Does transient increase in axial length during accommodation attenuate with age?

Background: The aim was to profile transient accommodative axial length (AXL) changes from early adulthood to advanced presbyopia and to determine whether any differences exist between the responses of myopic and emmetropic individuals. Methods: Ocular biometry was measured by the LenStar biometer (Haag-Streit, Switzerland) in response to 0.00, 3.00 and 4.50 D accommodative stimuli in 35 emmetropes and 37 myopes, aged 18 to 60 years. All results were corrected to reduce errors arising from the increase in crystalline lens thickness with accommodation. Accommodative responses were measured sequentially by the WAM 5500 Auto Ref/Keratometer (Grand Seiko, Japan). Results: AXL increased significantly with accommodation (p<0.001), with a mean corrected AXL elongation of 2 ± 18 µm and 8 ± 16 µm observed at 3.00 D and 4.50 D, respectively. The magnitude of accommodative AXL change was not dependent on refractive error classification (p=0.959), however a significant reduction in the magnitude and variance of AXL change was evident after 43-44 years of age (p<0.002). Conclusion: The negative association between transient AXL elongation and age, in combination with reduced variance of data after age 43-44 years, is consistent with a significant increase in posterior ocular rigidity, which may be influential in the development of presbyopia