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Brar S, Ganesh S, Karegowda M. Clinical outcomes and rotational stability after implantation of a monofocal toric intraocular lens with textured haptics in normal vs high axial lengths. J Cataract Refract Surg 2024; 50:718-723. [PMID: 38377183 DOI: 10.1097/j.jcrs.0000000000001429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/11/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE To compare the clinical outcomes and rotational stability after implantation of a toric intraocular lens (IOL) with textured haptics in eyes with normal vs high axial lengths (ALs). SETTING Nethradhama Superspeciality Eye Hospital, Bangalore, India. DESIGN 2-arm, retrospective comparative study. METHODS This retrospective study included 114 eyes of 114 patients who underwent femtolaser cataract surgery followed by implantation of the HOYA Vivinex Toric monofocal IOL (Model XY1A-SP), of which 62 and 52 eyes belonged to normal (≤23.9 mm) and high (≥24 mm) AL groups, respectively. 1 week and 3 months postoperatively, clinical outcomes and rotational stability of the toric IOL was evaluated. RESULTS 3 months postoperatively, % eyes achieving refractive astigmatism accuracy within ≤0.50 diopter, was 100% (n = 62) in the normal vs 94% (n = 49) in the high AL group. All eyes that is, 100% (n = 62) in the normal and 96.15% (n = 50) eyes in the high myopia group were <5 degrees of the intended axis. The mean change in postoperative rotation from 1 week to 3 months was 0.28 ± 0.09 degrees in the normal, and 0.30 ± 1.11 degrees in the high AL group ( P = .80). No significant correlation was observed between AL and white-to-white diameter with 1-week postoperative rotation values. No eye required repositioning of toric IOL for significant misalignment. CONCLUSIONS No significant differences were observed for clinical outcomes and postoperative rotational stability between eyes with normal and high ALs, suggesting excellent rotational stability of the Vivinex Toric IOL with textured haptics in all eyes, irrespective of the preoperative AL measurements.
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Affiliation(s)
- Sheetal Brar
- From the Department of Phaco and Refractive Services, Nethradhama Super Speciality Eye Hospital, Bangalore, India
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Yang S, Park J, Whang WJ, Byun YS, Kim HS, Chung SH. Accuracy of Toric Intraocular Lens Calculators with Predicted and Measured Posterior Corneal Astigmatism Across Different Types of Astigmatism. Ophthalmol Ther 2024; 13:1877-1889. [PMID: 38581606 PMCID: PMC11178704 DOI: 10.1007/s40123-024-00931-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/07/2024] [Indexed: 04/08/2024] Open
Abstract
INTRODUCTION This study is a retrospective case series to compare the accuracy of the Barrett toric calculator using predicted posterior corneal astigmatism (PCA) and PCA measurements using swept-source optical coherence tomography (SS-OCT) and a Scheimpflug camera. This evaluation was conducted across different types of anterior and posterior astigmatism. METHODS A total of 146 eyes from 146 patients implanted with toric intraocular lenses were included. Mean absolute prediction error, standard deviation of prediction error, and the percentage of eyes with prediction errors within ±0.50 diopters (D) were calculated using vector analysis. Biometric measurements were conducted using the IOLMaster 700 and Pentacam HR. A subgroup analysis was conducted based on the orientation of both anterior and posterior corneal astigmatism. RESULTS The Barrett toric calculator with predicted PCA yielded the best results, with 78.1% having a prediction error ≤ 0.50 D, which was a significantly higher percentage than the Barrett formula with the two versions of measured PCA (P < 0.05). In the subgroup with a horizontally steep meridian PCA using the IOLMaster 700, the Barrett formula with predicted PCA yielded the best results, with 78.3% of cases having a prediction error of less than 0.5 D. This percentage was significantly higher than the other two measured PCA subgroups (P < 0.05). CONCLUSION The Barrett toric formula with predicted PCA demonstrated a statistically significantly higher proportion of cases with a prediction error ≤ 0.5 D compared to the two measured PCA formulas (from the IOLMaster 700 or Pentacam). This trend persisted even when the posterior corneal astigmatism was horizontally steep.
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Affiliation(s)
- Soonwon Yang
- Department of Ophthalmology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jaehyun Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Woong Joo Whang
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-Soo Byun
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Hyun Seung Kim
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - So-Hyang Chung
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Li Z, Guo R, Hu X, Yang X, Wen Z, Lin Y, Zhang H. Comparison of cataract patients with regular corneal astigmatism after implantation of extended range-of-vision and bifocal toric intraocular lenses. Front Med (Lausanne) 2023; 10:1105876. [PMID: 37849485 PMCID: PMC10577169 DOI: 10.3389/fmed.2023.1105876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/07/2023] [Indexed: 10/19/2023] Open
Abstract
Purpose To compare the postoperative visual acuity and visual quality between extended range-of-vision and multifocal toric intraocular lens (IOLs) after implantation in cataract patients with regular corneal astigmatism. Setting Department of Ophthalmology, the Second Hospital of Jilin University, Changchun, Jilin Province, China. Design Retrospective and single-center study. Methods The study involved implanting the Tecnis Symphony (ZXR00IOL) or the bifocal toric (ZMTIOL) in patients undergoing cataract surgery. Three months after surgery, lens performance was evaluated using distance, intermediate, and near visual acuity tests, defocus curves, the modulation transfer function (MTF), a visual function index questionnaire (VF-14), and the adverse optical interference phenomena. Results The 3-month postoperative follow-up found that both groups had good corrected distance vision. The ZMT group had better-uncorrected distance visual acuity and near visual acuity (p < 0.05). However, the ZXR group showed better uncorrected intermediate visual acuity (p < 0.05) and visual continuity. Overall astigmatism in the postoperative ZMT group was significantly lower than that in the pre-operative group (p < 0.05). The ZMT group had lower total high-order aberrations (tHOs), higher MTF values, and higher VF-14 scores (p < 0.05). Finally, the ZXR group exhibited reduced halo and glare phenomena (p < 0.05). Conclusion We found that ZMT can effectively correct a corneal astigmatism of 1.0-1.5 D and ZXR can improve patient outcomes regarding subjective optical quality and range of vision. These findings have the potential to improve future astigmatism treatment options.
