Investigating the impact of preoperative corneal astigmatism orientation on the postoperative spherical equivalent refraction following intraocular lens implantation

Richard N. McNeely, Salissou Moutari, Eric Pazo, Jonathan E. Moore

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Abstract

Background: To investigate the impact of the orientation of preoperative corneal astigmatism on achieving the
postoperative target refraction following monofocal intraocular lens (IOL) implantation.
Methods: This 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.
Results: In 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.
Conclusions: The 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.
Original languageEnglish
Article number7
Number of pages8
JournalEye and Vision
Volume5
DOIs
Publication statusPublished - 25 Apr 2018

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