A Prediction Model For Sulcus-To-Sulcus Diameter In Myopic Eyes: A 1466-Sample Retrospective Study

A Prediction Model For Sulcus-To-Sulcus Diameter In Myopic Eyes: A 1466-Sample Retrospective Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Prediction Model For Sulcus-To-Sulcus Diameter In Myopic Eyes: A 1466-Sample Retrospective Study Qiu-Jian zhu, Wei-Jian Zhu, Wen-Jing Chen, Lie Ma, You Yuan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1368138/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background: To establish and verify the accuracy and reliability of a sulcus-to-sulcus diameter (STS) prediction model. Methods: In this retrospective study, the prediction formula was established with the data from 1466 eyes from 733 subjects from July 2020 to April 2021 and verified with the data from 278 eyes from 139 subjects between May 2021 and June 2021. Each subject was measured with a Pentacam, IOLMaster 700, OPD-Scan III, and ultrasound biomicroscope. The prediction formulas were established with multiple linear regression, and intergroup correlation coefficients (ICCs) and Bland–Altman tests were used to assess the agreement between the predicted and actual STS. Results: The explanatory variables relevant to the horizontal STS (STSH) were the Pentacam white-to-white diameter (WTWP; standardized partial regression coefficient [β] = 0.330; p < 0.001), the flat K value (β = -0.211; p < 0.001), and the anterior corneal diameter (ACD) (β = 0.178; p < 0.001). The corresponding multiple regression equation was : STSH (mm) = 8.061 + 0.510 × WTWP - 0.090 × Flat K value + 0.430 × ACD. The explanatory variables relevant to the vertical STS (STSV) were the WTWP (β = 0.435; p < 0.001), the steep K value (β = -0.271; p < 0.001), and the ACD (β = 0.187; p < 0.001). The corresponding multiple regression equation was : STSV (mm) = 8.540 + 0.492 × WTWP - 0.075 × Steep K value + 0.329 × ACD. The bias of the predicted to the actual STSH was -0.021, with 95% limits of agreement (95% LoA) from -0.499 to 0.457. The bias of the predicted to the actual STSV was 0.057, with 95% LoA from -0.462 to 0.575. The ICC was 0.883 between the predicted and actual STSH and 0.859 between the predicted and actual STSV. Conclusions: The Pentacam-measured WTW, the K value and the ACD are important for predicting the STS diameter. The prediction model has good accuracy and reliability. Trial registration: Not applicable WTW STS prediction model Bland–Altman test Figures Figure 1 Figure 2 Background By 2050, 4758 million people worldwide will be expected to develop myopia and 938 million people will have high myopia [ 1 ]. The implantable collamer lens (ICL; Staar Surgical, Monrovia, California, USA) is a safe and effective option for correcting myopia [ 2 – 5 ]; with no corneal excision and few high-order aberrations, it is often the first choice for surgically correcting high myopia [ 6 , 7 ]. The vault refers to the distance from the posterior surface of the intraocular lens to the anterior surface of the crystalline lens and is an important indicator for evaluating safety after ICL implantation [ 8 ]. Many postoperative complications are associated with vault anomalies; a high vault can cause acute angle-closure glaucoma, pigment spread syndrome and iris atrophy, while a low vault can cause subcapsular cataract [ 9 – 14 ]. The improper selection of ICL size is the main cause of postoperative vault abnormalities [ 15 ]. Conventionally, the ICL size is chosen based on the white-to-white diameter (WTW) and anterior chamber depth (ACD), which is also recommended by the STAAR company. However, the accuracy of this strategy is not entirely satisfactory [ 16 ]. Nakamura et al. [ 17 ] found that only 69% of patients achieved an ideal vault using STAAR’s recommended approach. Since the haptics of the ICL are located in the ciliary sulcus, the sulcus-to-sulcus diameter (STS) is used to choose the ICL size that produces the better effect [ 18 ]. Kojima et al. [ 19 ] chose the ICL size based on the STS diameter, and subsequently, 88.9% of the implant recipients had a vault measuring between 0.15-1 mm. However, measurement of the STS requires the use of ultrasound biomicroscopy, an invasive test that requires very high operational skill [ 16 ]. Therefore, in this study, conventional noninvasive examination results were used to establish a prediction formula for the STS, whose accuracy was then further verified in the hope of providing additional references for surgeons for selecting the size of the ICL. Methods Study population This retrospective study was conducted in Lixiang Eye Hospital of Soochow University, Suzhou, China. The study was approved by the Ethics Committee of Lixiang Eye Hospital of Soochow University and adhered to the tenets of the Declaration of Helsinki. All subjects were examined preoperatively for ICL implantation; 1466 eyes from 733 subjects from July 2020 to April 2021 were recruited for the establishment of a prediction formula, and 278 eyes from 139 subjects between May 2021 and June 2021 were further selected for verification of the prediction formula. No further inclusion or exclusion criteria were applied to the study cohort. Measurements All subjects underwent a complete preoperative examination, which included standard comprehensive optometry, slit-lamp microscopy, and tonometry (noncontact tonometer; NT-530, Nidek Co., Ltd., Aichi, Japan). The spherical equivalent (SE) was calculated as the original spherical power plus half of the cylindrical power. A Scheimpflug camera (Pentacam, Oculus, Germany) was used to measure the flat K, steep K, mean K, and ACD values. The crystalline lens thickness (LT) and axial length (AL) were measured using a swept-source optical coherence tomography–based biometer (IOLMaster 700, Carl Zeiss Meditec AG, Jena, Germany). The horizontal WTW distance measurements were performed with three devices: the Pentacam (WTWP), the IOLMaster 700 (WTWI) and an OPD-Scan III (Nidek Technologies, Gamagori, Japan) (WTWO). The STS was obtained by an ultrasound biomicroscope (UBM; SW-3200L; SUOER, Tianjin, China) equipped with a 50-MHz transducer. We measured the STS horizontally and vertically (STSH and STSV) for each eye. Each examination was performed by the same experienced technician or physician. Establishment of a prediction formula for the STSH and STSV Multiple linear regression was used to analyse the relationship between other factors and the STS values (STSH and STSV) and to establish the corresponding prediction formulas. The stepwise method was used to select relevant independent variables and exclude confounding parameters, with input criteria less than 0.025 and output criteria greater than 0.1. Assessment of the prediction formula A total of 278 eyes was used to validate the prediction formula. The intergroup correlation coefficient (ICC) and Bland–Altman test were used to assess the agreement between the predicted and actual STS values. The cumulative percentages of eyes that had a prediction error from the targeted STS values were calculated. Statistical analysis SPSS 19.0 (IBM Corp., New York, NY, USA) was used to perform the data analysis, and the Kolmogorov–Smirnov test was performed for all measurement data. Normally distributed data are expressed as the means ± standard deviation (SD); nonnormally distributed data are expressed as medians and quartiles. Pearson’s correlation test was used to analyse the relationship between the STS diameters and other ocular parameters. All tests were 2-tailed, and P values < 0.05 were considered statistically significant. Results There were 1466 eyes in the model establishment group and 278 eyes in the model validation group. The baseline data of the two groups in this study are summarized in Table 1 . Table 1 Baseline characteristics of the study participants, Mean ± SD (Range). Characteristics 1466 eyes for establishment 278 eyes for validation Age, years 27.82 ± 6.55 (17 to 49) 27.50 to 6.93 (17 to 49) Sex (male/female) 507/959 96/182 Refractive error (D) Spherical -7.35 ± 3.01 (-24.50 to 2.50) -7.46 ± 2.43 (-16.00 to 1.75) Cylindrical -1.14 ± 0.96 (-7 to 0) -1.34 ± 1.08 (-6.5 to 0) Spherical equivalent -7.92 ± 3.01 (-25.75 to 1.25) -8.13 ± 2.46 (-17 to -1.5) Keratometric value (D) Flat K 42.91 ± 1.39 (36.9 to 50.0) 42.97 ± 1.53 (39.5 to 46.7) Steep K 44.33 ± 1.55 (37.8 to 54.4) 44.58 ± 1.73 (40.6 to 49.9) Mean K 43.62 ± 1.42 (37.35 to 52.2) 43.78 ± 1.58 (40.1 to 48.3) STS (mm) Vertical 11.96 ± 0.43 (10.61 to 13.65) 11.92 ± 0.43 (10.51 to 13.01) Horizontal 11.49 ± 0.59 (10.14 to 12.98) 11.53 ± 0.41 (10.23 to 12.66) IOP (mmHg) 13.30 ± 2.59 (6.0 to 22.3) 13.46 ± 2.85 (9.0 to 20.3) AL (mm) 26.76 ± 1.56 (22.56 to 34.30) 26.70 ± 1.35 (23.52 to 31.32) ACD (mm) 3.21 ± 0.24 (2.44 to 3.90) 3.22 ± 0.25 (2.72 to 4.03) WTW (mm) Pentacam 11.59 ± 0.38 (10.4 to 12.9) 11.62 ± 0.36 (10.5 to 12.7) OPD-Scan III 11.81 ± 0.74 (10.58 to 13.19) 11.88 ± 0.41 (10.60 to 13.13) IOLMaster 700 11.99 ± 0.39 (10.8 to 14.7) 12.04 ± 0.38 (10.9 to 13.00) Crystalline LT (mm) 3.70 ± 0.25 (3.09 to 4.87) 3.67 ± 0.27 (3.04 to 4.45) STS = sulcus-to-sulcus diameter; WTW = white-to-white diameter; IOP = intraocular pressure; AL = axial length; ACD = anterior chamber depth; LT = lens thickness Table 2 shows the Pearson correlation analysis results. The STSH was correlated with age, astigmatism, the flat K, steep K and mean K values, AL, ACD, crystalline LT and three WTW values, while the STSV was correlated with age, the flat K, steep K and mean K values, IOP, AL, ACD, crystalline LT and three WTW values. Table 2 Pearson correction analyse between the STSH and STSV and other parameters. STSH (mm) STSV (mm) r P r P Age, years -0.067 0.011 -0.126 < 0.001 Refractive errors (D) Spherical 0.016 0.549 0.027 0.306 Cylindrical -0.069 0.008 0.029 0.264 Spherical equivalent 0.001 0.963 0.028 0.280 