Abstract
Purpose To clarify the distribution of corneal spherical aberrations (SAs) in cataract patients with different corneal astigmatism and axial length. Setting Department of Ophthalmology and Vision Science of the Eye and ENT Hospital of Fudan University, Shanghai, China. Design Retrospective case series. Methods The axial length, corneal SAs, and other corneal biometrics were collected in cataract patients with Pentacam HR and IOLMaster 500. The statistical analysis of the corneal SAs was based on the stratification of axial length and anterior corneal astigmatism. Results In total, 6747 eyes of 6747 patients were recruited, with 2416 eyes (58.17 ± 16.81 years old) in the astigmatism group (anterior corneal astigmatism ≥1 D) and others (61.82 ± 12.64 years old) in the control group. In patients with astigmatism <2 D, the total and anterior SAs decreased as the axial length increased (P < 0.001). The total corneal SAs of patients with astigmatism of 2-3 D stabilized at around 0.29 μm, whereas those of patients with anterior corneal astigmatism ≥3 D tended to be variable. Age and anterior corneal astigmatism had positive and negative effects, respectively, on SA in the regression model. Conclusions Axial length has a negative effect on the anterior and total corneal SAs, which stabled around 0.33 μm and 0.30 μm in patients with axial length of ≥26 mm, respectively. Individualized SA adjustments are essential for patients undergoing aspheric toric IOL implantation with preoperative anterior corneal astigmatism of 1-2 D or ≥3 D. Toric IOLs with a negative SA of −0.20 μm are recommended for patients with anterior corneal astigmatism of 2-3 D if no customized therapy is warranted.
Highlights
Intraocular lenses (IOLs) have been designed for and are implanted into aphakic eyes to substitute for natural lenses, partly to rectify the spherical refractive power in the ocular optical system
To identify practical and operational parameters for clinical IOL selection, all the patients were stratified into seven levels according to their axial length:
Several statistically significant correlations of the corneal biometrics were found with the axial length and the anterior corneal astigmatism (Supplementary Material Table 2). e compositions of the astigmatism types varied with the different astigmatism levels and axial length
Summary
Intraocular lenses (IOLs) have been designed for and are implanted into aphakic eyes to substitute for natural lenses, partly to rectify the spherical refractive power in the ocular optical system. Nowadays other astigmatism belonging to high-order aberrations were beyond the correction of both IOLs and glasses. 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. 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 ailand, 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 [1,2,3,4,5,6,7,8,9,10]. 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 ailand, 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 [1,2,3,4,5,6,7,8,9,10]. e correction of SA is widely performed and is clinically important [11, 12]
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