Analysis of corneal astigmatism and aberration in chinese congenital cataract and developmental cataract patients before cataract surgery

Abstract

Background To investigate the distribution of corneal astigmatism, aberration, and biometric parameters in Chinese congenital cataract (CC) /developmental cataract patients before cataract surgery. Methods We evaluated eyes of CC /developmental cataract patients scheduled for cataract surgery from January 2016 to September 2019. Astigmatism, aberrations, and biometric parameters were measured with the Pentacam Scheimpflug imaging device (Pentacam HR, Oculus). Cataract was diagnosed and classified by slit-lamp examination after full mydriasis. Results We evaluated 538 eyes in 356 patients. The mean values of anterior corneal astigmatism (ACA), posterior corneal astigmatism (PCA), and total corneal astigmatism (TCA) were determined as 1.98 ± 1.06 D (range 0.0‒4.8 D), 0.49 ± 0.26 D (range 0.0‒1.9 D), and 2.09 ± 1.19 D (range 0.2‒8.8 D), respectively. ACA and TCA ≥ 1.25 D was present in 379 eyes (70.3%) and 392 eyes (72.8%), respectively. PCA between 0.25 D and 0.75 D was found in 380 eyes (70.6%). There was a statistically significant positive linear correlation between lower-order aberrations root mean square values (LOA RMS) and corneal astigmatism (CA). Furthermore, in terms of distribution of central cornea thickness, anterior chamber depth, ACA, PCA, and TCA in different types of cataracts, ACA was highest in patients with zonular cataracts. Finally, we found anterior corneal measurements may overestimate WTR astigmatism, underestimate ATR astigmatism, and underestimate oblique astigmatism, respectively. Conclusions Most CC /developmental cataract patients had moderate to high astigmatism and ACA accounted for the largest proportion in the zonular group. This can provide a basis for planning of CC/developmental cataract surgery by ophthalmologists in clinical practice.

Epidemiology and Burden of Astigmatism: A Systematic Literature Review

“… 70 In comparison, distribution rates up to 39% (United States) and 34% (China) were recorded for moderate and significant astigmatism, respectively. 35 , 68 The distribution of mild, moderate, and significant astigmatism across studies is summarized in Table 4 .…”

“… 71 In adult astigmatic patients, prevalence of mild astigmatism is more compared with moderate/significant astigmatism. 35 , 57 , 68 …”

“…Although against-the-rule astigmatism was more frequently reported in males and with-the-rule astigmatism was more common in females, 50,53,85,127,128 sex-related differences may be attributed to differences in sex hormones 71 . In adult astigmatic patients, prevalence of mild astigmatism is more compared with moderate/significant astigmatism 35,57,68 …”

“…71 In adult astigmatic patients, prevalence of mild astigmatism is more compared with moderate/significant astigmatism. 35,57,68 None of the retrieved studies reported the incidence of astigmatism during adulthood. Thus, there is a need for robust studies to better understand the onset in adults to provide better vision care to patients, inform treatment guidelines, and assist in policy decisions related to ophthalmic care.…”

Analysis of the Effect of Phacoemulsification and Intraocular Lens Implantation Combined With Trabeculectomy on Cataract and Its Influence on Corneal Endothelium

“…With the aging of the population, the number of cases of visual impairment caused by cataracts is increasing. Cataract leads to the closure of the angle of the chamber, the thickness of the lens increases in the elderly, and the relaxation of the suspensory ligament leads to the relative forward movement of the lens (9,10). How to treat these patients effectively has become one of the key problems to be solved urgently in clinical ophthalmology.…”