Purpose. To investigate the differences in axial length, corneal curvature, and corneal astigmatism with age in patients with Marfan\nsyndrome (MFS) and ectopia lentis. Methods. A retrospective case series study was conducted. MFS patients with ectopia lentis were\ndivided into groups according to age. Axial length, corneal curvature, and corneal astigmatism were measured. Results. This study\nincluded 114 MFS patients (215 eyes) with a mean age of 19.0 �± 13.9 years. Axial length differed significantly across age groups in\nMFS patients (P < 0 001), whereas corneal curvature did not (P = 0 767). Corneal astigmatism was statistically significant\nthroughout the MFS cohort (P = 0 009), but no significant difference was found in young MFS patients (P = 0 838). With\nincreasing age, the orientation of the corneal astigmatism changed from with-the-rule astigmatism to against-the-rule or oblique\nastigmatism (P < 0 001). A linear correlation analysis showed weak correlations between age and axial length for both eyes and\nwith corneal astigmatism for the left eye, but there was no correlation between age and corneal curvature. Conclusions. In MFS,\naxial length varies with age, corneal curvature remains stable, and corneal astigmatism is higher in young patients and tends to\nshift toward against-the-rule or oblique astigmatism. Therefore, it is important to consider age when diagnosing MFS with\nocular biometric data.
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