Keratometric value (D) Flat K -0.379 < 0.001 -0.452 < 0.001 Steep K -0.314 < 0.001 -0.444 < 0.001 Mean K -0.358 < 0.001 -0.465 < 0.001 IOP (mmHg) -0.043 0.102 -0.089 0.001 AL (mm) 0.231 < 0.001 0.273 < 0.001 ACD (mm) 0.359 < 0.001 0.418 < 0.001 WTW (mm) Pentacam 0.523 < 0.001 0.633 < 0.001 OPD-Scan III 0.291 < 0.001 0.355 < 0.001 IOLMaster 700 0.492 < 0.001 0.578 < 0.001 Crystalline LT (mm) -0.070 0.008 -0.053 0.043 STS = sulcus-to-sulcus diameter; WTW = white-to-white diameter; IOP = intraocular pressure; AL = axial length; ACD = anterior chamber depth; LT = lens thickness Table 3 shows the results of the stepwise multivariate regression analysis. The explanatory variables relevant to the STSH were the Pentacam WTW (WTWP) (standardized partial regression coefficient [β] = 0.330; p < 0.001), the flat K value (β = -0.211; p < 0.001), and ACD (β = 0.178; p < 0.001). The multiple regression equation for the STSH was expressed as follows: STSH (mm) = 8.061 + 0.510 × WTWP − 0.090 × Flat K value + 0.430 × ACD. The R, R 2 and adjusted R 2 values of the model were 0.563, 0.317 and 0.316, respectively. The explanatory variables relevant to the STSV were the WTWP (standardized partial regression coefficient [β] = 0.435; p < 0.001), the steep K value (β = -0.271; p < 0.001), and the ACD (β = 0.187; p < 0.001). The multiple regression equation for the STSV was expressed as follows: STSV (mm) = 8.540 + 0.492 × WTWP − 0.075 × Steep K value + 0.329 × ACD. The R, R 2 and adjusted R 2 values of the model were 0.688, 0.474 and 0.473, respectively. Table 3 Stepwise multivariate regression analysis of STSH and STSV. STSH (mm) STSV (mm) (constant = 8.061; R = 0.563; R 2 = 0.317; adjusted R 2 = 0.316) (constant = 8.540; R = 0.688; R 2 = 0.474; adjusted R 2 = 0.473) Partial regression coefficient (B) Standardized partial regression coefficient (β) P value Partial regression coefficient (B) Standardized partial regression coefficient (β) P value Age, years Refractive errors (D) Spherical Cylindrical Spherical equivalent Keratometric value (D) Flat K -0.090 -0.211 < 0.001 Steep K -0.075 -0.271 < 0.001 Mean K IOP (mmHg) AL (mm) ACD (mm) 0.430 0.178 < 0.001 0.329 0.187 < 0.001 WTW (mm) Pentacam 0.510 0.330 < 0.001 0.492 0.435 < 0.001 OPD-Scan III IOLMaster 700 Crystalline LT (mm) STS = sulcus-to-sulcus diameter; WTW = white-to-white diameter; IOP = intraocular pressure; AL = axial length; ACD = anterior chamber depth; LT = lens thickness Figure 1 shows the Bland–Altman plot of the predicted and actual STS values. The bias of the predicted versus the actual STSH was -0.021, with 95% limits of agreement (95% LoA) from -0.499 to 0.457, and the standard deviation (SD) of the bias was 0.244. The bias of the predicted versus the actual STSV was 0.057, with 95% LoA from -0.462 to 0.575, and the SD of the bias was 0.265. Figure 2 shows the cumulative probability distribution of the prediction error. For the STSH, 72.7% of eyes were within 0.2 mm, and 92.1% of eyes were within 0.4 mm. For the STSV, 66.5% of eyes were within 0.2 mm, and 87.4% of eyes were within 0.4 mm. The ICC between the predicted and actual STSH was 0.883 (95% CI: 0.852, 0.907), while that between the predicted and actual STSV was 0.859 (95% CI: 0.821, 0.888). Discussion Since the ICL is implanted into the ciliary sulcus, measurement of STS is very important for predicting the subsequent vault. To date, UBMs remain the only device that can directly detect the morphology of the ciliary sulcus and measure the STS. However, the required measurements are time consuming and require considerable skill and experience, and the test is invasive, causing considerable discomfort to the patient. Therefore, our study established a prediction formula for the STS by retrospectively analysing certain noninvasive test results for a large sample size. The accuracy and reliability of the prediction formula were verified in a subsequent study. The large sample size improved the validity of the statistical analysis and made this study highly reliable. According to previous studies, the human ciliary sulcus is vertically elliptical, and the vertical STS tends to be larger than the horizontal STS [ 20 , 21 ]. According to our previous study, the vertical STS affects the vault after ICL implantation independent of the horizontal STS [ 22 ]. Therefore, in this study, separate prediction formulas were established for the horizontal and vertical STS. According to the results of correlation and multivariate analyses, the WTWP, flat K value and ACD were the influencing factors of the STSH, producing the following regression formula: STSH (mm) = 8.061 + 0.510 × WTWP − 0.090 × flat K value + 0.430 × ACD. Furthermore, the WTWP, steep K value and ACD were the influencing factors of the STSV, producing the following regression formula: STSV (mm) = 8.540 + 0.492 × WTWP − 0.075 × Steep K value + 0.329 × ACD. This is very interesting. The most suitable instrument for measuring the WTW for selecting the size of the ICL has been a consistent point of argument in the literature, as different instruments produce significantly different WTW measurements, which thus are not completely interchangeable [ 23 – 25 ]. In this study, three pieces of equipment with different principles for conducting anterior segmental analysis used to measure the WTW. The Pentacam is a Scheimpflug camera that rotates around the optical axis of the eye to create a three-dimensional model of the anterior segment. The WTW is automatically measured from photographs of the anterior surface of the eye with a resolution of 0.1 mm [ 25 ]. The IOLMaster 700 is an SS-OCT-based biometer, and the limbus is used for WTW measurement via automatic detection by a digital greyscale photograph of the anterior eye segment [ 26 ]. The OPD Scan III is capable of automatically detecting the limbus by comparing greyscale steps of slit-scanning images and calculates the horizontal corneal diameter [ 27 ]. According to the results of this study, the WTWP had the highest correlation with the STS in both the horizontal and vertical directions (Pearson’s correlation coefficient 0.532 vs. 0.492, 0.291 and 0.633 vs. 0.578, 0.355, respectively). Moreover, only the WTWP entered the final results of the stepwise multiple linear regression. Therefore, we believe that compared with the other two WTW measurements, the WTWP can better predict the STS and is more suitable for ICL size selection. Furthermore, the WTWP was the most influential factor for both the STSH and STSV (standardized partial regression coefficient [β] = 0.330; p < 0.001 and β] = 0.435; p < 0.001). The WTW and STS both describe the size of the anterior segment, so the correlation between the two is unsurprising. However, most scholars believe that there is obvious bias between the WTW and STS. In Guber et al.'s [ 28 ] study, the horizontal WTW measures obtained using the Pentacam device were significantly larger than the STS measures (bias = 0.91 mm, P < 0.01). Chen et al. [ 29 ] reported that the mean difference between the STS and WTW was − 0.02 +/- 0.33 (-1.36 to 1.11) mm. Hashemian et al. [ 30 ] also suggested that there was a correlation between the WTW and STS but found a significant difference in their measurements that could diminish after adjustment. The K value is the second influencing factor of the STS. Ghoreishi et al. [ 31 ] obtained a similar result in their study and established their own predicted model: STS = 9.549 + 0.518 WTW − 0.083 mean K. However, the sample size of their study was small (58 eyes), and there was no follow-up verification. In this study, the flat K values were used to predict the horizontal STS, and the steep K values were used to predict the vertical STS. We hypothesized that this might be because most of the subjects in this study were relatively young, and astigmatism with the rule was common, while a flat K value often represents a horizontal corneal state, and a steep K value represents the corneal status in the vertical direction. In this study, the ACD was positively correlated with and was an important parameter for predicting both the horizontal and vertical sulcus-to-sulcus diameters. A study by Kawamorita et al. [ 32 ] showed that the ACD and STS had extremely high agreement, with an intergroup correlation coefficient of 0.918. Additionally, Gao et al. [ 33 ] found that the ACD was very important for describing the difference between the WTW and STS. In their research, the WTW and ciliary sulcus diameter were 11.46 ± 0.38 and 11.57 ± 0.32 mm in the shallow anterior chamber group, 11.58 ± 0.31 and 11.77 ± 0.26 mm in the medium anterior chamber group, and 11.68 ± 0.22 and 11.91 ± 0.23 mm in the deep anterior chamber group, respectively, and they concluded that the difference between the two diameters increased with greater anterior chamber depth. In addition, another of their studies showed similar results [ 34 ]. Chen et al. [ 29 ] also suggested that as the anterior chamber depth increased, the difference between the STS and WTW increased. These results are consistent with our findings. The Bland–Altman test results showed that the consistency of our prediction formula was satisfactory. The bias between the predicted and actual value was 0.021 for the STSH and 0.057 for the STSV. In addition, 85.6% and 79.5% of subjects, respectively, had deviations within 0.3 mm, and 92.1% and 87.4% of subjects had deviations within 0.4 mm. Hashemian et al. [ 30 ] published an adjustment formula to improve the correlation of the WTW with the ciliary sulcus diameter. After adjustment, the SD of the STS-Caliper WTW was 0.28 mm, and the 95% LoA ranged from − 0.56 to 0.54, while the SD of the STS-Orbscan WTW was 0.31 mm, and the 95% LoA ranged from − 0.61 to 0.61. In contrast, the SD of the actual STSH-predicted STSH bias in this study was 0.24 mm, and the 95% LoA ranged from − 0.499 to 0.457. In