Influence of posterior corneal astigmatism on postoperative refractive astigmatism in pseudophakic eyes after cataract surgery

Sano, Maki; Hiraoka, Takahiro; Ueno, Yuta; Itagaki, Hideo; Ogami, Tomohiro; Oshika, Tetsuro

doi:10.1186/s12886-016-0391-1

Cited by 25 publications

(22 citation statements)

References 18 publications

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“…e previous studies demonstrated that refractive and total corneal astigmatism in pseudophakic eyes after cataract surgery with a 2.8 mm or more incision had a weak correlation in univariate regression analysis (R 2 values: 0.13 to 0.36) [2,17]. A more recent study showed a strong correlation in pseudophakic eyes after cataract surgery with a 2.0 mm incision (R 2 values: 0.70 to 0.85) [18].…”

Section: Discussionmentioning

confidence: 95%

“…A previous study showed that, in pseudophakic eyes after cataract surgery with an incision of 3.5 mm or more, preoperative keratometric astigmatism was the most significant predictor of postoperative refractive astigmatism in multivariate regression analysis [1]. On the other hand, total corneal astigmatism seems to be more suitable than keratometric astigmatism for the evaluation of postoperative refractive astigmatism as the relationship between refractive and total corneal astigmatism is stronger than that between refractive and keratometric astigmatism in pseudophakic eyes [2]. Currently, advances in technology in cataract surgery have led to a reduction of incision size to 2.4-mm or less [3].…”

Section: Introductionmentioning

confidence: 99%

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Multivariate Regression Analysis to Predict Postoperative Refractive Astigmatism in Cataract Surgery

Kawahara

Sato

Hayashi

2020

Journal of Ophthalmology

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Purpose. To assess the correlation between postoperative refractive astigmatism and preoperative parameters in cataract surgery. Methods. Left eyes of 100 consecutive patients scheduled for cataract surgery with a 2.4 mm clear corneal incision were examined prospectively. Refractive astigmatism was measured using an autokerato/refractometer. Corneal astigmatism of the total cornea was calculated using a Scheimpflug camera. The vertical/horizontal component (J0) and oblique component (J45) of refractive and total corneal astigmatism were determined using power vector analysis. Refractive astigmatism at 8 weeks postoperatively was estimated using multivariate linear regression analysis. Independent variables analyzed included age, sex, refractive astigmatism, total corneal astigmatism, sphere, intraocular pressure, corneal thickness, anterior chamber depth, lens thickness, axial length, and pupil diameter. Results. Multivariate regression analysis identified total corneal J0 and age as significant contributors to postoperative refractive J0 (P<0.001 and P=0.029, respectively). The standard partial regression coefficients in the multiple regression analysis were 0.59 and −0.16 for total corneal J0 and age, respectively. Significant contributors to postoperative refractive J45 were total corneal J45 and lens thickness (P<0.001 and P=0.015, respectively). The standard partial regression coefficients were 0.79 and −0.15 for total corneal J45 and lens thickness, respectively. Conclusion. These results suggest that preoperative total corneal astigmatism is the most significant predictor of postoperative refractive astigmatism when performing astigmatism correction in cataract surgery.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Multivariate Regression Analysis to Predict Postoperative Refractive Astigmatism in Cataract Surgery

Kawahara

Sato

Hayashi

2020

Journal of Ophthalmology

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“…Although some authors believe posterior corneal indices add no value to the diagnosis of keratoconus, 14 others suggest that posterior corneal curvature has an important role in different fields, such as differentiation of subclinical keratoconus from normal, 15 and in the accurate calculation of intraocular lens (IOL) power in cataract patients. 16 The importance is highlighted in patients with Down syndrome due to their higher risk for keratoconus 2 and higher prevalence of cataract. 17…”

Section: Discussionmentioning

confidence: 99%

Total corneal refractive power and shape in Down syndrome

Asgari

Mehravaran

Fotouhi

et al. 2019

European Journal of Ophthalmology

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Purpose: To determine the total corneal refractive power in 1–8 mm corneal zones and the 8 mm Q-value in non-keratoconic patients with Down syndrome and normal subjects aged 10–30 years. Methods: Right eye data from 203 Down syndrome patients (mean ± standard deviation age: 17.0 ± 4.7 years) and 189 age- and gender-matched normal subjects (17.1 ± 4.5 years) were compared. Main extracted Pentacam indices were total corneal refractive power in steep and flat axes, and mean and difference (corneal astigmatism) total corneal refractive power in 1–8 mm zones. Results: Mean total corneal refractive power in 1–8 mm zones was 45.17–45.74 D and 42.91–43.52 D in Down and normal group, respectively (all p < 0.001). The coefficients of variation of total corneal refractive power from the center to the periphery were similar in the two groups (p = 0.855). None of the mean total corneal refractive powers significantly correlated with age, and all of them were significantly higher in females (p < 0.001). Mean total corneal refractive power–based corneal astigmatism in these zones changed from 1.46 to 1.66 D in Down syndrome patients and 1.64 to 1.99 D in normal group. All corneal astigmatism indices were similar between two groups (all p > 0.05). The prevalence of against the rule and oblique astigmatism in all zones were higher in the Down syndrome group (all p < 0.05). Conclusion: Adolescent and young non-keratoconic patients with Down syndrome have a more prolate cornea and a homogeneous keratometry distribution. In this population, females have a steeper cornea.

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“…In contrast, in ATR eyes, the Barrett calculator suggests a stronger spherical component ( Table 4 ). These results can be explained based on the expected overcorrection in WTR astigmatism and undercorrection in ATR astigmatism, as is often described in the literature [ 21 , 22 ]. The Barrett calculator weakens lens power in WTR astigmatism to avoid overcorrection and strengthens it in ATR astigmatism to avoid the expected undercorrection.…”

Section: Discussionmentioning

confidence: 74%

Comparison of Two Toric IOL Calculation Methods

Kern

Kortüm

Müller

et al. 2018

Journal of Ophthalmology

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Purpose To compare two calculators for toric intraocular lens (IOL) calculation and to evaluate the prediction of refractive outcome. Methods Sixty-four eyes of forty-five patients underwent cataract surgery followed by implantation of a toric intraocular lens (Zeiss Torbi 709 M) calculated by a standard industry calculator using front keratometry values. Prediction error, median absolute error, and refractive astigmatism error were evaluated for the standard calculator. The predicted postoperative refraction and toric lens power values were evaluated and compared after postoperative recalculation using the Barrett calculator. Results We observed a significant undercorrection in the spherical equivalent (0.19 D) by using a standard calculator (p ≤ 0.05). According to the Baylor nomogram and the refractive influence of posterior corneal astigmatism (PCA), undercorrection of the cylinder was lower for patients with WTR astigmatism, because of the tendency of overcorrection. An advantage of less residual postoperative SE, sphere, and cylinder for the Barrett calculator was observed when retrospectively comparing the calculated predicted postoperative refraction between calculators (p ≤ 0.01). Conclusion Consideration of only corneal front keratometric values for toric lens calculation may lead to postoperative undercorrection of astigmatism. The prediction of postoperative refractive outcome can be improved by using appropriate methods of adjustment in order to take PCA into account.

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Influence of posterior corneal astigmatism on postoperative refractive astigmatism in pseudophakic eyes after cataract surgery

Cited by 25 publications

References 18 publications

Multivariate Regression Analysis to Predict Postoperative Refractive Astigmatism in Cataract Surgery

Multivariate Regression Analysis to Predict Postoperative Refractive Astigmatism in Cataract Surgery

Total corneal refractive power and shape in Down syndrome

Comparison of Two Toric IOL Calculation Methods

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