68 mm), and keratometry (43.62 D) were within the normal range. Overall, very weak correlations could be established between AL and CCT (R = 0.17, p = 0.02), AL and keratometry (R = − 0.28, p < 0.001), and AL and WTW (R = 0.22, p = 0.002), while ACD did not relate to AL significantly. The ACD and CCT did not relate significantly to AL in any of the three groups. Keratometry had a weak negative relation with AL in groups 1 and 2, while WTW had a weakly positive relation with AL in group 2 only. No variable had any significant relation with AL in group 3.


There is disproportionate elongation of the eyeball in myopic patients with very weak or no correlation between anterior biometry and AL. This discord is more in longer eyes. Such a scenario can be challenging to a refractive surgeon treating highly myopic eyes and needs further evaluation.


Myopia Refractive surgery High myopia Posterior elongation of eye 


Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (All India institute of Medical Sciences, New Delhi) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Sudarshan Khokhar
    • 1
  • Brijesh Takkar
    • 1
  • Esha Agarwal
    • 1
  • Nripen Gaur
    • 1
  • Raghav Ravani
    • 1
  • Pradeep Venkatesh
    • 1
  1. 1.Retina and Uvea Services, Dr R P Centre for Ophthalmic SciencesAll India Institute of Medical SciencesNew DelhiIndia

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