addition, the ICCs of their study were 0.775 and 0.700, whereas ours was 0.883, which showed that our prediction model had better reliability. Moreover, the sample size of Hashemian’s study was small, and they performed validation with previous data, while ours was based on a new cohort of subjects, improving the reliability of our results. There are certain limitations in this study. First, although this study was the largest sample-size STS prediction study to date, all the people included in this study were of Han ethnicity. Whether the conclusions of this study can be applied to other ethnic groups requires further verification. Second, examination with the UBM requires highly technical expertise and experience. All the UBM examinations in this study were completed by the same experienced technician with superb skills, and whether different operators would obtain different results requires further study. Third, the findings of this study have not been introduced into clinical application. Whether this model can be helpful in ICL size selection will be the subject of a follow-up study. In conclusion, the WTW measured by the Pentacam, the K values and the ACD are three important parameters for predicting the STS. The prediction model has good accuracy and reliability. List of abbreviations STS: sulcus-to-sulcus diameter; WTW: white-to-white diameter; IOP: intraocular pressure; AL: axial length; ACD: anterior chamber depth; LT: lens thickness; WTWP: white-to-white diameter measured by the Pentacam; WTWI: white-to-white diameter measured by the IOLMaster 700; WTWO: white-to-white diameter measured by the OPD-Scan III; STSH: horizontal sulcus-to-sulcus diameter; STSV: vertical sulcus-to-sulcus diameter. Declarations Ethics approval and consent to participate The study was approved by the Ethics Committee of Lixiang Eye Hospital of Soochow University and adhered to the tenets of the Declaration of Helsinki. Informed consent was obtained from all subjects. Consent for publication Not applicable. Availability of data and materials We have already uploaded the data in the current study as supplementary material. If someone wishes to request the data from this study, please contact You Yuan (Corresponding author) Competing interests The authors declare that they have no competing interests. Funding No funding Authors’ contributions QJZ analysed and interpreted the patient data and wrote the paper. WJC and WJZ collected the data and conducted the examinations. LM checked and revised the paper. YY designed the study. All authors have read and approved the manuscript. Acknowledgements We thank Dr. Chen Qing and Dr. Yu Peng for their help in data collection. Authors' information Qiujian Zhu, the doctor of Lixiang Eye Hospital of Soochow University. The main directions are refractive surgery and cataract surgery. References Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123:1036–42. Niu L, Miao H, Han T, Ding L, Wang X, Zhou X. Visual outcomes of Visian ICL implantation for high myopia in patients with shallow anterior chamber depth. BMC Ophthalmol. 2019;19:121. Nakamura T, Isogai N, Kojima T, Yoshida Y, Sugiyama Y. Posterior chamber phakic intraocular lens implantation for the correction of myopia and myopic astigmatism: a retrospective 10-year follow-up study. Am J Ophthalmol. 2019;206:1–10. Alfonso JF, Fernandez-Vega-Cueto L, Alfonso-Bartolozzi B, Montes-Mico R, Fernandez-Vega L. Five-year follow-up of correction of myopia: posterior chamber phakic intraocular lens with a central port design. J Refract Surg. 2019;35:169–76. Vasavada V, Srivastava S, Vasavada SA, Sudhalkar A, Vasavada AR, Vasavada VA. Safety and efficacy of a new phakic posterior chamber iol for correction of myopia: 3 years of follow-up. J Refract Surg. 2018;34:817–23. Eissa S, Eldin NB. ICL versus SMILE in management of anisometropic myopic amblyopia in children. Can J Ophthalmol. 2018;53:560–67. Niu L, Miao H, Tian M, Fu D, Wang X, Zhou X. One-year visual outcomes and optical quality of femtosecond laser small incision lenticule extraction and Visian Implantable Collamer Lens (ICL V4c) implantation for high myopia. Acta Ophthalmol. 2020;98:e662-7. Chen X, Miao H, Naidu RK, Wang X, Zhou X. Comparison of early changes in and factors affecting vault following posterior chamber phakic implantable collamer lens implantation without and with a central hole (ICL V4 and ICL V4c). BMC Ophthalmol. 2016;16:161. Chun YS, Park IK, Lee HI, Lee JH, Kim JC. Iris and trabecular meshwork pigment changes after posterior chamber phakic intraocular lens implantation. J Cataract Refract Surg. 2006;32:1452–8. Ye C, Patel CK, Momont AC, Liu Y. Advanced pigment dispersion glaucoma secondary to phakic intraocular collamer lens implant. Am J Ophthalmol Case Rep. 2018;10:65–7. Shipper I. Surgical management of acute angle-closure glaucoma after implantation of a toric ICL. J Cataract Refract Surg. 2007;33:563–4. Gimbel HV, LeClair BM, Jabo B, Marzouk H. Incidence of implantable collamer lens-induced cataract. Can J Ophthalmol. 2018;53:518–22. Guber I, Mouvet V, Bergin C, Perritaz S, Othenin-Girard P, Majo F. Clinical outcomes and cataract formation rates in eyes 10 years after posterior phakic lens implantation for myopia. JAMA Ophthalmol. 2016;134:487–94. Alfonso JF, Lisa C, Abdelhamid A, Fernandes P, Jorge J, Montes-Mico R. Three-year follow-up of subjective vault following myopic implantable collamer lens implantation. Graefes Arch Clin Exp Ophthalmol. 2010;248:1827–35. Trancon AS, Manito SC, Sierra OT, Baptista AM, Serra PM. Determining vault size in implantable collamer lenses: preoperative anatomy and lens parameters. J Cataract Refract Surg. 2020;46:728–36. Igarashi A, Shimizu K, Kato S, Kamiya K. Predictability of the vault after posterior chamber phakic intraocular lens implantation using anterior segment optical coherence tomography. J Cataract Refract Surg. 2019;45:1099–1104. Nakamura T, Isogai N, Kojima T, Yoshida Y, Sugiyama Y. Implantable collamer lens sizing method based on swept-source anterior segment optical coherence tomography. Am J Ophthalmol. 2018;187:99–107. Lee DH, Choi SH, Chung ES, Chung TY. Correlation between preoperative biometry and posterior chamber phakic visian implantable collamer lens vaulting. Ophthalmology. 2012;119:272–7. Kojima T, Yokoyama S, Ito M, Horai R, Hara S, Nakamura T, et al. Optimization of an implantable collamer lens sizing method using high-frequency ultrasound biomicroscopy. Am J Ophthalmol. 2012;153:632–7, 637.e1. Oh J, Shin HH, Kim JH, Kim HM, Song JS. Direct measurement of the ciliary sulcus diameter by 35-megahertz ultrasound biomicroscopy. Ophthalmology. 2007;114:1685–8. Biermann J, Bredow L, Boehringer D, Reinhard T. Evaluation of ciliary sulcus diameter using ultrasound biomicroscopy in emmetropic eyes and myopic eyes. J Cataract Refract Surg. 2011;37:1686–93. Zhu QJ, Chen WJ, Zhu WJ, Xiao HX, Zhu MH, Ma L, et al. Short-term changes in and preoperative factors affecting vaulting after posterior chamber phakic implantable collamer lens implantation. BMC Ophthalmol. 2021;21:199. Cruz S, Valenzuela F, Stoppel J, Maul E, Gibbons A. Comparison of horizontal corneal diameter measurements using orbscan IIz, OPD scan III, and IOLMaster 700. Eye Contact Lens. 2021;47:533–38. Buckenham Boyle A, Namkung S, Shew W, Gokul A, McGhee CNJ, Ziaei M. Repeatability and agreement of white-to-white measurements between slit-scanning tomography, infrared biometry, dual rotating Scheimpflug camera/Placido disc tomography, and swept source anterior segment optical coherence tomography. PLoS One. 2021;16:e0254832. Tana-Rivero P, Aguilar-Corcoles S, Rodriguez-Prats JL, Montes-Mico R, Ruiz-Mesa R. Agreement of white-to-white measurements with swept-source OCT, Scheimpflug and color LED devices. Int Ophthalmol. 2021;41:57–65. Akman A, Asena L, Gungor SG. Evaluation and comparison of the new swept source OCT-based IOLMaster 700 with the IOLMaster 500. Br J Ophthalmol. 2016;100:1201–5. Asgari S, Hashemi H, Jafarzadehpur E, Mohamadi A, Rezvan F, Fotouhi A. OPD-Scan III: a repeatability and inter-device agreement study of a multifunctional device in emmetropia, ametropia, and keratoconus. Int Ophthalmol. 2016;36:697–705. Guber I, Bergin C, Perritaz S, Majo F. Correcting interdevice bias of horizontal white-to-white and sulcus-to-sulcus measures used for implantable collamer lens sizing. Am J Ophthalmol. 2016;161:116 – 25.e1. Chen X, Han T, Zhao W, Wang X, Xu Y, Cheng M, et al. Effect of the difference between the white-to-white and sulcus-to-sulcus on vault and the related factors after ICL implantation. Ophthalmol Ther. 2021;10:947–55. Hashemian SJ, Mohebbi M, Yaseri M, Jafari ME, Nabili S, Hashemian SM, et al. Adjustment formulae to improve the correlation of white-to-white measurement with direct measurement of the ciliary sulcus diameter by ultrasound biomicroscopy. J Curr Ophthalmol. 2018;30:217–22. Ghoreishi M, Abdi-Shahshahani M, Peyman A, Pourazizi M. A model for predicting sulcus-to-sulcus diameter in posterior chamber phakic intraocular lens candidates: correlation between ocular biometric parameters. Int Ophthalmol. 2019;39:661–6. Kawamorita T, Uozato H, Kamiya K, Shimizu K. Relationship between ciliary sulcus diameter and anterior chamber diameter and corneal diameter. J Cataract Refract Surg. 2010;36:617–24. Gao J, Liao RF. Correlation between white-to-white diameter and ciliary sulcus diameter of high myopia eyes. Zhonghua Yan Ke Za Zhi. 2013;49:627–32. Gao J, Liao RF, Li N. Ciliary sulcus diameters at different anterior chamber depths in highly myopic eyes. J Cataract Refract Surg. 2013;39:1011–6. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Major revision 09 Jun, 2022 Reviews received at journal 24 May, 2022 Reviews received at journal 29 Apr, 2022 Reviewers agreed at journal 29 Apr, 2022 Reviewers agreed at journal 20 Mar, 2022 Reviewers invited by journal 09 Mar, 2022 Editor assigned by journal 04 Mar, 2022 Editor invited by journal 01 Mar, 2022 Submission checks completed at journal 01 Mar, 2022 First submitted to journal 17 Feb, 2022 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1368138","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":87511468,"identity":"9ad27f43-29a1-4c18-b4bd-eb71f7164935","order_by":0,"name":"Qiu-Jian zhu","email":"","orcid":"","institution":"Lixiang Eye Hospital of Soochow University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Qiu-Jian","middleName":"","lastName":"zhu","suffix":""},{"id":87511469,"identity":"170949bc-8827-4cd5-8be2-ca4ae10bdef6","order_by":1,"name":"Wei-Jian Zhu","email":"","orcid":"","institution":"Lixiang Eye Hospital of Soochow University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Wei-Jian","middleName":"","lastName":"Zhu","suffix":""},{"id":87511470,"identity":"446efb9b-6be1-418f-a972-9f2e537859b3","order_by":2,"name":"Wen-Jing Chen","email":"","orcid":"","institution":"Lixiang Eye Hospital of Soochow University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Wen-Jing","middleName":"","lastName":"Chen","suffix":""},{"id":87511471,"identity":"8f71d548-23ce-45ec-813b-9e8b429719e6","order_by":3,"name":"Lie Ma","email":"","orcid":"","institution":"Lixiang Eye Hospital of Soochow University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Lie","middleName":"","lastName":"Ma","suffix":""},{"id":87511472,"identity":"7532d883-bc12-4df1-aa30-a583d4d4b166","order_by":4,"name":"You Yuan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0UlEQVRIiWNgGAWjYBADOSA2AGJm4rUYk64lsYFoLQY3kp895qk4nD5/RvLGDwwV1okN7GcPENCSZm7Mc+Zw7oYbacUSDGfSExt48hIIaEkwk+ZtA2qRyDGQYGw7nNggwWNAQEv6N5CWdPkZOcY/GP8RpSUHbEsCA5AhwdhAhBbJM2/KJOecSTfccOZZmUXCsXTjNp4c/Fr4jqdvk3hTYS0v3568+caHGmvZfvYz+LUoHGBgYOKB8RKAmA2veiCQb2BgYPxBSNUoGAWjYBSMbAAAortF07vA7kMAAAAASUVORK5CYII=","orcid":"","institution":"Lixiang Eye Hospital of Soochow University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"You","middleName":"","lastName":"Yuan","suffix":""}],"badges":[],"createdAt":"2022-02-17 06:44:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1368138/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1368138/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":19085665,"identity":"019716b7-a682-448f-8ea9-70c56fb36d4c","added_by":"auto","created_at":"2022-03-10 17:45:23","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":646129,"visible":true,"origin":"","legend":"\u003cp\u003eBland–Altman test for the predicted and actual STS values. (a) shows the agreement between the predicted and actual STSH, and (b) shows the agreement between the predicted and actual STSV.\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-1368138/v1/26232525c52acdcfdf09fe9f.png"},{"id":19085850,"identity":"90102a83-80cf-4209-ab4d-c44114148091","added_by":"auto","created_at":"2022-03-10 17:48:23","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":592479,"visible":true,"origin":"","legend":"\u003cp\u003eCumulative probability distribution of the prediction error. (a) shows the cumulative probability distribution of the error between the predicted and actual STSH, and (b) shows the cumulative probability distribution of the error between the predicted and actual STSV.\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-1368138/v1/cc014f952693476effaf09b2.png"},{"id":19085851,"identity":"5385b42f-16bb-4989-b840-6560b1cd6611","added_by":"auto","created_at":"2022-03-10 17:48:26","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":323183,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1368138/v1/229fc71e-0c28-42a6-ae3f-3803c77615c7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eA Prediction Model For Sulcus-To-Sulcus Diameter In Myopic Eyes: A 1466-Sample Retrospective Study\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eBy 2050, 4758\u0026nbsp;million people worldwide will be expected to develop myopia and 938\u0026nbsp;million people will have high myopia [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The implantable collamer lens (ICL; Staar Surgical, Monrovia, California, USA) is a safe and effective option for correcting myopia [\u003cspan additionalcitationids=\"CR3 CR4\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]; with no corneal excision and few high-order aberrations, it is often the first choice for surgically correcting high myopia [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The vault refers to the distance from the posterior surface of the intraocular lens to the anterior surface of the crystalline lens and is an important indicator for evaluating safety after ICL implantation [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Many postoperative complications are associated with vault anomalies; a high vault can cause acute angle-closure glaucoma, pigment spread syndrome and iris atrophy, while a low vault can cause subcapsular cataract [\u003cspan additionalcitationids=\"CR10 CR11 CR12 CR13\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe improper selection of ICL size is the main cause of postoperative vault abnormalities [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Conventionally, the ICL size is chosen based on the white-to-white diameter (WTW) and anterior chamber depth (ACD), which is also recommended by the STAAR company. However, the accuracy of this strategy is not entirely satisfactory [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Nakamura et al. [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] found that only 69% of patients achieved an ideal vault using STAAR\u0026rsquo;s recommended approach. Since the haptics of the ICL are located in the ciliary sulcus, the sulcus-to-sulcus diameter (STS) is used to choose the ICL size that produces the better effect [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Kojima et al. [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] chose the ICL size based on the STS diameter, and subsequently, 88.9% of the implant recipients had a vault measuring between 0.15-1 mm. However, measurement of the STS requires the use of ultrasound biomicroscopy, an invasive test that requires very high operational skill [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTherefore, in this study, conventional noninvasive examination results were used to establish a prediction formula for the STS, whose accuracy was then further verified in the hope of providing additional references for surgeons for selecting the size of the ICL.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy population\u003c/h2\u003e \u003cp\u003eThis retrospective study was conducted in Lixiang Eye Hospital of Soochow University, Suzhou, China. The study was approved by the Ethics Committee of Lixiang Eye Hospital of Soochow University and adhered to the tenets of the Declaration of Helsinki.\u003c/p\u003e \u003cp\u003eAll subjects were examined preoperatively for ICL implantation; 1466 eyes from 733 subjects from July 2020 to April 2021 were recruited for the establishment of a prediction formula, and 278 eyes from 139 subjects between May 2021 and June 2021 were further selected for verification of the prediction formula. No further inclusion or exclusion criteria were applied to the study cohort.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eMeasurements\u003c/h2\u003e \u003cp\u003eAll subjects underwent a complete preoperative examination, which included standard comprehensive optometry, slit-lamp microscopy, and tonometry (noncontact tonometer; NT-530, Nidek Co., Ltd., Aichi, Japan). The spherical equivalent (SE) was calculated as the original spherical power plus half of the cylindrical power. A Scheimpflug camera (Pentacam, Oculus, Germany) was used to measure the flat K, steep K, mean K, and ACD values. The crystalline lens thickness (LT) and axial length (AL) were measured using a swept-source optical coherence tomography\u0026ndash;based biometer (IOLMaster 700, Carl Zeiss Meditec AG, Jena, Germany). The horizontal WTW distance measurements were performed with three devices: the Pentacam (WTWP), the IOLMaster 700 (WTWI) and an OPD-Scan III (Nidek Technologies, Gamagori, Japan) (WTWO). The STS was obtained by an ultrasound biomicroscope (UBM; SW-3200L; SUOER, Tianjin, China) equipped with a 50-MHz transducer. We measured the STS horizontally and vertically (STSH and STSV) for each eye. Each examination was performed by the same experienced technician or physician.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eEstablishment of a prediction formula for the STSH and STSV\u003c/h2\u003e \u003cp\u003eMultiple linear regression was used to analyse the relationship between other factors and the STS values (STSH and STSV) and to establish the corresponding prediction formulas. The stepwise method was used to select relevant independent variables and exclude confounding parameters, with input criteria less than 0.025 and output criteria greater than 0.1.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eAssessment of the prediction formula\u003c/h2\u003e \u003cp\u003eA total of 278 eyes was used to validate the prediction formula. The intergroup correlation coefficient (ICC) and Bland\u0026ndash;Altman test were used to assess the agreement between the predicted and actual STS values. The cumulative percentages of eyes that had a prediction error from the targeted STS values were calculated.