Ethnic differences in biometric characteristics of the anterior segment of the eye in patients with primary glaucoma and without glaucoma in the Republic of Sakha (Yakutia)

A high prevalence of primary angle-closure glaucoma (PACG) has been reported in the Sakha Republic (Yakutia).

The purpose of this study was to identify biometric features of the anterior segment of the eye associated with the risk of PACG in patients of the Yakut and European populations. This retrospective cross-sectional study included 281 patients with cataract (422 eyes) aged 68,58 ± 6,94 including 79 patients (106 eyes) of the European population and 202 patients (316 eyes) of the indigenous inhabitants of the Republic of Sakha (Yakutia) — Yakuts, examined by optical biometry (Lenstar LS 900).

Results. It was found that Yakuts without glaucoma, compared with Europeans, have significantly lower central corneal thickness (CCT), corneal diameter (WTW), anterior chamber depth (ACD), and relative lens position (RLP), indicating a more anterior position of the lens. Logistic regression identified three independent predictors of ethnicity associated with the risk of PACG: values of CCT, WTW, and RLP. The combined CCT + WTW + RLP model demonstrated satisfactory discriminatory ability (AUC = 0.743). A comparison of PACG surgical techniques in Yakuts revealed that phacoemulsification of cataracts (PEC) provides a deeper anterior chamber and significantly lower IOP in the long-term period compared to laser iridectomy.

Conclusion. The complex of biometric features identified in Yakuts explains the high risk of PACG. PEC should be considered a priority method for the surgical treatment of PACG in this ethnic group.

1. Movsisyan A.B., Kuroyedov A.V., Arkharov M.A., et al. Epidemiological analysis of the incidence and prevalence of primary open-angle glaucoma in the Russian Federation. RMJ. Clinical ophthalmology. 2022; 22 (1): 3–10 (In Russ.). doi: 10.32364/2311-7729-2022-22-1-3-10

2. Chuprov A.D., Lositskiy A.O., Trubnikov V.A., et al. Epidemiological features of glaucoma distribution among the population of the Russian Federation. Natsionalnyi zhurnal Glaukoma. 2021; 20 (3): 3–10 (In Russ.). doi: 10.53432/2078-4104-2021-20-3-3-10

3. Bourne RR, Stevens GA, White RA, et al. Causes of vision loss worldwide, 1990-2010: a systematic analysis. Lancet Glob Health. 2013; 1 (6): e339–49. doi: 10.1016/S2214-109X(13)70113-X

4. Tham YC, Li X, Wong TY, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014; 121 (11): 2081–90. doi: 10.1016/j.ophtha.2014.05.013

5. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014; 311 (18): 1901–11. doi: 10.1001/jama.2014.3192

6. Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006; 90 (3): 262–7. doi: 10.1136/bjo.2005.081224

7. Wang Y, Liang ZQ, Zhang Y, et al. Efficacy and safety of phacoemulsification plus goniosynechialysis and trabectome in patients with primary angle-closure glaucoma. Sci Rep. 2021; 11 (1): 13921. doi: 10.1038/s41598-021-92972-9

8. Neroev V.V., Malishevskaya T.N., Petrov S.Yu., et al. Epidemiological features of primary angle-closure glaucoma in the Russian Federation. Russian ophthalmological journal. 2025; 18 (1): 7–16 (In Russ.). https://doi.org/10.21516/2072-0076-2025-18-1-7-16

9. Wang D, Amoozgar B, Porco T, et al. Ethnic differences in lens parameters measured by ocular biometry in a cataract surgery population. PLoS One. 2017; 12(6): e0179836. doi: 10.1371/journal.pone.0179836

10. Devereux JG, Foster PJ, Baasanhu J, et al. Anterior chamber depth measurement as a screening tool for primary angle-closure glaucoma in an East Asian population. Arch Ophthalmol. 2000; 118 (2): 257–63. doi: 10.1001/archopht.118.2.257

11. Lim MC, Lim LS, Gazzard G, et al. Lens opacity, thickness, and position in subjects with acute primary angle closure. J Glaucoma. 2006; 15 (3): 260–3. doi: 10.1097/01.ijg.0000212212.10395.76

12. Saxena S, Agrawal PK, Pratap VB, Nath R, Saxena RC. The predictive value of the relative lens position in primary angle-closure glaucoma. Ann Ophthalmol. 1993 Dec; 25 (12): 453–6. PMID: 8129328.