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Affiliation(s)
| | | | | | | | | | | | - Hui Zhang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China
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Gauthier A, Awidi AA, Noble PM, Daoud YJ. Factors Predictive of Refractive Error After Toric Lens Implantation. Clin Ophthalmol 2023; 17:1813-1821. [PMID: 37397954 PMCID: PMC10312349 DOI: 10.2147/opth.s407414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/02/2023] [Indexed: 07/04/2023] Open
Abstract
Purpose To identify factors related to suboptimal refractive outcomes after toric intraocular lens implantation. Patients and Methods A retrospective case-control chart review of 446 eyes with toric lens insertion by the same surgeon at a university hospital from 2016 to 2020 was conducted. Pre-operative exam findings, biometry, and one month and three month post-operative vision and refraction were noted. Reviewed charts were considered cases if uncorrected distance visual acuity (UDVA) was worse than 20/40, spherical equivalent (SE) >1 diopter (D) off target, or cylinder >1 D off target. Results Overall, 93.7% (n = 343) of eyes achieved UDVA of 20/40 or better, 92.7% (n = 306) were within 1 D of target SE, and 90.9% (n = 300) were within 1 D of target cylinder. UDVA cases had more eyes with prior LASIK (21.7% vs 7.0%, p = 0.01) and keratoconus (8.7% vs 0.6%, p < 0.001) than controls. More SE cases had prior radial keratotomy (RK) (8.3% vs 0%, p < 0.001) and keratoconus (12.5% vs 0%, p < 0.001) than controls. More cylinder cases had prior LASIK (30.0% vs 8.7%, p < 0.001) and higher mean astigmatism (2.3 vs 1.5 D, p = 0.02) than controls. More cases in all three analyses had higher toric cylinder power (T5-T9) than controls. Age, sex, eye laterality, axial length, anterior chamber depth, lens power, dry eye, anterior basement membrane dystrophy, and Fuchs' endothelial dystrophy differences were not significant. Conclusion Prior LASIK or RK, keratoconus, and higher astigmatism may increase the chance of a suboptimal outcome.
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Affiliation(s)
- Angela Gauthier
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA
| | | | - Paige M Noble
- Department of Ophthalmology, University of Iowa, Iowa City, IA, USA
| | - Yassine J Daoud
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA
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Fus M, Pitrova S. Evaluation of Decentration, Tilt and Angular Orientation of Toric Intraocular Lens. Clin Ophthalmol 2022; 15:4755-4761. [PMID: 34983999 PMCID: PMC8699775 DOI: 10.2147/opth.s346968] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 11/30/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose The aim of this study was to develop software for the universal objective evaluation of factors influencing intraocular correction of astigmatism, such as decentration, tilt, axial position and angular orientation the toric intraocular lens (IOL). Patients and Methods Software was developed using the MS Visual Studio environment. The analysis was presented using images of 67 eyes with an implanted IOLs of the SN6ATx model series. Decentration and angular position of the lens were obtained from images of the anterior segment of the eye, using a Visucam unit. Tilt was measured on tomographic images from OCT Avanti (in meridian of highest tilt and perpendicular meridian) and preoperative biometry parameters of eye (axial length, anterior chamber depth – ACD, ocular lens thickness – LT, limbus diameter and mean keratometry value) including postoperative anterior chamber depth (pACD) were measured using Lenstar LS900. Results Applying the software methodology to the evaluation of individual toric IOL parameters, the following results were obtained: mean decentration 0.25 ± 0.17 mm which was observed in 61.19% of eyes, mean misalignment to the planned axis equal to 3.8 ± 3.6 degrees, mean highest inclination equal to 3.7 ± 1.2 degrees and mean difference of pACD and ACD was equal to 1.46 ± 0.31 mm. There was only a weak nonsignificant correlation between preoperative ACD versus decentration and tilt of IOL or a weak significant correlation between preoperative LT and both decentration and misalignment of IOL. Conclusion The use of the presented methodology for determining the positional parameters of the toric IOL provided comparable results with the results of recent studies. Software design can be considered as a suitable alternative to previously published techniques, with the significant advantage of the possibility of using universal input images, their graphical editing and especially the possibility of comprehensive analysis of all parameters.
