Abstract
BackgroundIn the present study, we aimed to analyze the effects of cataract surgery using a 1.8-mm steep-axis clear corneal incision (CCI) on the posterior corneal surfaces based on the keratometry from the rotating Scheimpflug imaging device (Pentacam HR) in candidates for toric intraocular lens (IOL) implantation.MethodsPreoperative and at least 1-month postoperative data measured by Pentacam HR were collected in patients for toric IOL implantation. Surgically induced astigmatism on the posterior cornea (P-SIA) was calculated based on the preoperative and postoperative keratometric data, and the related factors of P-SIA were analyzed.ResultsA total of 60 eyes from 56 patients were enrolled. The preoperative anterior, posterior and total corneal astigmatism was 1.58 ± 0.61 D,0.28 ± 0.22 D and 1.70 ± 0.52 D respectively. The postoperative anterior, posterior and total corneal astigmatism was 1.26 ± 0.68 D, 0.41 ± 0.26 D and 1.30 ± 0.51 D respectively. The astigmatism was significantly decreased on anterior surface (P<0.001, paired t-test) and increased on posterior surface (P<0.001, paired t-test). The mean of P-SIA calculated by Holladay–Cravy–Koch method was 0.34 ± 0.20 D, with 0.5 D or greater accounting for 26.7%. A statistically significant correlation was observed between the P-SIA and preoperative anterior corneal astigmatism (r = 0.29, P = 0.024), as well as preoperative posterior corneal astigmatism (r = 0.27, P = 0.038). Multivariate regression analysis showed the preoperative anterior and posterior corneal astigmatism had a significant effect on P-SIA (F = 7.344, P = 0.001).ConclusionsIn candidates for toric IOL implantation with a 1.8-mm steep-axis CCI, the incision caused a significant reduction of the anterior corneal astigmatism but an increase of the posterior corneal astigmatism. P-SIA could not be ignored, and it played a significant role in SIA, especially in cases with higher preoperative anterior or posterior corneal astigmatism.
Highlights
In the present study, we aimed to analyze the effects of cataract surgery using a 1.8-mm steep-axis clear corneal incision (CCI) on the posterior corneal surfaces based on the keratometry from the rotating Scheimpflug imaging device (Pentacam HR) in candidates for toric intraocular lens (IOL) implantation
Patients were included if they met the criteria as follows: (1) patients aged at least 45 years old who were scheduled for cataract surgery; (2) regular corneal astigmatism
The number of eyes with the preoperative anterior corneal astigmatism less than 1.5 D accounted for 48.3%, that of ≥1.5 D and < 2.5 D accounted for 43.3%, and that of more than 2.5 D accounted for 8.3% (Table 1)
Summary
We aimed to analyze the effects of cataract surgery using a 1.8-mm steep-axis clear corneal incision (CCI) on the posterior corneal surfaces based on the keratometry from the rotating Scheimpflug imaging device (Pentacam HR) in candidates for toric intraocular lens (IOL) implantation. Corneal relaxing incision (CRI), limbal relaxing incision (LRI) and toric intraocular lens (IOL) are used to correct corneal astigmatism, and remarkable results have been achieved [4,5,6,7]. The accurate measurements of corneal astigmatism are overwhelmingly important for the correction of corneal astigmatism. With the development of the Scheimpflug anterior segment analysis system, the measurement of astigmatism on the posterior cornea has been achieved. Some characteristics about posterior cornea have been revealed [8,9,10,11], and it has been widely accepted that the posterior corneal astigmatism is non-ignorable, especially in patients for toric IOL implantation [11,12,13]
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