Abstract
BackgroundTo investigate the impact of the orientation of preoperative corneal astigmatism on achieving the postoperative target refraction following monofocal intraocular lens (IOL) implantation.MethodsThis study enrolled 339 eyes who had uneventful cataract surgery or refractive lens exchange (RLE) with subsequent monofocal IOL implantation. Eyes were initially categorized dependent upon axial length and then on the orientation of preoperative anterior corneal astigmatism. Group 1 had against-the-rule (ATR) anterior corneal astigmatism, group 2 had with-the-rule (WTR) anterior corneal astigmatism, and group 3 had oblique (OB) anterior corneal astigmatism. The preoperative corneal astigmatism was determined by the IOLMaster (Carl Zeiss Meditec AG). Postoperative refraction was completed for all eyes, and the results were calculated and compared for the separate groups.ResultsIn eyes with axial lengths greater than 22.0 mm and less than 25.0 mm there was a significant difference between the magnitude of preoperative corneal astigmatism between groups 2 and 3 with 0.827 ± 0.376 D in group 2, and 0.677 ± 0.387 D in group 3. The mean postoperative spherical equivalent (SE) prediction error was − 0.132 ± 0.475 D in group 1, 0.026 ± 0.497 D in group 2, and − 0.130 ± 0.477 D in group 3. There was a significant difference between groups 1 and 2. There was no significant difference in the magnitude of preoperative corneal astigmatism and postoperative SE prediction error between the anterior corneal astigmatism orientation groups in eyes with axial lengths of less than or equal to 22.0 mm and greater than or equal to 25.0 mm.ConclusionsThe orientation of preoperative anterior corneal astigmatism significantly affected the postoperative biometry prediction error in eyes with astigmatism of 1.75 D or less in eyes with the axial length between 22.0 mm and 25.0 mm. However, the results were not clinically significant.
Highlights
To investigate the impact of the orientation of preoperative corneal astigmatism on achieving the postoperative target refraction following monofocal intraocular lens (IOL) implantation
It has been reported that postoperative spherical equivalent (SE) refraction is within ±0.50 dioptres (D) of the target refraction in 75% of eyes following routine cataract surgery [4]
All eyes had 1.75 D or less of preoperative corneal astigmatism, and the eyes were divided, initially, on axial length and into groups depending upon the orientation of preoperative anterior corneal astigmatism
Summary
To investigate the impact of the orientation of preoperative corneal astigmatism on achieving the postoperative target refraction following monofocal intraocular lens (IOL) implantation. It is assumed that there is a fixed relationship between the front and back corneal surfaces, it has been recognized that there is not a fixed relationship between the anterior and posterior corneal astigmatism with both the anterior and posterior cornea changing in shape with age [6,7,8]. It is unknown how this relationship affects biometry outcomes. This study sought to investigate the impact of the anterior corneal
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