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Affiliation(s)
- Martin Fus
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Sarka Pitrova
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
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Hashemian SJ, Hashemian SM, Karimian F, Hadavandkhani A, Jafari ME, Hashemian MS, Hadi Y, Semnani FN. Ocular Biometric Values and Prevalence of Corneal Astigmatism in Patients Candidate for Cataract Surgery. J Curr Ophthalmol 2022; 34:56-59. [PMID: 35620375 PMCID: PMC9128422 DOI: 10.4103/joco.joco_33_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 08/21/2021] [Accepted: 08/24/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To analyze the biometric values and the prevalence of corneal astigmatism in cataract surgery candidates. Methods This is a prospective study. Ocular biometric values and corneal keratometric astigmatism were measured by optical low-coherence reflectometry (Lenstar LS 900) before surgery in patients who were candidates for cataract extraction surgery. Descriptive measurements of biometric dimensions and keratometric cylinder data and their correlations with sex and age were evaluated. Results Ocular biometric and keratometric values from 2084 eyes of 2084 patients (mean age 66.43, range 19-95 years) were analyzed. The mean values were as follows: corneal astigmatism 0.89 diopter (D), mean corneal keratometry 44.29 D, central corneal thickness 534 μ, internal anterior chamber depth (ACD) 3.11 mm, lens thickness 4.50 mm, and axial length 23.35 mm. Corneal astigmatism was <1.25 D in 1660 (79.5%) of eyes. Astigmatism was with-the-rule in 976 (46.8%) of eyes, against-the-rule (ATR) in 702 (33.7%), and oblique in 406 (19.5%). Analysis of corneal astigmatism revealed a change toward "ATR" with age which was not statistically significant. The ACD was correlated with age. The amount of corneal astigmatism had no correlation with age and sex. Conclusion Corneal astigmatism was higher than 1.25 D in about 21% of cataract surgery candidates with slight differences between the various age ranges and had no correlation with age and sex.
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Affiliation(s)
- Seyed Javad Hashemian
- Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Farid Karimian
- Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Hadavandkhani
- Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mahsa Sadat Hashemian
- Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Yasaman Hadi
- Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Nadjafi Semnani
- Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Guven S. Comparison of corneal astigmatism characteristics and prevalence of corneal astigmatism between Turkish individuals and Syrian refugees. Eur J Ophthalmol 2021; 32:1504-1512. [PMID: 34231399 DOI: 10.1177/11206721211030779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To compare the prevalence, magnitude and type of corneal astigmatism between Turkish individuals and Syrian refugees. MATERIAL AND METHODS Data of patients scheduled for cataract surgery between January 2019 and 2020 were reviewed. The patients were randomly stratified according to their ethnicity (Turkish individuals or Syrian refugees). Keratometry was performed with the keratometer of IOLMaster 500. Quantitative analysis was performed using the power vector method (J0 and J45). The association between age and astigmatism in the two groups was explored. RESULTS The study included 4085 eyes of 2049 patients (3962 eyes of Turkish individuals and 123 eyes of Syrian refugees). The mean magnitude of corneal astigmatism, J0, J45 and prevalence of against the rule (ATR) astigmatism and with the rule (WTR) astigmatism were 1.01 D, 0.06, 0.01 D, 37.6% and 43.7% in Turkish individuals and 1.13 D, -0.02, 0.07 D, 46.3% and 37.4% in Syrian refugees, respectively. There were no significant differences according to age, sex, right/left eyes, corneal astigmatism magnitude, keratometric values, J0 and J45 (p > 0.05) between the two groups. Below 40 years of age, the mean corneal astigmatism magnitude in Syrian refugees was significantly higher than that in Turkish individuals (p = 0.037). At all ages, ATR astigmatism prevalence was higher in Syrian refugees than in Turkish individuals. ATR astigmatic shift began at a younger age in Syrian refugees (p = 0.037). Age- and sex-adjusted analysis showed that J0 was significantly lower in Syrian refugees than in Turkish individuals (p = 0.013). CONCLUSION The prevalence and magnitude of ATR astigmatism were higher and onset earlier in Syrian refugees than in Turkish individuals.
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Affiliation(s)
- Soner Guven
- Department of Ophthalmology, Kayseri City Hospital, Kayseri, Turkey
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Refractive and Visual Outcome of Misaligned Toric Intraocular Lens After Operative Realignment. Am J Ophthalmol 2021; 224:150-157. [PMID: 33309811 DOI: 10.1016/j.ajo.2020.11.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE The study was performed to evaluate the refractive and visual outcome of patients with misaligned toric intraocular lenses (IOLs) after operative realignment, with and without back-calculation of the toric axis after implantation of the IOL. DESIGN Institutional, retrospective case-control study. METHODS This is a retrospective case series of 39 patients who underwent a second operation to realign a misaligned toric IOL from August 2013 to December 2019 at the Department of Ophthalmology, Goethe University, Frankfurt, Germany. Ideal toric axis was calculated using the back-calculator astigmatismfix.com. RESULTS The study consists of 39 treated eyes (20 [51%] right eyes). The toric IOLs showed a postoperative misalignment of 25.69 ± 26.06°. Postrotational, uncorrected distance visual acuity (UDVA) improved from 0.39 ± 0.29 logMAR to 0.27 ± 0.18 logMAR. Refractive outcome showed a reduction of residual sphere and cylinder. The postoperative UDVA when performing alignment to the preoperative calculated axis (51%) was 0.24 ± 0.16 logMAR with a cylinder of 0.90 ± 0.90 diopter (D). In the group with alignment to a back-calculated axis (49%), the UDVA was 0.32 ± 0.20 logMAR with a cylinder of 0.76 ± 0.72 D. High cylinder power IOLs (≥2 D) showed a higher decrease in residual cylinder when back-calculation was performed than low cylinder power IOLs (<2 D) (27% vs 9%). The mean spherical equivalent prediction error of the back-calculator was 0.54 ± 0.55 D. CONCLUSION Realignment of misaligned toric IOLs improves visual acuity and reduces residual refractive errors. Especially for high cylinder power IOLs, better refractive outcome can be seen when performing a back-calculation before realignment.
