Distribution of preoperative and postoperative astigmatism in a large population of patients undergoing cataract surgery in the UK

Day, Alexander C; Dhariwal, Mukesh; Keith, Michael; Ender, F; Vives, C. Pérez; Miglio, Cristiana; Zou, Lu; Anderson, David F.

doi:10.1136/bjophthalmol-2018-312025

Cited by 55 publications

(41 citation statements)

References 23 publications

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“…The distribution of astigmatism in the large population reported in this study supports evidence from previous smaller studies, both in the UK and worldwide, in pre-operative patients [11,12,22–25] and from large consortiums such as CREAM (n = 55,177) [13]. We found that 69%, 29%, 11% and 5% had corneal astigmatism ≥0.5, 1.0, 1.5 and 2.0 dioptres respectively.…”

Section: Discussionsupporting

confidence: 89%

Frequency and distribution of corneal astigmatism and keratometry features in adult life: Methodology and findings of the UK Biobank study

et al. 2019

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PurposeTo describe corneal astigmatism in the UK Biobank population and to look for associations with other biometric variables and socio-demographic factors.MethodsThis analysis included a subsample of 107,452 participants of the UK Biobank study who underwent an enhanced ophthalmic examination including autorefractor keratometry (Tomey RC 5000, Tomey Corp., Nagoya, Japan). Participants were recruited from across the United Kingdom between 2006 and 2010, and all were between 40 to 69 years. After quality control and applying relevant exclusions, data on corneal astigmatism on 83,751 participants were included for analysis. Potential associations were tested through univariable regression and significant parameters carried forward for multivariable analysis.ResultsIn univariable analysis, the characteristics significantly associated with higher corneal astigmatism (P<0.001), by order of magnitude were, female gender, white ethnicity, lighter skin colour, use of UV protection, lower alcohol intake, lower corneal-compensated intraocular pressure (ccIOP), older age at completion of education, younger age, higher Townsend deprivation index, lower height and lower systolic blood pressure. After inclusion in the multivariable analysis, gender, skin colour, alcohol intake, age at completion of full-time education, ccIOP, age and Townsend deprivation score remained significant (all P<0.001). Increased corneal astigmatism was also found to be significantly associated with amblyopia or strabismus.ConclusionsThis analysis confirms previous associations with astigmatism such as younger age and female gender, and identified novel risk factors including lighter skin colour, lower alcohol intake, later age having completed full time education later, lower ccIOP and higher Townsend deprivation index. Further research is needed to investigate these novel associations.

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Section: Discussionsupporting

confidence: 89%

Frequency and distribution of corneal astigmatism and keratometry features in adult life: Methodology and findings of the UK Biobank study

et al. 2019

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“…An estimated three-quarters of eyes undergoing cataract surgery have astigmatism >0.5 D 1 – 3 and one-third have >1.0 D. 1 , 2 , 4 The correction of pre-existing astigmatism is fundamental to the goal of achieving emmetropia and increased spectacle independence after cataract surgery. 5 Partial-thickness arcuate incisions, corneal limbal relaxing incisions, and toric IOLs are the most commonly performed procedures to address pre-existing astigmatism at the time of cataract surgery; however, astigmatic outcomes are often suboptimal, particularly in patients with pre-existing dry eye.…”

Section: Introductionmentioning

confidence: 99%

<p>Impact of Thermal Pulsation Treatment on Astigmatism Management and Outcomes in Meibomian Gland Dysfunction Patients Undergoing Cataract Surgery</p>