13. Leske MC, Heijl A, Hussein M, et al. Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol. 2003; 121 (1): 48–56. doi: 10.1001/archopht.121.1.48

14. Brizido M, Rodrigues PF, Almeida AC, et al. Cataract surgery and IOP: a systematic review of randomised controlled trials. Graefes Arch Clin Exp Ophthalmol. 2023; 261 (5): 1257–66. doi: 10.1007/s00417-022-05911-3

15. Coh P, Moghimi S, Chen RI, et al. Lens position parameters as predictors of intraocular pressure reduction after cataract surgery in glaucomatous versus nonglaucomatous eyes. Invest Ophthalmol Vis Sci. 2016; 57 (6): 2593–9. doi: 10.1167/iovs.16-19384

16. Poley BJ, Lindstrom RL, Samuelson TW, et al. Intraocular pressure reduction after phacoemulsification with intraocular lens implantation in glaucomatous and nonglaucomatous eyes: evaluation of a causal relationship between the natural lens and open-angle glaucoma. J Cataract Refract Surg. 2009; 35 (11): 1946–55. doi: 10.1016/j.jcrs.2009.05.061

17. Huang G, Gonzalez E, Peng PH, et al. Anterior chamber depth, iridocorneal angle width, and intraocular pressure changes after phacoemulsification: narrow vs open iridocorneal angles. Arch Ophthalmol. 2011; 129 (10): 1283–90. doi: 10.1001/archophthalmol.2011.272

18. Helmy H. Long-term effect of early phacoemulsification in primary angle closure glaucoma patients with cataract: A 10-year follow-up study. Clin Ophthalmol. 2021; 15: 3969–81. doi: 10.2147/OPTH.S333202

19. Mansoori T, Balakrishna N. Anterior segment morphology in primary angle closure glaucoma using ultrasound biomicroscopy. J Curr Glaucoma Pract. 2017; 11 (3): 86–91. doi: 10.5005/jp-journals-10028-1230

20. Foster PJ, Baasanhu J, Alsbirk PH, et al. Glaucoma in Mongolia. A populationbased survey in Hovsgol province, northern Mongolia. Arch Ophthalmol. 1996; 114 (10): 1235–41. doi: 10.1001/archopht.1996.01100140435011

21. He M, Foster PJ, Ge J, et al. Prevalence and clinical characteristics of glaucoma in adult Chinese: a population-based study in Liwan District, Guangzhou. Invest Ophthalmol Vis Sci. 2006; 47 (7): 2782–8. doi: 10.1167/iovs.06-0051

22. Abdulrazik M. Model of pulsatile-flow of aqueous humor through the iris-lens canal. J Glaucoma. 2007; 16 (1): 129–36. doi: 10.1097/01.ijg.0000212280.80724.e3

23. Jonas JB, Iribarren R, Nangia V, et al. Lens position and age: The Central India Eye and Medical Study. Invest Ophthalmol Vis Sci. 2015; 56 (9): 5309–14. doi: 10.1167/iovs.15-16796

24. Leydolt C, Findl O, Drexler W. Effects of change in intraocular pressure on axial eye length and lens position. Eye (Lond). 2008; 22 (5): 657–61. doi: 10.1038/sj.eye.6702709

25. Shamseldin Shalaby W, Reddy R, Razeghinejad R, et al. Contemporary approach to narrow angles. J Ophthalmic Vis Res. 2024; 19 (1): 88–108. doi: 10.18502/jovr.v19i1.15443

26. Sun X, Dai Y, Chen Y, et al. Primary angle closure glaucoma: What we know and what we don’t know. Prog Retin Eye Res. 2017; 57: 26–45. doi: 10.1016/j.preteyeres.2016.12.003

27. Danilenko O.V., Bol’shunov A.V. Laser iridectomy and anatomical and functional parameters in primary angle-closure glaucoma. Vestnik oftal’mologii. 2014; 130 (3): 54–9 (In Russ.).

28. Lee JR, Choi JY, Kim YD, et al. Laser peripheral iridotomy with iridoplasty in primary angle closure suspect: anterior chamber analysis by pentacam. Korean J Ophthalmol. 2011; 25 (4): 252–6. doi: 10.3341/kjo.2011.25.4.252

29. Vizzeri G., Weinreb R.N. Cataract surgery and glaucoma. Curr Opin Ophthalmol. 2010; 21 (1): 20–4. doi: 10.1097/ICU.0b013e328332f562

30. Zhao R, Geng W, Wu Y, et al. Assessing the clinical efficacy of phacoemulsification cataract extraction in treating acute primary angle closure and fellow primary angle closure suspect eyes using AS-OCT. Front Med (Lausanne). 2024; 11: 1436991. doi: 10.3389/fmed.2024.1436991