Inter-eye comparison of ocular biometry, topography, and ocular aberrations in patients with unilateral high myopia

Purpose To compare the optical and biometric properties of the highly myopic eye and less myopic eye of individuals with unilateral high myopia, and study the correlation of ocular biometry, topography, corneal, and internal aberrations in these eyes. Methods This retrospective analysis was conducted on 32 patients with unilateral high myopia. Biometric parameters, corneal topography, and wavefront aberrations were recorded in both eyes. Paired t-tests and MANOVA were used to compare parameters and analyse associations amongst ocular measurements. Results In unilateral high myopia, eyes with high myopia had significantly higher levels of internal aberrations than fellow less myopic eyes of the same individual ( p  < 0.001). Corneal aberrations were similar between the eyes, except for a higher corneal trefoil 2 in high myopes (p = 0.043). The other biometric parameters did not differ significantly. In highly myopic eyes, the degree of internal aberrations showed a positive correlation with axial length, whereas total aberrations showed a marginal correlation with lens thickness and spherical equivalent. In less myopic eyes, specific aberrations correlated more with mean keratometry and spherical equivalent. Conclusion This study revealed that highly myopic eyes are associated with significantly more internal higher-order aberrations with axial length playing a dominant role in their development. In contrast, corneal curvature more strongly influences aberrations in less myopic eyes. These findings highlight the structural and optical complexities of high myopia and underscore the need for targeted interventions to enhance visual quality. Further longitudinal studies are essential to understand myopia progression and optimize corrective strategies.