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Sharma A, Phulke S, Agrawal A, Kapoor I, Bansal RK. Prevalence of Astigmatism in Patients Undergoing Cataract Surgery at a Tertiary Care Center in North India. Clin Ophthalmol 2021; 15:617-622. [PMID: 33628007 PMCID: PMC7897979 DOI: 10.2147/opth.s291467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/05/2021] [Indexed: 11/23/2022] Open
Abstract
Aim To assess the demography, magnitude, and type of corneal astigmatism in patients undergoing cataract surgery in North India. Methods It is a clinic-based, cross-sectional, observational study. Keratometric values and demographic data were collected for eligible patients who had undergone phacoemulsification at a tertiary eye care center between January 2010 and December 2017, using a non contact, optical low coherence reflectometry (OLCR). Results A total of 3597 eyes were recruited for the study. There were 1810 (50.3%) females and 1787 (49.7%) males. The mean age was 59.121±15.19 (range 5–100 years). A total of 3559 eyes were qualified for astigmatism analysis. The mean corneal astigmatism among all patients was 1.17±1.15 D (range 0–12.5 D). There was no astigmatism in 99 eyes (2.78%), with-the-rule (WTR) in 1062 eyes (29.83%), against-the-rule (ATR) in 1843 eyes (51.72%) and oblique astigmatism (OA) in 555 eyes (15.59%). The tendency of a gradual change from with the rule (WTR) to against the rule (ATR) astigmatism was noted as the age advanced. Conclusion In the present study around 56.69% of eyes had corneal astigmatism of <1.0 D that can be managed by simple cost-effective keratorefractive procedures especially in developing countries. However, our 40.49% patients had >1.0 D of corneal astigmatism, which may benefit by toric intraocular lenses.
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Affiliation(s)
- Anuj Sharma
- Department of Ophthalmology, Government Medical College and Hospital (GMCH-32), Sector 32, Chandigarh, 160030, India
| | - Sonia Phulke
- Department of Ophthalmology, Government Medical College and Hospital (GMCH-32), Sector 32, Chandigarh, 160030, India
| | - Anugya Agrawal
- Department of Ophthalmology, Government Medical College and Hospital (GMCH-32), Sector 32, Chandigarh, 160030, India
| | - Isha Kapoor
- Department of Ophthalmology, Government Medical College and Hospital (GMCH-32), Sector 32, Chandigarh, 160030, India
| | - Rakesh Kumar Bansal
- Department of Ophthalmology, Government Medical College and Hospital (GMCH-32), Sector 32, Chandigarh, 160030, India
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Arriola-Villalobos P, Burgos-Blasco B, Fernández-Vigo JI, Ariño-Gutiérrez M, Burgos-Blasco P, Carmona-González D, Fernández-Pérez C. Biometry data and prevalence of corneal astigmatism in caucasian spanish candidates for cataract surgery. J Fr Ophtalmol 2020; 44:76-83. [PMID: 33162179 DOI: 10.1016/j.jfo.2020.03.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/12/2020] [Accepted: 03/25/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To describe ocular biometric parameters and the prevalence of corneal astigmatism as well as age and gender correlations in a population of cataract surgery candidates and to estimate the number of eyes that would be candidates for a toric intraocular lens (IOL). METHODS In consecutive patients requiring cataract surgery over a one-year period (June 2016 to June 2017), the following optical biometry measurements were performed on an IOLMaster 700 or Lenstar 900: axial length (AL), anterior chamber depth (ACD), lens thickness (LT), mean keratometry (K), flat keratometry (K1), steep keratometry (K2), corneal astigmatism (Cyl) and white-to-white diameter (WTW). Descriptive statistics for the demographic and biometric data were analyzed. RESULTS The study sample included 6111 eyes of 3332 patients (59.3% women), with a mean age of 74.78±9.7years. The means of the compiled data are as follows: AL 23.58±1.55mm, ACD 3.08±0.41mm, LT 4.55±0.52mm,K 44.15±1.54 diopters (D), K1 43.64±1.57 D, K2 44.69±1.61 D, Cyl 1.0±0.81. D and WTW 11.88±0.46mm. The male patients had significantly larger eyes (higher AL, ACD and WTW) and flatter corneas (lower flat and steep K). Older patients had significantly lower AL, ACD and WTW, while their LT values were higher. Corneas became significantly steeper with age. 60.5% of eyes had less than 1 D of corneal astigmatism, while 3.1% had ≥3.0 D. CONCLUSIONS Less than 1 D of corneal astigmatism was present in the majority of cataract surgery candidates. 3.1% of eyes were candidates for a toric IOL. This study provides useful information on inventory requirements for planning hospital resources.
