Abstract

BackgroundCurrently, there is no standard technique for determining corneal astigmatism. The iTrace wavefront aberrometry of cornea calculated steep power and axis based on the best Zernike mathematical fit from all topo data within 4 mm circle. It was supposed to be more accurate than iTrace simulated keratometry which was calculated based on only 4 points on the circle of 3 mm. This aim of this study was to evaluate visual outcomes and rotational stability after toric intraocular lens (IOL) implantation using the wavefront aberrometry of the cornea with iTrace.Setting: Single site in China, Shanxi Eye Hospital, Shanxi, China.Design: Prospective case series.MethodsThe study included 85 eyes of 63 patients undergoing phacoemulsification and toric IOL implantation. The IOL power and cylinders were chosen with the help of the iTrace toric planning program using wavefront keratometric astigmatism. Astigmatic changes were assessed using Alpins vector method over a 3-month follow-up period.ResultsPreoperative mean corneal topographic astigmatism was 1.91 diopters (D) ± 0.69 (standard deviation). Postoperative mean refractive astigmatism decreased significantly to 0.48 D ± 0.34. Surgical induced astigmatism was 1.73 D ± 0.77 and the mean correction index was 0.89 ± 0.22, showing a slight undercorrection. The proportion of astigmatism ≤0.50 D increased from 0 to 71.8% postoperatively.ConclusionsThis is the first study on evaluation of clinical outcomes of toric IOL implantation in corneal astigmatism patients using iTrace wavefront keratometric readings. The findings show that use of iTrace built-in toric calculator is safe and effective for planning toric IOL surgery for wavefront keratometric astigmatism.Trial registrationCurrent Controlled Trials ISRCTN94956424, Retrospectively registered (Date of registration: 05 February 2020).

Highlights

  • There is no standard technique for determining corneal astigmatism

  • Inclusion criteria were cataract patients with preexisting regular corneal astigmatism and wanted a toric intraocular lens (IOL) implantation; their cylindric values were between 0.75 D and 5.0 D

  • The iTrace wavefront aberrometry of cornea calculated steep power and axis based on the best Zernike mathematical fit from all topo data within 4 mm circle

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Summary

Introduction

There is no standard technique for determining corneal astigmatism. It was supposed to be more accurate than iTrace simulated keratometry which was calculated based on only 4 points on the circle of 3 mm. This aim of this study was to evaluate visual outcomes and rotational stability after toric intraocular lens (IOL) implantation using the wavefront aberrometry of the cornea with iTrace. Corneal astigmatism management has become crucial in modern cataract and refractive surgery practices. Keratometers, corneal topographers, anterior segment tomographers, and intraoperative aberrometers can each provide corneal measurements necessary to accurately predict the ideal IOL cylinder power and alignment meridian to correct astigmatism during cataract surgery [6]. There is no standard technique for measuring corneal astigmatism

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