Comparison of predicted and measured axial length for ophthalmic lens design

Ocular parameters have been applied to ophthalmic lens designs in order to satisfy individual wearers. An axial length (AL) of them can be used in individual ophthalmic lens designs. Our aim was to propose a reliable formula that predicts an individual’s AL using the corneal radius and refractive error, and to demonstrate the applicability of this formula. A total of 348 subjects underwent keratometry, objective and subjective refraction, and AL measurement. The formula of calculated AL for prediction obtained from the original Gullstrand simplified schematic eye: calculated AL = (24.00 × aveK/7.80)—(SE × 0.40), where aveK and SE denote average corneal radius and spherical equivalent, respectively. Calculated AL was 24.50 ± 1.83 mm, which was 0.18 ± 0.47 mm longer than the measured value of 24.32 ± 1.73 mm (p < 0.001). The proportion showing the differences between the calculated and measured ALs were 284 eyes (40.8%) for 0.00–0.25 mm, 525 eyes (75.4%) for less than 0.50 mm, 665 eyes (95.5%) for less than 1.00 mm, and 31 eyes (4.5%) for more than 1.01 mm. Correlation coefficient showed a very high correlation between calculated and measured ALs (r = 0.967, p < 0.001), and higher in the myopic than in the hyperopic group. The mean difference was 0.18 mm; the 95% limit of agreement was +1.10—-0.75 mm in all groups. Agreement was better in hyperopic eyes than myopic eyes. Prediction from calculation of AL with a formula using the corneal radius and SE provides an alternative method to direct measurements of AL, especially in the restricted environment, which can’t use biometric equipment for personalized ophthalmic lens design.