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Affiliation(s)
- P Arriola-Villalobos
- Servicio de Oftalmología, Hospital Clínico San Carlos, Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - B Burgos-Blasco
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - J I Fernández-Vigo
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - M Ariño-Gutiérrez
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - P Burgos-Blasco
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | - C Fernández-Pérez
- Servicio de Medicina Preventiva y Salud Pública, Hospital Clínico San Carlos, Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Yang JJ, Qin YZ, Qin L, Li JM. Comparison of the clinical efficacy of AcrySof ® IQ and TECNIS ® toric intraocular lenses: A real-world study. Exp Ther Med 2020; 20:25. [PMID: 32934690 PMCID: PMC7471847 DOI: 10.3892/etm.2020.9153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 05/13/2020] [Indexed: 11/23/2022] Open
Abstract
Corneal astigmatism significantly compromises uncorrected visual acuity (UCVA) after phacoemulsification with implantation of traditional spherical or non-spherical monofocal intraocular lens (IOL). Toric IOL provides an effective way to gain favorable postoperative UCVA for the patients with cataracts with corneal astigmatism. There are numerous types of toric IOLs; however AcrySof® IQ toric IOL (Alcon Laboratories, Inc.) and TECNIS® toric IOL (Johnson & Johnson Vision; Johnson & Johnson) are most frequently used in our clinical practice. The purpose of the current study was to compare the clinical efficacy of AcrySof IQ with TECNIS toric IOL implantation, and to provide a clinical basis on selecting an appropriate toric IOL before cataract surgery for patients with corneal astigmatism. A total of 30 patients with cataract (44 eyes) with corneal astigmatism [0.82-7.27 diopters (D)], who have undergone phacoemulsification with toric IOL implantation between October 2012 and December 2017, were included in the current retrospective cohort study. Patients were divided into two groups: One group (26 eyes) received the AcrySof IQ toric IOL (AcrySof group) and the other group (18 eyes) received the TECNIS toric IOL (Tecnis group). The indexes of curative effect, such as uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively), refractive outcomes, contrast sensitivity (CS), IOL rotation, and satisfaction, were evaluated. Both toric IOLs significantly improved UDVA and CDVA. Postoperative mean residual astigmatism was similar in the AcrySof group and in the Tecnis group (0.75±0.50 and 0.78±0.90 D; P=0.896). There was no statistically significant between postoperative CS in the AcrySof and Tecnis groups. Rotations of >10˚ were considered to be significant and were identified in three eyes. The mean IOL rotation showed no statistically significant difference (AcrySof group, 0.24±5.54˚; Tecnis group, -0.19±6.28˚; P=0.416). The mean patient satisfaction score was 8.46±1.21 in the AcrySof group and 8.78±1.44 in the Tecnis group (P=0.260). The results of the current study indicated that patients with cataracts with corneal astigmatism undergoing phacoemulsification with AcrySof IQ and TECNIS toric IOL implantation achieved similar clinical efficacy in term of visual outcomes, refraction correction, CS, rotational stability and satisfaction.
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Affiliation(s)
- Juan-Juan Yang
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Ya-Zhou Qin
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Li Qin
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Jing-Ming Li
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
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Matossian C. Impact of Thermal Pulsation Treatment on Astigmatism Management and Outcomes in Meibomian Gland Dysfunction Patients Undergoing Cataract Surgery. Clin Ophthalmol 2020; 14:2283-2289. [PMID: 32903836 PMCID: PMC7445505 DOI: 10.2147/opth.s263046] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/09/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose This study aimed to assess the effects of thermal pulsation system (TPS) treatment on astigmatism management in meibomian gland dysfunction (MGD) patients undergoing cataract surgery. Patients and Methods This single-center pilot study included 25 eyes of 23 patients who had visually significant cataract and concomitant MGD-associated dry eye in at least 1 eye and were willing to undergo TPS treatment and wait for at least 6 weeks for tear film stabilization prior to cataract surgery. Post-TPS keratometric readings were used for presurgical planning, and the actual postoperative residual refractive astigmatism (RRA) was recorded. Pre-TPS keratometry was used to mathematically simulate the RRA that would have been obtained from the lens choice and astigmatism management without TPS treatment. Results Following TPS treatment, the magnitude of astigmatism increased in 52% of eyes, decreased in 24%, and remained unchanged in 24%. Correspondingly, astigmatism treatment modality changed in 68% of eyes after tear film stabilization with TPS treatment. The type of astigmatism management increased (ie, shifted from no treatment to LRI or LRI to toric IOL) in 25% of eyes and decreased in 8%. Actual RRA ≤0.5 D was achieved in 76% of eyes, compared to simulated RRA ≤0.5 D in 40% of eyes (p=0.004). Conclusion Stabilization of the tear film with TPS treatment resulted in less RRA than if pre-TPS keratometric readings had been used to determine the astigmatism management method and toric IOL power and axis.
