Comparative analysis of biometry and anterior chamber metrics in the eyes of extreme hyperopic and emmetropic children

Purpose: To investigate the clinical and biometric features of pediatric eyes with extreme hyperopia and report baseline biometric values. Methods: In this prospective case-control study, the biometric parameters of eyes in children with extreme hyperopia were compared to those of an emmetropic cohort of similar age. Comprehensive eye examinations were conducted for new patients. Anterior OCT (CASIA-2, Tomey) and ocular biometry imaging (IOL Master 700, Zeiss) were performed for all participants. Results: A total of 19 children (mean age, 12.3 ± 2.3 years) with extreme hyperopia (+8.84 ± 0.77) were compared with 17 emmetropic (+0.53 ± 0.43) controls of similar age (mean age, 12.4 ± 2.2 years [P = 0.864]). Extreme hyperopic eyes exhibited significantly shorter axial length, normal spherical equivalent corneal keratometry, higher astigmatism, lower anterior chamber area and volume, and narrower iridotrabecular angle optical coherence tomography (OCT) parameters. Lens thickness and curvature were similar, with a slightly anterior and tilted position. Conclusions: In our study cohort, extreme hyperopia was associated with shorter axial length, reduction in anterior chamber size, with well-formed, regular-sized lens positioned anteriorly, and a narrower iridotrabecular angle.