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eSPSS 19.0 (IBM Corp., New York, NY, USA) was used to perform the data analysis, and the Kolmogorov\u0026ndash;Smirnov test was performed for all measurement data. Normally distributed data are expressed as the means\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD); nonnormally distributed data are expressed as medians and quartiles. Pearson\u0026rsquo;s correlation test was used to analyse the relationship between the STS diameters and other ocular parameters. All tests were 2-tailed, and P values\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThere were 1466 eyes in the model establishment group and 278 eyes in the model validation group. The baseline data of the two groups in this study are summarized in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable border=\"1\" id=\"Tab1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eBaseline characteristics of the study participants, Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (Range).\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e1466 eyes for establishment\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e278 eyes for validation\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge, years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27.82\u0026thinsp;\u0026plusmn;\u0026thinsp;6.55 (17 to 49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27.50 to 6.93 (17 to 49)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSex (male/female)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e507/959\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96/182\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRefractive error (D)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpherical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-7.35\u0026thinsp;\u0026plusmn;\u0026thinsp;3.01 (-24.50 to 2.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-7.46\u0026thinsp;\u0026plusmn;\u0026thinsp;2.43 (-16.00 to 1.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCylindrical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.96 (-7 to 0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.34\u0026thinsp;\u0026plusmn;\u0026thinsp;1.08 (-6.5 to 0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpherical equivalent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-7.92\u0026thinsp;\u0026plusmn;\u0026thinsp;3.01 (-25.75 to 1.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-8.13\u0026thinsp;\u0026plusmn;\u0026thinsp;2.46 (-17 to -1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKeratometric value (D)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFlat K\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.91\u0026thinsp;\u0026plusmn;\u0026thinsp;1.39 (36.9 to 50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.97\u0026thinsp;\u0026plusmn;\u0026thinsp;1.53 (39.5 to 46.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSteep K\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44.33\u0026thinsp;\u0026plusmn;\u0026thinsp;1.55 (37.8 to 54.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44.58\u0026thinsp;\u0026plusmn;\u0026thinsp;1.73 (40.6 to 49.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMean K\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.62\u0026thinsp;\u0026plusmn;\u0026thinsp;1.42 (37.35 to 52.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.78\u0026thinsp;\u0026plusmn;\u0026thinsp;1.58 (40.1 to 48.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSTS (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVertical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.96\u0026thinsp;\u0026plusmn;\u0026thinsp;0.43 (10.61 to 13.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.92\u0026thinsp;\u0026plusmn;\u0026thinsp;0.43 (10.51 to 13.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHorizontal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.49\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59 (10.14 to 12.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.53\u0026thinsp;\u0026plusmn;\u0026thinsp;0.41 (10.23 to 12.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIOP (mmHg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.30\u0026thinsp;\u0026plusmn;\u0026thinsp;2.59 (6.0 to 22.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.46\u0026thinsp;\u0026plusmn;\u0026thinsp;2.85 (9.0 to 20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAL (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.76\u0026thinsp;\u0026plusmn;\u0026thinsp;1.56 (22.56 to 34.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.70\u0026thinsp;\u0026plusmn;\u0026thinsp;1.35 (23.52 to 31.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eACD (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.24 (2.44 to 3.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.25 (2.72 to 4.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWTW (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePentacam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.38 (10.4 to 12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.36 (10.5 to 12.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOPD-Scan III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74 (10.58 to 13.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.41 (10.60 to 13.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIOLMaster 700\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.99\u0026thinsp;\u0026plusmn;\u0026thinsp;0.39 (10.8 to 14.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.38 (10.9 to 13.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCrystalline LT (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.70\u0026thinsp;\u0026plusmn;\u0026thinsp;0.25 (3.09 to 4.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.67\u0026thinsp;\u0026plusmn;\u0026thinsp;0.27 (3.04 to 4.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\"\u003eSTS\u0026thinsp;=\u0026thinsp;sulcus-to-sulcus diameter; WTW\u0026thinsp;=\u0026thinsp;white-to-white diameter; IOP\u0026thinsp;=\u0026thinsp;intraocular pressure; AL\u0026thinsp;=\u0026thinsp;axial length; ACD\u0026thinsp;=\u0026thinsp;anterior chamber depth; LT\u0026thinsp;=\u0026thinsp;lens thickness\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e shows the Pearson correlation analysis results. The STSH was correlated with age, astigmatism, the flat K, steep K and mean K values, AL, ACD, crystalline LT and three WTW values, while the STSV was correlated with age, the flat K, steep K and mean K values, IOP, AL, ACD, crystalline LT and three WTW values.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable border=\"1\" id=\"Tab2\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003ePearson correction analyse between the STSH and STSV and other parameters.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eSTSH (mm)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eSTSV (mm)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge, years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRefractive errors (D)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpherical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.549\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.306\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCylindrical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.069\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.264\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpherical equivalent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.280\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKeratometric value (D)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFlat K\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.379\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.452\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSteep K\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.314\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.444\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMean K\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.358\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.465\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIOP (mmHg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAL (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.273\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eACD (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.359\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.418\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWTW (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePentacam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.523\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.633\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOPD-Scan III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.291\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.355\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIOLMaster 700\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.492\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.578\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCrystalline LT (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eSTS\u0026thinsp;=\u0026thinsp;sulcus-to-sulcus diameter; WTW\u0026thinsp;=\u0026thinsp;white-to-white diameter; IOP\u0026thinsp;=\u0026thinsp;intraocular pressure; AL\u0026thinsp;=\u0026thinsp;axial length; ACD\u0026thinsp;=\u0026thinsp;anterior chamber depth; LT\u0026thinsp;=\u0026thinsp;lens thickness\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e shows the results of the stepwise multivariate regression analysis. The explanatory variables relevant to the STSH were the Pentacam WTW (WTWP) (standardized partial regression coefficient [\u0026beta;]\u0026thinsp;=\u0026thinsp;0.330; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), the flat K value (\u0026beta; = -0.211; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and ACD (\u0026beta;\u0026thinsp;=\u0026thinsp;0.178; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The multiple regression equation for the STSH was expressed as follows: STSH (mm)\u0026thinsp;=\u0026thinsp;8.061\u0026thinsp;+\u0026thinsp;0.510 \u0026times; WTWP \u0026minus;\u0026thinsp;0.090 \u0026times; Flat K value\u0026thinsp;+\u0026thinsp;0.430 \u0026times; ACD. The R, R\u003csup\u003e2\u003c/sup\u003e and adjusted R\u003csup\u003e2\u003c/sup\u003e values of the model were 0.563, 0.317 and 0.316, respectively. The explanatory variables relevant to the STSV were the WTWP (standardized partial regression coefficient [\u0026beta;]\u0026thinsp;=\u0026thinsp;0.435; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), the steep K value (\u0026beta; = -0.271; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and the ACD (\u0026beta;\u0026thinsp;=\u0026thinsp;0.187; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The multiple regression equation for the STSV was expressed as follows: STSV (mm)\u0026thinsp;=\u0026thinsp;8.540\u0026thinsp;+\u0026thinsp;0.492 \u0026times; WTWP \u0026minus;\u0026thinsp;0.075 \u0026times; Steep K value\u0026thinsp;+\u0026thinsp;0.329 \u0026times; ACD. The R, R\u003csup\u003e2\u003c/sup\u003e and adjusted R\u003csup\u003e2\u003c/sup\u003e values of the model were 0.688, 0.474 and 0.473, respectively.