Matossian¹

2020

OPTH

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This study aimed to assess the effects of thermal pulsation system (TPS) treatment on astigmatism management in meibomian gland dysfunction (MGD) patients undergoing cataract surgery. Patients and Methods: This single-center pilot study included 25 eyes of 23 patients who had visually significant cataract and concomitant MGD-associated dry eye in at least 1 eye and were willing to undergo TPS treatment and wait for at least 6 weeks for tear film stabilization prior to cataract surgery. Post-TPS keratometric readings were used for presurgical planning, and the actual postoperative residual refractive astigmatism (RRA) was recorded. Pre-TPS keratometry was used to mathematically simulate the RRA that would have been obtained from the lens choice and astigmatism management without TPS treatment. Results: Following TPS treatment, the magnitude of astigmatism increased in 52% of eyes, decreased in 24%, and remained unchanged in 24%. Correspondingly, astigmatism treatment modality changed in 68% of eyes after tear film stabilization with TPS treatment. The type of astigmatism management increased (ie, shifted from no treatment to LRI or LRI to toric IOL) in 25% of eyes and decreased in 8%. Actual RRA ≤0.5 D was achieved in 76% of eyes, compared to simulated RRA ≤0.5 D in 40% of eyes (p=0.004). Conclusion: Stabilization of the tear film with TPS treatment resulted in less RRA than if pre-TPS keratometric readings had been used to determine the astigmatism management method and toric IOL power and axis.

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“…Therefore, preoperative corneal astigmatism in patients has attracted extensive attention [ 1 , 2 ]. Some studies have observed the distribution of astigmatism in regions such as Brazil [ 3 ], northeastern India [ 4 , 5 ], southern Europe [ 6 ], and the United Kingdom [ 1 , 7 ]. In China, there are only studies reported in the southern, northern, and central [ 8 – 10 ] regions.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Corneal Astigmatism in Patients before Cataract Surgery in Western China

Chen

et al. 2020

Journal of Ophthalmology

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Purpose. To investigate the demographics and distribution of corneal astigmatism before cataract surgery in patients from western China and to compare and analyze these findings with those of patients in southern China. Setting. People’s Hospital of Xinjiang Uygur Autonomous Region. Design. Clinical-based cross-sectional study. Methods. Patients undergoing cataract surgery in the People’s Hospital of Xinjiang Uygur Autonomous Region from February 2012 to August 2019 were recruited. Preoperative keratometric data measured by performing preoperative bilateral partial coherence interferometry (IOLMaster), and patient demographics were recorded and analyzed. Results. This study comprised 12,236 eyes of 7065 patients with a mean age of 64.75 ± 9.66 years, and 52.77% of the patients were female. The mean axial length was 23.14 ± 0.96 mm. Astigmatism ranged from 0 diopters (D) to 6.94 D, with a mean of 1.28 D. Corneal astigmatism was between 0.25 D and 1.25 D in 53.71% of eyes, 1.25 D or higher in 39.06% eyes, and less than 0.25 D in 7.23% of eyes. Astigmatism was with the rule (WTR) in 41.94% of the patients and against the rule (ATR) in 38.80% of patients. The mean flat and steep keratometry measurement was 43.19 ± 1.50 D and 44.24 ± 1.62 D, respectively. After matching, corneal astigmatism in western China was 1.30 ± 1.03 D, and it was significantly higher than that in southern China (0.98 ± 0.67 D, P<0.001). After matching, the proportion of WTR astigmatism was 40.99% in western China, which was also significantly higher than the proportion (26.46%) in southern China (P<0.001). Conclusion. Corneal astigmatism in patients before cataract surgery in western China was mainly between 0.25 D and 1.25 D. Compared with patients in southern China, patients in western China are younger, have a much higher degree of astigmatism, and have a higher proportion of WTR astigmatism.

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Distribution of preoperative and postoperative astigmatism in a large population of patients undergoing cataract surgery in the UK

Cited by 55 publications

References 23 publications

Frequency and distribution of corneal astigmatism and keratometry features in adult life: Methodology and findings of the UK Biobank study

Frequency and distribution of corneal astigmatism and keratometry features in adult life: Methodology and findings of the UK Biobank study

<p>Impact of Thermal Pulsation Treatment on Astigmatism Management and Outcomes in Meibomian Gland Dysfunction Patients Undergoing Cataract Surgery</p>

Prevalence of Corneal Astigmatism in Patients before Cataract Surgery in Western China

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