Association of ocular biometrics with clinical severity in acute angle-closure glaucoma with cataract: a...

To determine the correlation between axial length (AL), anterior chamber depth (ACD), and lens thickness (LT) with clinical severity in patients with acute angle-closure glaucoma (AACG) complicated with cataracts.

This retrospective study analyzed the clinical data of 247 consecutive patients (247 eyes) diagnosed with AACG complicated with cataracts. Ocular biomechanical parameters (AL, ACD, LT) were measured using IOL Master. Recorded clinical characteristics included peak intraocular pressure (IOP), best corrected visual acuity (BCVA, LogMAR), angle closure extent (quadrant number), and corneal edema grade. Statistical analysis was performed using Pearson correlation analysis and multiple linear regression.

The mean AL, ACD, and LT were 22.11±0.24 mm, 1.90±0.07 mm, and 5.08±0.17 mm, respectively. Pearson correlation analysis showed that ACD was strongly negatively correlated with peak IOP, BCVA (LogMAR), angle closure extent, and corneal edema grade (all P<0.001); LT was significantly positively correlated with all the above clinical indicators (all P<0.001); while AL showed a weaker negative correlation with the above indicators (all P<0.01). Multivariate regression identified ACD (β=-3.042, P<0.001) and LT (β=0.732, P<0.001) as independent predictors of peak IOP. Peak IOP, ACD, LT, and female gender were all independent influencing factors for BCVA (all P<0.05).

In patients with AACG and cataract, shallow anterior chamber and thickened lens are important independent anatomical determinants of more severe clinical presentation. These findings support the use of ACD and LT as key biomarkers for risk assessment and individualized treatment planning.