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable border=\"1\" id=\"Tab3\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eStepwise multivariate regression analysis of STSH and STSV.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"7\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eSTSH (mm)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eSTSV (mm)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e(constant\u0026thinsp;=\u0026thinsp;8.061; R\u0026thinsp;=\u0026thinsp;0.563; R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.317; adjusted R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.316)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e(constant\u0026thinsp;=\u0026thinsp;8.540; R\u0026thinsp;=\u0026thinsp;0.688; R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.474; adjusted R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.473)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePartial regression coefficient (B)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStandardized partial regression coefficient (\u0026beta;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePartial regression coefficient (B)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStandardized partial regression coefficient (\u0026beta;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge, years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRefractive errors (D)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpherical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCylindrical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpherical equivalent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKeratometric value (D)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFlat K\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.211\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSteep K\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.075\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMean K\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIOP (mmHg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAL (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eACD (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.430\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWTW (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePentacam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.510\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.330\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.492\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.435\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOPD-Scan III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIOLMaster 700\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCrystalline LT (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eSTS\u0026thinsp;=\u0026thinsp;sulcus-to-sulcus diameter; WTW\u0026thinsp;=\u0026thinsp;white-to-white diameter; IOP\u0026thinsp;=\u0026thinsp;intraocular pressure; AL\u0026thinsp;=\u0026thinsp;axial length; ACD\u0026thinsp;=\u0026thinsp;anterior chamber depth; LT\u0026thinsp;=\u0026thinsp;lens thickness\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eFigure 1 shows the Bland\u0026ndash;Altman plot of the predicted and actual STS values. The bias of the predicted versus the actual STSH was -0.021, with 95% limits of agreement (95% LoA) from -0.499 to 0.457, and the standard deviation (SD) of the bias was 0.244. The bias of the predicted versus the actual STSV was 0.057, with 95% LoA from -0.462 to 0.575, and the SD of the bias was 0.265.\u003c/p\u003e\n\u003cp\u003eFigure 2 shows the cumulative probability distribution of the prediction error. For the STSH, 72.7% of eyes were within 0.2 mm, and 92.1% of eyes were within 0.4 mm. For the STSV, 66.5% of eyes were within 0.2 mm, and 87.4% of eyes were within 0.4 mm.\u003c/p\u003e\n\u003cp\u003eThe ICC between the predicted and actual STSH was 0.883 (95% CI: 0.852, 0.907), while that between the predicted and actual STSV was 0.859 (95% CI: 0.821, 0.888).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eSince the ICL is implanted into the ciliary sulcus, measurement of STS is very important for predicting the subsequent vault. To date, UBMs remain the only device that can directly detect the morphology of the ciliary sulcus and measure the STS. However, the required measurements are time consuming and require considerable skill and experience, and the test is invasive, causing considerable discomfort to the patient. Therefore, our study established a prediction formula for the STS by retrospectively analysing certain noninvasive test results for a large sample size. The accuracy and reliability of the prediction formula were verified in a subsequent study. The large sample size improved the validity of the statistical analysis and made this study highly reliable.\u003c/p\u003e \u003cp\u003eAccording to previous studies, the human ciliary sulcus is vertically elliptical, and the vertical STS tends to be larger than the horizontal STS [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. According to our previous study, the vertical STS affects the vault after ICL implantation independent of the horizontal STS [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Therefore, in this study, separate prediction formulas were established for the horizontal and vertical STS.\u003c/p\u003e \u003cp\u003eAccording to the results of correlation and multivariate analyses, the WTWP, flat K value and ACD were the influencing factors of the STSH, producing the following regression formula: STSH (mm)\u0026thinsp;=\u0026thinsp;8.061\u0026thinsp;+\u0026thinsp;0.510 \u0026times; WTWP \u0026minus;\u0026thinsp;0.090 \u0026times; flat K value\u0026thinsp;+\u0026thinsp;0.430 \u0026times; ACD. Furthermore, the WTWP, steep K value and ACD were the influencing factors of the STSV, producing the following regression formula: STSV (mm)\u0026thinsp;=\u0026thinsp;8.540\u0026thinsp;+\u0026thinsp;0.492 \u0026times; WTWP \u0026minus;\u0026thinsp;0.075 \u0026times; Steep K value\u0026thinsp;+\u0026thinsp;0.329 \u0026times; ACD. This is very interesting. The most suitable instrument for measuring the WTW for selecting the size of the ICL has been a consistent point of argument in the literature, as different instruments produce significantly different WTW measurements, which thus are not completely interchangeable [\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In this study, three pieces of equipment with different principles for conducting anterior segmental analysis used to measure the WTW. The Pentacam is a Scheimpflug camera that rotates around the optical axis of the eye to create a three-dimensional model of the anterior segment. The WTW is automatically measured from photographs of the anterior surface of the eye with a resolution of 0.1 mm [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The IOLMaster 700 is an SS-OCT-based biometer, and the limbus is used for WTW measurement via automatic detection by a digital greyscale photograph of the anterior eye segment [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The OPD Scan III is capable of automatically detecting the limbus by comparing greyscale steps of slit-scanning images and calculates the horizontal corneal diameter [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. According to the results of this study, the WTWP had the highest correlation with the STS in both the horizontal and vertical directions (Pearson\u0026rsquo;s correlation coefficient 0.532 \u003cem\u003evs.\u003c/em\u003e 0.492, 0.291 and 0.633 \u003cem\u003evs.\u003c/em\u003e 0.578, 0.355, respectively). Moreover, only the WTWP entered the final results of the stepwise multiple linear regression. Therefore, we believe that compared with the other two WTW measurements, the WTWP can better predict the STS and is more suitable for ICL size selection. Furthermore, the WTWP was the most influential factor for both the STSH and STSV (standardized partial regression coefficient [β]\u0026thinsp;=\u0026thinsp;0.330; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 and β]\u0026thinsp;=\u0026thinsp;0.435; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The WTW and STS both describe the size of the anterior segment, so the correlation between the two is unsurprising. However, most scholars believe that there is obvious bias between the WTW and STS. In Guber et al.'s [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] study, the horizontal WTW measures obtained using the Pentacam device were significantly larger than the STS measures (bias\u0026thinsp;=\u0026thinsp;0.91 mm, P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Chen et al. [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] reported that the mean difference between the STS and WTW was \u0026minus;\u0026thinsp;0.02 +/- 0.33 (-1.36 to 1.11) mm. Hashemian et al. [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] also suggested that there was a correlation between the WTW and STS but found a significant difference in their measurements that could diminish after adjustment.