Abstract

Estimation of corneal refractive power (CRP) is of crucial importance to refractive and cataract surgery. The ratio of posterior to anterior curvature radii of the cornea (P/A ratio) is one of the key factors to determine the actual CRP (True-K). While the traditional method to calculate the CRP (Sim-K) is based on a constant P/A ratio (0.82), it is suggested that the P/A ratio varies in different people and exhibits a distribution pattern, which may have an impact on the accuracy of CRP estimation and postoperative refractive outcome. In this multicenter study, we aimed to investigate the distribution pattern of the P/A ratio in a large number of myopic patients, and further explore the relationship between P/A ratio and ΔK (the difference between True-K and Sim-K). We found that distribution of the P/A ratio ranged from 0.72 to 0.86 with an average value of 0.82 ± 0.01. The compensation effect of the refractive power of the posterior on the anterior surface of the cornea decreased with the increase of P/A ratio. There was a significant correlation between P/A ratio and ΔK in all eyes (r = 0.9764, P < 0.0001). A change of 0.1 in P/A ratio could cause a change of 0.75 D in ΔK. Our study suggests that the actual P/A ratio should be taken into consideration in refractive and cataract surgery when calculating the CRP and power of the intraocular lens in eyes with significantly deviated P/A ratios.

Highlights

  • The corneal refractive power (CRP) accounts for 2/3 of the total refractive power of human eyes and it is essential in refractive and cataract surgery

  • Our results could be of clinical significance and implications in myopic refractive and cataract surgery. This retrospective study conformed to the tenets of the Declaration of Helsinki and was approved by the Institutional Review Board (IRB) of Guangzhou Aier Eye Hospital (GZ), Shenyang Aier Eye Hospital (SY), Wuhan Aier Eye Hospital (WH), Chengdu Aier Eye Hospital (CD) and Hankou Aier Eye Hospital (HK)

  • P/A ratio distribution was slightly negatively skewed.The average P/A ratio was 0.82 ± 0.01 (95% normal range: 0.79–0.84) with a 95% confidence interval (CI) of 0.8148–0.8154 and a coefficient of variance of 1.66%

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Summary

Introduction

The corneal refractive power (CRP) accounts for 2/3 of the total refractive power of human eyes and it is essential in refractive and cataract surgery. A small change in the CRP can lead to a significantly alteration of the refractive state. Accurate estimation of the CRP is important for achieving satisfactory postoperative visual acuity after refractive and cataract surgery. Errors in calculation of the intraocular lens (IOL) power mainly stem from inaccurate measurement of the axial length, anterior chamber depth and CRP [1, 2]. 3.69% of the refractive errors after cataract surgery are caused by the wrong P/A ratio [3].

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