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Keshav V, Henderson BA. Astigmatism Management with Intraocular Lens Surgery. Ophthalmology 2020; 128:e153-e163. [PMID: 32798525 DOI: 10.1016/j.ophtha.2020.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 08/03/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022] Open
Abstract
Corneal astigmatism is common. More than 40% of patients undergoing cataract surgery have 1 diopter (D) power or more of astigmatism, which left untreated is visually significant. Because toric intraocular lenses (IOLs) are available, the current standard of care is to offer treatment of astigmatism at the time of cataract surgery. PubMed, MEDLINE, Embase databases, and the Cochrane Library were systematically searched from inception to October 2019. Search words included astigmatism, corneal astigmatism, toric IOLs, alignment, and IOL calculation. Studies evaluated included review articles regarding the origin and history of astigmatism, the diagnosis and management of the disease, and the history of surgical management options for astigmatism. Other studies evaluated in this review included clinical trials, meta-analyses, and retrospective analysis of surgical refractive outcomes. Prediction of refractive outcomes was evaluated with a review of IOL calculators and their use in lens prediction for cataract surgery. Evaluation of these articles also showed improved uncorrected visual acuity with the use of toric IOLs in patients undergoing cataract surgery. New diagnostic technology, new toric IOLs, updated lens formulas, intraoperative guidance, and advanced imaging technology and software have contributed to improvements in the surgical correction of astigmatism.
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Affiliation(s)
- Vinny Keshav
- Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts
| | - Bonnie An Henderson
- Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts.
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Rotational slit-beam marking: an advanced manual corneal astigmatic marking method for toric intraocular lens implantation. Int Ophthalmol 2020; 40:3115-3125. [PMID: 32623630 DOI: 10.1007/s10792-020-01498-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 06/25/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the accuracy of an advanced manual corneal astigmatic marking method for toric intraocular lens (IOL) implantation. METHODS From 52 patients, 52 eyes with cataracts and corneal astigmatism were included. The target axis of the toric IOL was marked with the new manual marking method preoperatively and with the Zeiss CALLISTO Eye image-guided system intraoperatively. For the manual method, a slit-lamp with a minimum rotation angle of 5 degrees was used and rotated to the meridian of the toric IOL and incision axes. The relative rotational and vertical deviation of the IOL and incision axes were measured using the digital marker as a reference. RESULTS There was no significant difference between the manually marked IOL axis (100.9° ± 65.62°) and the digital mark (100.8° ± 65.76°; P = 0.771). The absolute values of the relative rotational and vertical deviations of the manually marked IOL axis were small, at 2.03° ± 1.44° and 0.46 ± 0.43 mm, respectively. There was no significant difference between the manually marked corneal incision and the digital meridian (P = 0.179). Then, patients were classified into three groups based on the type of astigmatism they had. There was no significant difference in mean absolute deviation among the groups (P = 0.112). The manual incision mark had a relative rotational deviation of 1.65° ± 1.44°. The vertical misalignment of the manually marked incision axis was 0.27 ± 0.30 mm. CONCLUSION Rotational slit-beam marking could be an effective and convenient marking method for toric IOL implantation. This method could be a potential alternative in underdeveloped areas where digital image-guided systems are not available.
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Outcome of toric intraocular lenses implanted in eyes with previous corneal refractive surgery. J Cataract Refract Surg 2020; 46:534-539. [PMID: 32271520 DOI: 10.1097/j.jcrs.0000000000000089] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the outcome of toric intraocular lens (IOL) implantation in eyes with previous laser in situ keratomileusis/photorefractive keratectomy (LASIK/PRK). SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. DESIGN Retrospective case series. METHODS Consecutive cases that had previous myopic or hyperopic LASIK/PRK and had undergone cataract surgery with toric IOL implantation were retrospectively reviewed. Included were eyes that had (1) preoperative ocular biometry measurements with the Lenstar, (2) no intraoperative or postoperative complications, and (3) available postoperative manifest refraction at ≥3 weeks with corrected distance visual acuity of 20/30 or better. Vector analysis was used to assess the preoperative corneal and postoperative refractive astigmatism. RESULTS In 56 eyes with previous myopic LASIK/PRK and 19 eyes with previous hyperopic LASIK/PRK, respectively, the mean magnitudes of corneal astigmatism were 1.34 ± 0.62 diopters (D) and 1.66 ± 0.80 D, 5% and 0% of eyes had anterior corneal astigmatism ≤0.50 D, and the centroid values were 0.31 D at 19 degrees ± 1.45 D and 0.74 D at 92 degrees ± 1.72 D preoperatively. Postoperatively, the mean magnitudes of refractive astigmatism were 0.36 ± 0.31 D and 0.34 ± 0.34 D, 80% and 84% of eyes had refractive astigmatism of ≤0.50 D, and the centroid values were 0.12 D at 152 degrees ± 0.46 D and 0.05 D at 172 degrees ± 0.48 D (all P < .05). CONCLUSIONS Toric IOLs were effective to correct preexisting corneal astigmatism in eyes with previous excimer laser corneal refractive surgery.
