BMJ Open Ophthalmol. 2026 Aug 20;11(3):e002819. doi: 10.1136/bmjophth-2026-002819.

ABSTRACT

OBJECTIVE: To evaluate the estimated lens diameter (eLD) of the crystalline lens in a large European cohort.

METHODS AND ANALYSIS: Data sets from an Austrian population acquired between 2020 and 2022 were analysed in this study. Measurements included optical biometry (IOLMaster 700, Carl Zeiss Meditec AG, Germany) as well as anterior segment optical coherence tomography (CASIA2, Tomey, Japan). For eLD prediction, three different machine learning approaches were implemented.

RESULTS: In total, 2352 eyes of 2352 patients were included in this study. The eLD was normally distributed with a mean value of 10.18±0.56 mm, showing a statistically significant difference (p=0.008) between females and males (10.16±0.54 mm and 10.22±0.57 mm, respectively). There was a low but significant correlation (p<0.01 for all) with age (r=0.246), lens thickness (r=0.265), white-to-white (r=0.122), corneal radii (r=0.090), axial eye length (r=0.092), anterior chamber depth (r=-0.060), decentration (r=-0.087) and tilt (r=-0.159), respectively. Subanalysis of short and long eyes yielded no significant difference in eLD. For eLD prediction, age and lens thickness appeared to be relevant parameters, with all three models demonstrating low predictive accuracy.

CONCLUSION: The crystalline lens diameter followed a normal distribution with no significant differences between short and long eyes. All three models demonstrated low predictive accuracies, suggesting that reliable prediction of eLD is currently not attainable.

PMID:42624621 | DOI:10.1136/bmjophth-2026-002819