Ocular biometric parameters in patients with lens dislocation: a case-control study

Lens dislocation, whether traumatic or idiopathic, is a sight-threatening condition with diagnostic challenges due to subtle early manifestations. Current biometric data on anterior segment alterations are insufficient, and the influence of different etiologies remains poorly understood. This study aimed to systematically compare ocular biometric parameters between patients with lens dislocation (including both subtypes) and non-dislocation cataract controls to explore potential biometric associations. This was a single-center, retrospective case-control study. The study recruited 58 patients with lens dislocation (63 eyes) and 112 cataract patients without lens dislocation as the control group. The lens dislocation group was subdivided into idiopathic lens dislocation (ILD) and traumatic lens dislocation (TLD); all lens dislocation (ALD) included both ILD and TLD. All participants underwent ocular examinations using the IOL Master 700 and Pentacam HR. Compared with controls, ILD had significantly longer axial length after adjustment, whereas ALD did not remain significant and TLD did not differ significantly. TLD and ALD had significantly flatter corneal curvature than controls after adjustment, whereas ILD did not. Corneal asymmetry was increased in a parameter- and subgroup-specific manner: TLD showed greater vertical anterior corneal curvature asymmetry; ALD showed greater horizontal anterior corneal curvature and Total Corneal Refractive Power asymmetry; and TLD, ILD, and ALD showed greater horizontal corneal thickness asymmetry. The ACD/WTW ratio was significantly lower in TLD and ALD than in controls. Spherical aberration was significantly lower only in ILD after adjustment, while TLD and ALD showed non-significant reductions. Higher-order aberrations tended to be higher but without statistical significance. Some biometric parameters, particularly horizontal corneal thickness asymmetry, were also altered in contralateral fellow eyes, suggesting potential bilateral susceptibility. These findings suggest that patients with lens dislocation may have distinct anterior segment and corneal biometric features in specific subgroups, including longer axial length in ILD, flatter corneal curvature in TLD and ALD, greater corneal asymmetry, especially horizontal corneal thickness asymmetry, and a lower ACD/WTW ratio in TLD and ALD. Similar trends in some biometric parameters in fellow eyes suggest possible bilateral structural involvement, but these findings should be considered exploratory. Chinese Clinical Trial Registry (ChiCTR), ChiCTR2600130426; retrospectively registered on August 19, 2026.