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Effect of corneal marking features on toric intraocular lens alignment. Int Ophthalmol 2020; 40:1653-1658. [PMID: 32193779 DOI: 10.1007/s10792-020-01333-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 03/13/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to investigate the relation of the corneal ink mark size, shape, and location with the corneal perimeter in terms of the corresponding corneal axis. MATERIAL AND METHODS This study was designed both prospective experimental and literature search. Contact lenses were used to demonstrate the spreading effect of the surgical ink mark. Open-access published corneal images with corneal ink marks were reviewed. Mark size and perimeter of both contact lenses and corneal images were performed in Image J software. RESULTS Twenty contact lenses and 15 corneal images with 32 corneal marks, which were obtained from the literature, were included in the study. Mean degree corresponding to the ink size for the group 1 was 8.3° ± 1.2° (range 5.5-10.3), for group 2 was 11° ± 1.1° (range 8-12), for group 3 was 4.2° ± 0.7° (range 3.2-5.5), for group 4 was 4.2° ± 0.7° (range 3.2-5.5), and for group 5 was 6.3° ± 2.5° (range 2-11.5). DISCUSSION Theoretically, it is wise to target further located ink mark from central cornea based on the 360/2π × (r2 - r1)/(r1 × r2) × M formula. It has been experimentally shown that the smaller corneal perimeter and closer mark to the central cornea may lead the more significant deviation from the targeted axis. Preoperative manual corneal marking may be more responsible for residual astigmatism than it is thought.
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Joshi RS, Jadhav SA. Frequency of Corneal Astigmatism in Patients Presenting for Senile Cataract Surgery at a Teaching Hospital in Indian Rural Population. Asia Pac J Ophthalmol (Phila) 2020; 9:126-129. [PMID: 31923034 DOI: 10.1097/apo.0000000000000262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE The aim of this study was to assess prevalence of corneal astigmatism before cataract surgery in old age in Indian rural population. DESIGN Prospective, cross-sectional, and observational study. METHODS Keratometric values were measured with an auto refractokeratometer in patients presenting for cataract surgery between January 2017 and May 2018. The demographic profiles of patients were recorded. Axial length and intraocular lens power were measured. Data were analyzed in SPSS software. RESULTS This study included 1000 eyes of 880 patients with a mean age of 65.1 ± 10.12 years. The mean astigmatism was 0.89 ± 0.63 D. A total of 179 eyes (17.9%) had astigmatism between 1.00 and 1.49 D; 34 eyes (3.4%) had astigmatism between 2.00 and 2.5 D; and 20 eyes (2%) had astigmatism >3 D. Overall, 325 eyes (32.5%) had astigmatism >1.00 D. Against the rule astigmatism was seen in 44.6% cases, oblique astigmatism was seen in 32% cases, and with the rule astigmatism was seen in 20.7% cases. Against the rule astigmatism increased with age and reached a maximum between 60 and 69 years. Male eyes had flatter corneal curvature than female eyes. The mean axial length was 25.59 mm, and the mean intraocular lens power was 21.05 ± 1.0D. CONCLUSIONS We found that 32.5% patients had corneal astigmatism >1 D and may benefit from toric intraocular lenses implantation. The results of this analysis provide normative data for the hospital to plan for correction of corneal astigmatism in patients undergoing cataract surgery.
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Affiliation(s)
- Rajesh Subhash Joshi
- Associate Professor, Department of Ophthalmology, Vasantrao Naik Government Medical College, Yavatmal-400001, Maharashtra India
| | - Sonali Arun Jadhav
- Resident ophthalmology, Department of Ophthalmology, Vasantrao Naik Government Medical College, Yavatmal- 445001, Maharashtra, India
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Webers VSC, Bauer NJC, Visser N, Berendschot TTJM, van den Biggelaar FJHM, Nuijts RMMA. Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery. J Cataract Refract Surg 2019; 43:781-788. [PMID: 28732612 DOI: 10.1016/j.jcrs.2017.03.041] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/08/2017] [Accepted: 03/13/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure. SETTING University Eye Clinic Maastricht, Maastricht, the Netherlands. DESIGN Prospective randomized clinical trial. METHODS Eyes with regular corneal astigmatism of at least 1.25 diopters (D) that required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T9) were randomly assigned to the image-guided group or the manual-marking group. The primary outcome was the alignment of the toric IOL based on preoperative images and images taken immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complications. RESULTS The study enrolled 36 eyes (24 patients). The mean toric IOL misalignment was significantly less in the image-guided group than in the manual group 1 hour (1.3 degrees ± 1.6 [SD] versus 2.8 ± 1.8 degrees; P = .02) and 3 months (1.7 ± 1.5 degrees versus 3.1 ± 2.1 degrees; P < .05) postoperatively. The mean residual refractive cylinder was -0.36 ± 0.32 D and -0.47 ± 0.28 D in the image-guided group and manual group, respectively (P > .05). The mean UDVA was 0.03 ± 0.10 logarithm of minimum angle of resolution (logMAR) and 0.04 ± 0.09 logMAR, respectively (both P > .05). No intraoperative complications occurred during any surgery. CONCLUSION The IOL misalignment was significantly less with digital marking than with manual marking; this did not result in a better UDVA or lower residual refractive astigmatism.