\u003c/p\u003e \u003cp\u003eThe K value is the second influencing factor of the STS. Ghoreishi et al. [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] obtained a similar result in their study and established their own predicted model: STS\u0026thinsp;=\u0026thinsp;9.549\u0026thinsp;+\u0026thinsp;0.518 WTW \u0026minus;\u0026thinsp;0.083 mean K. However, the sample size of their study was small (58 eyes), and there was no follow-up verification. In this study, the flat K values were used to predict the horizontal STS, and the steep K values were used to predict the vertical STS. We hypothesized that this might be because most of the subjects in this study were relatively young, and astigmatism with the rule was common, while a flat K value often represents a horizontal corneal state, and a steep K value represents the corneal status in the vertical direction.\u003c/p\u003e \u003cp\u003eIn this study, the ACD was positively correlated with and was an important parameter for predicting both the horizontal and vertical sulcus-to-sulcus diameters. A study by Kawamorita et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] showed that the ACD and STS had extremely high agreement, with an intergroup correlation coefficient of 0.918. Additionally, Gao et al. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] found that the ACD was very important for describing the difference between the WTW and STS. In their research, the WTW and ciliary sulcus diameter were 11.46\u0026thinsp;\u0026plusmn;\u0026thinsp;0.38 and 11.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.32 mm in the shallow anterior chamber group, 11.58\u0026thinsp;\u0026plusmn;\u0026thinsp;0.31 and 11.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.26 mm in the medium anterior chamber group, and 11.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.22 and 11.91\u0026thinsp;\u0026plusmn;\u0026thinsp;0.23 mm in the deep anterior chamber group, respectively, and they concluded that the difference between the two diameters increased with greater anterior chamber depth. In addition, another of their studies showed similar results [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Chen et al. [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] also suggested that as the anterior chamber depth increased, the difference between the STS and WTW increased. These results are consistent with our findings.\u003c/p\u003e \u003cp\u003eThe Bland\u0026ndash;Altman test results showed that the consistency of our prediction formula was satisfactory. The bias between the predicted and actual value was 0.021 for the STSH and 0.057 for the STSV. In addition, 85.6% and 79.5% of subjects, respectively, had deviations within 0.3 mm, and 92.1% and 87.4% of subjects had deviations within 0.4 mm. Hashemian et al. [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] published an adjustment formula to improve the correlation of the WTW with the ciliary sulcus diameter. After adjustment, the SD of the STS-Caliper WTW was 0.28 mm, and the 95% LoA ranged from \u0026minus;\u0026thinsp;0.56 to 0.54, while the SD of the STS-Orbscan WTW was 0.31 mm, and the 95% LoA ranged from \u0026minus;\u0026thinsp;0.61 to 0.61. In contrast, the SD of the actual STSH-predicted STSH bias in this study was 0.24 mm, and the 95% LoA ranged from \u0026minus;\u0026thinsp;0.499 to 0.457. In addition, the ICCs of their study were 0.775 and 0.700, whereas ours was 0.883, which showed that our prediction model had better reliability. Moreover, the sample size of Hashemian\u0026rsquo;s study was small, and they performed validation with previous data, while ours was based on a new cohort of subjects, improving the reliability of our results.\u003c/p\u003e \u003cp\u003eThere are certain limitations in this study. First, although this study was the largest sample-size STS prediction study to date, all the people included in this study were of Han ethnicity. Whether the conclusions of this study can be applied to other ethnic groups requires further verification. Second, examination with the UBM requires highly technical expertise and experience. All the UBM examinations in this study were completed by the same experienced technician with superb skills, and whether different operators would obtain different results requires further study. Third, the findings of this study have not been introduced into clinical application. Whether this model can be helpful in ICL size selection will be the subject of a follow-up study.\u003c/p\u003e \u003cp\u003eIn conclusion, the WTW measured by the Pentacam, the K values and the ACD are three important parameters for predicting the STS. The prediction model has good accuracy and reliability.\u003c/p\u003e"},{"header":"List of abbreviations","content":"\u003cp\u003eSTS: sulcus-to-sulcus diameter; WTW: white-to-white diameter; IOP: intraocular pressure; AL: axial length; ACD: anterior chamber depth; LT: lens thickness; WTWP: white-to-white diameter measured by the Pentacam; WTWI: white-to-white diameter measured by the IOLMaster 700; WTWO: white-to-white diameter measured by the OPD-Scan III; STSH: horizontal sulcus-to-sulcus diameter; STSV: vertical sulcus-to-sulcus diameter.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Ethics Committee of Lixiang Eye Hospital of Soochow University and adhered to the tenets of the Declaration of Helsinki. Informed consent was obtained from all subjects.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe have already uploaded the data\u0026nbsp;in the current study as supplementary material. If someone wishes to request the data from this study, please contact You Yuan (Corresponding author)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026rsquo; contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQJZ analysed and interpreted the patient data and wrote the paper. WJC and WJZ collected the data and conducted the examinations. LM checked and revised the paper. YY designed the study.\u0026nbsp;All authors have read and approved the manuscript.\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank Dr. Chen Qing and Dr. Yu Peng for their help in data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026apos; information\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQiujian Zhu, the doctor of Lixiang Eye Hospital of Soochow University. The main directions are refractive surgery and cataract surgery.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHolden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123:1036\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNiu L, Miao H, Han T, Ding L, Wang X, Zhou X. Visual outcomes of Visian ICL implantation for high myopia in patients with shallow anterior chamber depth. BMC Ophthalmol. 2019;19:121.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNakamura T, Isogai N, Kojima T, Yoshida Y, Sugiyama Y. Posterior chamber phakic intraocular lens implantation for the correction of myopia and myopic astigmatism: a retrospective 10-year follow-up study. Am J Ophthalmol. 2019;206:1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlfonso JF, Fernandez-Vega-Cueto L, Alfonso-Bartolozzi B, Montes-Mico R, Fernandez-Vega L. Five-year follow-up of correction of myopia: posterior chamber phakic intraocular lens with a central port design. J Refract Surg. 2019;35:169\u0026ndash;76.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVasavada V, Srivastava S, Vasavada SA, Sudhalkar A, Vasavada AR, Vasavada VA. Safety and efficacy of a new phakic posterior chamber iol for correction of myopia: 3 years of follow-up. J Refract Surg. 2018;34:817\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEissa S, Eldin NB. ICL versus SMILE in management of anisometropic myopic amblyopia in children. Can J Ophthalmol. 2018;53:560\u0026ndash;67.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNiu L, Miao H, Tian M, Fu D, Wang X, Zhou X. One-year visual outcomes and optical quality of femtosecond laser small incision lenticule extraction and Visian Implantable Collamer Lens (ICL V4c) implantation for high myopia. Acta Ophthalmol. 2020;98:e662-7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen X, Miao H, Naidu RK, Wang X, Zhou X. Comparison of early changes in and factors affecting vault following posterior chamber phakic implantable collamer lens implantation without and with a central hole (ICL V4 and ICL V4c). BMC Ophthalmol. 2016;16:161.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChun YS, Park IK, Lee HI, Lee JH, Kim JC. Iris and trabecular meshwork pigment changes after posterior chamber phakic intraocular lens implantation. J Cataract Refract Surg. 2006;32:1452\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYe C, Patel CK, Momont AC, Liu Y. Advanced pigment dispersion glaucoma secondary to phakic intraocular collamer lens implant. Am J Ophthalmol Case Rep. 2018;10:65\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShipper I. Surgical management of acute angle-closure glaucoma after implantation of a toric ICL. J Cataract Refract Surg. 2007;33:563\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGimbel HV, LeClair BM, Jabo B, Marzouk H. Incidence of implantable collamer lens-induced cataract. Can J Ophthalmol. 2018;53:518\u0026ndash;22.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuber I, Mouvet V, Bergin C, Perritaz S, Othenin-Girard P, Majo F. Clinical outcomes and cataract formation rates in eyes 10 years after posterior phakic lens implantation for myopia. JAMA Ophthalmol. 2016;134:487\u0026ndash;94.