Ying-Ying Jin1, Zhen Zhou2, Xiao-Yong Yuan2, Hui Song2, Xin Tang1,2,3,4. 1. Tianjin Medical University, Tianjin 300070, China. 2. Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Hospital, Tianjin 300020, China. 3. Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin 300020, China. 4. Tianjin Eye Institute, Tianjin 300020, China.
Abstract
AIM: To explore the effect of the posterior astigmatism on total corneal astigmatism and evaluate the error caused by substituting the corneal astigmatism of the simulated keratometriy (simulated K) for the total corneal astigmatism in age-related cataract patients. METHODS: A total of 211 eyes with age-related cataract from 164 patients (mean age: 66.8±9.0y, range: 45-83y) were examined using a multi-colored spot reflection topographer, and the total corneal astigmatism was measured. The power vector components J0 and J45 were analyzed. Correlations between the magnitude difference of the simulated K and total cornea astigmatism (magnitude differenceSimK-Tca), anterior J0, and absolute meridian difference (AMD) between the anterior and posterior astigmatisms were calculated. To compare the astigmatism of the simulated K and total cornea both in magnitude and axial orientation, we drew double-angle plots and calculated the vector difference between the two measures using vector analysis. A corrective regression formula was used to adjust the magnitude of the simulated K astigmatism to approach that of the total cornea. RESULTS: The magnitude differenceSimK-Tca was positively correlated with the anterior corneal J0 (Spearman's rho= 0.539; P<0.001) and negatively correlated with the AMDR (Spearman's rho=-0.875, P<0.001). When the anterior J0 value was larger than 1.3 D or smaller than -0.8 D, the errors caused by determining the total corneal astigmatism with the karatometric calculation tended to be greater than 0.25 D. An underestimation by 16% was observed for against the rule (ATR) astigmatism and an overestimation by 9% was observed for with the rule (WTR) astigmatism when ignoring the posterior measurements. CONCLUSION: Posterior corneal astigmatism should be valued for more precise corneal astigmatism management, especially for higher ATR astigmatism of the anterior corneal surface. We suggest a 9% reduction in the magnitude of the simulated K in eyes with WTR astigmatism, and a 16% addition of the magnitude of the simulated K in eyes with ATR astigmatism.
AIM: To explore the effect of the posterior astigmatism on total corneal astigmatism and evaluate the error caused by substituting the corneal astigmatism of the simulated keratometriy (simulated K) for the total corneal astigmatism in age-related cataractpatients. METHODS: A total of 211 eyes with age-related cataract from 164 patients (mean age: 66.8±9.0y, range: 45-83y) were examined using a multi-colored spot reflection topographer, and the total corneal astigmatism was measured. The power vector components J0 and J45 were analyzed. Correlations between the magnitude difference of the simulated K and total cornea astigmatism (magnitude differenceSimK-Tca), anterior J0, and absolute meridian difference (AMD) between the anterior and posterior astigmatisms were calculated. To compare the astigmatism of the simulated K and total cornea both in magnitude and axial orientation, we drew double-angle plots and calculated the vector difference between the two measures using vector analysis. A corrective regression formula was used to adjust the magnitude of the simulated K astigmatism to approach that of the total cornea. RESULTS: The magnitude differenceSimK-Tca was positively correlated with the anterior corneal J0 (Spearman's rho= 0.539; P<0.001) and negatively correlated with the AMDR (Spearman's rho=-0.875, P<0.001). When the anterior J0 value was larger than 1.3 D or smaller than -0.8 D, the errors caused by determining the total corneal astigmatism with the karatometric calculation tended to be greater than 0.25 D. An underestimation by 16% was observed for against the rule (ATR) astigmatism and an overestimation by 9% was observed for with the rule (WTR) astigmatism when ignoring the posterior measurements. CONCLUSION: Posterior corneal astigmatism should be valued for more precise corneal astigmatism management, especially for higher ATR astigmatism of the anterior corneal surface. We suggest a 9% reduction in the magnitude of the simulated K in eyes with WTR astigmatism, and a 16% addition of the magnitude of the simulated K in eyes with ATR astigmatism.
Authors: Douglas D Koch; Richard B Jenkins; Mitchell P Weikert; Elizabeth Yeu; Li Wang Journal: J Cataract Refract Surg Date: 2013-10-26 Impact factor: 3.351