Abstract

Study of steepening, flattening, clockwise, and counter-clockwise torque effect is indispensable to understand and design surgical induced astigmatism calculator. Hence, in this study by constructing a novel Microsoft Office Excel 2007 based astigmatic calculator following cataract surgery, analysis on the accuracy and predictability evaluated for the performance. Post-cataract surgery patients from May 2019 to January 2020 at a tertiary medical institution recruited for this present study. Based on Pythagoras principle, MS Excel calculator designed and the law of cousins for calculating the vector magnitude and axis respectively. Manual keratometry measurements for pre and postoperative horizontal (Kh) and vertical (Kv) curvatures established, and statistical analysis for the resultant SIA magnitude and axis deduced with Medcalc software comparing with the existing SIA 2.1 version calculator. A total of 29 eyes of 25 patients studied with a mean age of 62.55 (±8.08) years, males contributing to 14 (56%), and right laterally in 17 (58%) eyes. MS Excel and SIA 2.1 versions calculated a mean SIA magnitude of 0.66 (±0.47) D and 0.64 (±0.55) D respectively. Pearson coefficient correlation (r=-0.16, p=0.40), paired-two sample test (t value= 0.11, p= 0.91) and ROC curve analysis (AUC = 0.75, p= 0.34, 95% CI= 0.25 to 0.99) calculated. Regression equation (y = 0.75 + -0.14 x) and limits of agreements (95% CI -0.29 to 0.31) analyzed, and, 95% of data points distributed within ±1.96 SD of the line of equality on Bland-Altman difference plots.The present calculator proclaimed an acceptable accuracy and agreement with a prediction of 0.61 Diopter for every unit change in the magnitude of SIA 2.1 software in addition to consideration of interchangeability.

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