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlfonso JF, Lisa C, Abdelhamid A, Fernandes P, Jorge J, Montes-Mico R. Three-year follow-up of subjective vault following myopic implantable collamer lens implantation. Graefes Arch Clin Exp Ophthalmol. 2010;248:1827\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTrancon AS, Manito SC, Sierra OT, Baptista AM, Serra PM. Determining vault size in implantable collamer lenses: preoperative anatomy and lens parameters. J Cataract Refract Surg. 2020;46:728\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIgarashi A, Shimizu K, Kato S, Kamiya K. Predictability of the vault after posterior chamber phakic intraocular lens implantation using anterior segment optical coherence tomography. J Cataract Refract Surg. 2019;45:1099\u0026ndash;1104.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNakamura T, Isogai N, Kojima T, Yoshida Y, Sugiyama Y. Implantable collamer lens sizing method based on swept-source anterior segment optical coherence tomography. Am J Ophthalmol. 2018;187:99\u0026ndash;107.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee DH, Choi SH, Chung ES, Chung TY. Correlation between preoperative biometry and posterior chamber phakic visian implantable collamer lens vaulting. Ophthalmology. 2012;119:272\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKojima T, Yokoyama S, Ito M, Horai R, Hara S, Nakamura T, et al. Optimization of an implantable collamer lens sizing method using high-frequency ultrasound biomicroscopy. Am J Ophthalmol. 2012;153:632\u0026ndash;7, 637.e1.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOh J, Shin HH, Kim JH, Kim HM, Song JS. Direct measurement of the ciliary sulcus diameter by 35-megahertz ultrasound biomicroscopy. Ophthalmology. 2007;114:1685\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBiermann J, Bredow L, Boehringer D, Reinhard T. Evaluation of ciliary sulcus diameter using ultrasound biomicroscopy in emmetropic eyes and myopic eyes. J Cataract Refract Surg. 2011;37:1686\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhu QJ, Chen WJ, Zhu WJ, Xiao HX, Zhu MH, Ma L, et al. Short-term changes in and preoperative factors affecting vaulting after posterior chamber phakic implantable collamer lens implantation. BMC Ophthalmol. 2021;21:199.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCruz S, Valenzuela F, Stoppel J, Maul E, Gibbons A. Comparison of horizontal corneal diameter measurements using orbscan IIz, OPD scan III, and IOLMaster 700. Eye Contact Lens. 2021;47:533\u0026ndash;38.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBuckenham Boyle A, Namkung S, Shew W, Gokul A, McGhee CNJ, Ziaei M. Repeatability and agreement of white-to-white measurements between slit-scanning tomography, infrared biometry, dual rotating Scheimpflug camera/Placido disc tomography, and swept source anterior segment optical coherence tomography. PLoS One. 2021;16:e0254832.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTana-Rivero P, Aguilar-Corcoles S, Rodriguez-Prats JL, Montes-Mico R, Ruiz-Mesa R. Agreement of white-to-white measurements with swept-source OCT, Scheimpflug and color LED devices. Int Ophthalmol. 2021;41:57\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAkman A, Asena L, Gungor SG. Evaluation and comparison of the new swept source OCT-based IOLMaster 700 with the IOLMaster 500. Br J Ophthalmol. 2016;100:1201\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAsgari S, Hashemi H, Jafarzadehpur E, Mohamadi A, Rezvan F, Fotouhi A. OPD-Scan III: a repeatability and inter-device agreement study of a multifunctional device in emmetropia, ametropia, and keratoconus. Int Ophthalmol. 2016;36:697\u0026ndash;705.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuber I, Bergin C, Perritaz S, Majo F. Correcting interdevice bias of horizontal white-to-white and sulcus-to-sulcus measures used for implantable collamer lens sizing. Am J Ophthalmol. 2016;161:116 \u0026ndash; 25.e1.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen X, Han T, Zhao W, Wang X, Xu Y, Cheng M, et al. Effect of the difference between the white-to-white and sulcus-to-sulcus on vault and the related factors after ICL implantation. Ophthalmol Ther. 2021;10:947\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHashemian SJ, Mohebbi M, Yaseri M, Jafari ME, Nabili S, Hashemian SM, et al. Adjustment formulae to improve the correlation of white-to-white measurement with direct measurement of the ciliary sulcus diameter by ultrasound biomicroscopy. J Curr Ophthalmol. 2018;30:217\u0026ndash;22.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGhoreishi M, Abdi-Shahshahani M, Peyman A, Pourazizi M. A model for predicting sulcus-to-sulcus diameter in posterior chamber phakic intraocular lens candidates: correlation between ocular biometric parameters. Int Ophthalmol. 2019;39:661\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKawamorita T, Uozato H, Kamiya K, Shimizu K. Relationship between ciliary sulcus diameter and anterior chamber diameter and corneal diameter. J Cataract Refract Surg. 2010;36:617\u0026ndash;24.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGao J, Liao RF. Correlation between white-to-white diameter and ciliary sulcus diameter of high myopia eyes. Zhonghua Yan Ke Za Zhi. 2013;49:627\u0026ndash;32.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGao J, Liao RF, Li N. Ciliary sulcus diameters at different anterior chamber depths in highly myopic eyes. J Cataract Refract Surg. 2013;39:1011\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"boph","sideBox":"Learn more about [BMC Ophthalmology](http://bmcophthalmol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/boph","title":"BMC Ophthalmology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"WTW, STS, prediction model, Bland–Altman test","lastPublishedDoi":"10.21203/rs.3.rs-1368138/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1368138/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eTo establish and verify the accuracy and reliability of a sulcus-to-sulcus diameter (STS) prediction model.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eIn this retrospective study, the prediction formula was established with the data from 1466 eyes from 733 subjects from July 2020 to April 2021 and verified with the data from 278 eyes from 139 subjects between May 2021 and June 2021. Each subject was measured with a Pentacam, IOLMaster 700, OPD-Scan III, and ultrasound biomicroscope. The prediction formulas were established with multiple linear regression, and intergroup correlation coefficients (ICCs) and Bland–Altman tests were used to assess the agreement between the predicted and actual STS.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe explanatory variables relevant to the horizontal STS (STSH) were the Pentacam white-to-white diameter (WTWP; standardized partial regression coefficient [β] = 0.330; p \u0026lt; 0.001), the flat K value (β = -0.211; p \u0026lt; 0.001), and the anterior corneal diameter (ACD) (β = 0.178; p \u0026lt; 0.001). The corresponding multiple regression equation was : STSH (mm) = 8.061 + 0.510 × WTWP - 0.090 × Flat K value + 0.430 × ACD. The explanatory variables relevant to the vertical STS (STSV) were the WTWP (β = 0.435; p \u0026lt; 0.001), the steep K value (β = -0.271; p \u0026lt; 0.001), and the ACD (β = 0.187; p \u0026lt; 0.001). The corresponding multiple regression equation was : STSV (mm) = 8.540 + 0.492 × WTWP - 0.075 × Steep K value + 0.329 × ACD. The bias of the predicted to the actual STSH was -0.021, with 95% limits of agreement (95% LoA) from -0.499 to 0.457. The bias of the predicted to the actual STSV was 0.057, with 95% LoA from -0.462 to 0.575. The ICC was 0.883 between the predicted and actual STSH and 0.859 between the predicted and actual STSV.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eThe Pentacam-measured WTW, the K value and the ACD are important for predicting the STS diameter. The prediction model has good accuracy and reliability.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eTrial registration: \u003c/strong\u003eNot applicable\u003c/p\u003e","manuscriptTitle":"A Prediction Model For Sulcus-To-Sulcus Diameter In Myopic Eyes: A 1466-Sample Retrospective Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-03-10 17:45:21","doi":"10.21203/rs.3.rs-1368138/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2022-06-09T06:34:53+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2022-05-24T11:50:07+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2022-04-29T20:54:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"61cc6daf-8e1e-4e03-8961-cff5a8298c48","date":"2022-04-29T19:53:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"c06e53bc-7b07-49e1-ba6b-8609cad18fa9","date":"2022-03-20T13:19:42+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2022-03-10T01:57:14+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2022-03-05T00:40:30+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2022-03-01T20:48:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2022-03-01T20:45:29+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Ophthalmology","date":"2022-02-17T06:37:18+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"boph","sideBox":"Learn more about [BMC Ophthalmology](http://bmcophthalmol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/boph","title":"BMC Ophthalmology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8bde79ca-8fc4-46d2-a530-f8f0cb4763b5","owner":[],"postedDate":"March 10th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2022-07-13T09:29:17+00:00","versionOfRecord":[],"versionCreatedAt":"2022-03-10 17:45:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1368138","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1368138","identity":"rs-1368138","version":["v1"]},"buildId":"WrCJVZZCHTDjtuVLN7oU0","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}