Global prevalence and economic and humanistic burden of astigmatism in cataract patients: a systematic literature review

Abstract

PurposeTo systematically review the published evidence on the prevalence and economic and humanistic burden of astigmatism in cataract patients.Materials and methodsFor this systematic literature review, the Medline, PubMed, Embase, and Cochrane databases were searched from 1996 to September 2015 for available scientific literature that met the inclusion criteria. Studies published in the English language reporting prevalence and humanistic and economic burden in patients diagnosed with cataract and astigmatism were included.ResultsOf 3,649 papers reviewed, 31 studies from 32 publications met the inclusion criteria of this review. Preexisting astigmatism ≥1 D was present in up to 47% of cataract eyes. The cost burden of residual uncorrected astigmatism after cataract surgery was driven by the cost of spectacles, which was estimated to range from $2,151 to $3,440 in the US and $1,786 to $4,629 in Europe over a lifetime. In cataract patients, both preexisting and postoperative residual astigmatism were associated with poor vision-related patient satisfaction and quality of life, as well as higher spectacle burden. Astigmatism correction during cataract surgery appears to improve visual outcomes and results in overall lifetime cost savings compared to astigmatism correction with postoperative vision correction.ConclusionThere is a high prevalence of preexisting astigmatism in cataract patients. Although published data are limited, both preoperative astigmatism and postoperative residual astigmatism affect visual function and vision-related quality of life, resulting in increased humanistic burden. Suboptimal correction of astigmatism during cataract surgery drives the continuous need for vision correction with spectacles in the postoperative period. Patients must bear the out-of-pocket expenses, since payers often do not reimburse the cost of spectacles. Greater access to astigmatism correction during cataract surgery could improve visual outcomes and quality of life in patients. More research is required to gain a better understanding of the disease burden of astigmatism in cataract patients.

Correlations of Corneal Spherical Aberration with Astigmatism and Axial Length in Cataract Patients

“…Postoperative residual ocular astigmatism and SAs lead to halo or other visual complaints and worsen the optical performance, even when the best-corrected visual acuity is good. The overall prevalence of astigmatism ranges from 86.8% to 99% [1]. A considerable proportion of these eyes in patients with cataract require correction of astigmatism (43.9% of patients with corneal astigmatism of ≥1.0 D in Southern China, 46.70% in Northern China, 37.80% in Thailand, and 40.41% in the United Kingdom), which can be effectively accommodated by the cylindrical power of the toric IOLs available, as demonstrated in previous clinical studies [1–10].…”

“…The overall prevalence of astigmatism ranges from 86.8% to 99% [1]. A considerable proportion of these eyes in patients with cataract require correction of astigmatism (43.9% of patients with corneal astigmatism of ≥1.0 D in Southern China, 46.70% in Northern China, 37.80% in Thailand, and 40.41% in the United Kingdom), which can be effectively accommodated by the cylindrical power of the toric IOLs available, as demonstrated in previous clinical studies [1–10]. The correction of SA is also widely performed and is clinically important [11, 12].…”

Long non-coding RNA ANRIL alleviates H2O2-induced injury by up-regulating microRNA-21 in human lens epithelial cells

“…Cataract is the loss of normal transparency of the crystalline lens, which can reduce light transmission to the retina, resulting in decreased visual acuity and functional disability [1,2]. As a leading cause of blindness, cataract accounts for approximately half of the cases of blindness worldwide [3].…”

Resulting choice of toric intraocular lens using three devices and online Barrett calculator

“…Due to cataract patients' postoperative visual quality affected by both surgical induced astigmatism (SIA) and preoperative corneal astigmatism measurement, so better clear corneal incision size and location, precise preoperative corneal astigmatism measurement should both be considered for correction during cataract surgery to gain better postoperative visual quality [1][2][3]. Rational surgical planning (toric intraocular lens (IOL), clear corneal incision at the steepest axis, peripheral corneal relaxing incisions etc) plays an important role in the whole process.…”