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Angle Kappa in Patients with Cataracts and High Myopia
Ao Miao1,2,3,4, Dongjin Qian1,2,3, Jiajia Huang1
1Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200030, China.
Ophthalmology and Therapy
|February 9, 2026
Summary
High myopia (axial length ≥ 26 mm) and axial length ≥ 30 mm are risk factors for a large angle kappa distance. In high myopic eyes, angle kappa is most often found in the temporal-superior quadrant.
Area of Science:
- Ophthalmology
- Optometry
- Biomedical Optics
Background:
- Angle kappa, the misalignment between the visual and pupillary axes, is crucial in ophthalmic assessments.
- High myopia (axial length ≥ 26 mm) and age-related cataracts are common conditions affecting visual function.
- Understanding angle kappa distribution in high myopia is essential for accurate optical correction and surgical planning.
Purpose of the Study:
- To investigate the magnitude and quadrantal distribution of angle kappa in patients with cataracts and high myopia.
- To identify risk factors associated with a large angle kappa distance (≥ 0.5 mm) in this population.
Main Methods:
- A total of 2485 patients with cataracts and high myopia and 354 patients with cataracts without high myopia were included.
- Angle kappa location and value were measured using an Oculus Pentacam HR.
- Multivariable linear regression analysis was employed to identify associated factors.
Main Results:
- Longer axial length (≥ 30 mm), narrower white-to-white distance, lower keratometry, higher corneal astigmatism, and older age were significantly associated with larger angle kappa distance in high myopic eyes.
- An axial length of 30 mm was identified as a cutoff point for a large angle kappa distance (AUC = 0.64).
- In high myopic eyes, the most common angle kappa locations were temporal-superior (40%) and temporal-inferior (26%). In non-high myopic eyes, nasal-superior (31%) and nasal-inferior (31%) were most frequent.
Conclusions:
- An axial length of 30 mm or greater is a significant risk factor for a large angle kappa distance.
- The temporal-superior quadrant is the predominant location for angle kappa in high myopic eyes.
- These findings have implications for refractive surgery and optical device design in patients with high myopia and cataracts.
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