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Affiliation(s)
- Valentijn S C Webers
- From the University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - Noel J C Bauer
- From the University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Nienke Visser
- From the University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Tos T J M Berendschot
- From the University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | | | - Rudy M M A Nuijts
- From the University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
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Pontikos N, Chua S, Foster PJ, Tuft SJ, Day AC. Frequency and distribution of corneal astigmatism and keratometry features in adult life: Methodology and findings of the UK Biobank study. PLoS One 2019; 14:e0218144. [PMID: 31536508 PMCID: PMC6752876 DOI: 10.1371/journal.pone.0218144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/27/2019] [Indexed: 01/29/2023] Open
Abstract
Purpose To describe corneal astigmatism in the UK Biobank population and to look for associations with other biometric variables and socio-demographic factors. Methods This analysis included a subsample of 107,452 participants of the UK Biobank study who underwent an enhanced ophthalmic examination including autorefractor keratometry (Tomey RC 5000, Tomey Corp., Nagoya, Japan). Participants were recruited from across the United Kingdom between 2006 and 2010, and all were between 40 to 69 years. After quality control and applying relevant exclusions, data on corneal astigmatism on 83,751 participants were included for analysis. Potential associations were tested through univariable regression and significant parameters carried forward for multivariable analysis. Results In univariable analysis, the characteristics significantly associated with higher corneal astigmatism (P<0.001), by order of magnitude were, female gender, white ethnicity, lighter skin colour, use of UV protection, lower alcohol intake, lower corneal-compensated intraocular pressure (ccIOP), older age at completion of education, younger age, higher Townsend deprivation index, lower height and lower systolic blood pressure. After inclusion in the multivariable analysis, gender, skin colour, alcohol intake, age at completion of full-time education, ccIOP, age and Townsend deprivation score remained significant (all P<0.001). Increased corneal astigmatism was also found to be significantly associated with amblyopia or strabismus. Conclusions This analysis confirms previous associations with astigmatism such as younger age and female gender, and identified novel risk factors including lighter skin colour, lower alcohol intake, later age having completed full time education later, lower ccIOP and higher Townsend deprivation index. Further research is needed to investigate these novel associations.
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Affiliation(s)
- Nikolas Pontikos
- UCL Institute of Ophthalmology, London, England, United Kingdom
- NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, England, United Kingdom
- * E-mail:
| | - Sharon Chua
- UCL Institute of Ophthalmology, London, England, United Kingdom
- NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, England, United Kingdom
| | - Paul J. Foster
- UCL Institute of Ophthalmology, London, England, United Kingdom
- NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, England, United Kingdom
| | - Stephen J. Tuft
- UCL Institute of Ophthalmology, London, England, United Kingdom
- NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, England, United Kingdom
| | - Alexander C. Day
- UCL Institute of Ophthalmology, London, England, United Kingdom
- NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, England, United Kingdom
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Bagus T, Alberto K, Muteba M, Makgotloe A. Analysis of corneal biometry in a black South African population. AFRICAN VISION AND EYE HEALTH 2019. [DOI: 10.4102/aveh.v78i1.495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Mohammadi SF, Khorrami-Nejad M, Hamidirad M. Posterior corneal astigmatism: a review article. CLINICAL OPTOMETRY 2019; 11:85-96. [PMID: 31496856 PMCID: PMC6697663 DOI: 10.2147/opto.s210721] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/29/2019] [Indexed: 05/15/2023]
Abstract
Most human eyes show at least a small degree of corneal astigmatism and it can arise from both surfaces of the cornea. The shape of the anterior corneal surface provides no definitive basis for knowing the toricity of the posterior surface. In the previous studies, average astigmatism of the posterior corneal surface was -0.26 to -0.78 diopter. The radius of the posterior corneal surface is less than the radius of the anterior corneal surface. Most studies have found a clear correlation between the anterior and posterior corneal asphericities and the asphericity of the posterior surface is independent of the vertex radius of curvature, refractive error and gender. In contrast to the anterior corneal surface, the asphericity of the posterior corneal surface varies significantly between meridians. The anterior and posterior corneal surface would have approximately parallel principal meridians and both of these surfaces are often flatter in the horizontal meridian than the vertical one. This is especially true in the higher degrees of corneal astigmatism, and then about 10% of any anterior corneal astigmatism is neutralized by an astigmatism arising from the posterior corneal surface. Although the second corneal surface only contributes to about 10% of the total refractive power of the eye, a precise knowledge of its morphology is needed for the correct diagnosis and monitoring the corneal diseases or the surgical interventions and in many eyes neglecting the posterior corneal surface measurement may lead to significant deviations from the corneal astigmatism estimation. In this article, we have reviewed the shape and the toricity of the posterior corneal surface and also the effect of age on it. We investigated the contribution of posterior corneal astigmatism to the total corneal astigmatism and evaluated the accuracy of corneal astigmatism estimation by neglecting the posterior corneal surface measurement.
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Affiliation(s)
- Seyed-Farzad Mohammadi
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences
, Tehran, Iran
| | - Masoud Khorrami-Nejad
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences
, Tehran, Iran
- School of Rehabilitation, Shahid Beheshti University of Medical Sciences
, Tehran, Iran
| | - Moein Hamidirad
- School of Rehabilitation, Shahid Beheshti University of Medical Sciences
, Tehran, Iran
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Han ES, Kim M. Evaluation of biometry and corneal astigmatism in cataract surgery patients in Northern United Arab Emirates. Int Ophthalmol 2019; 39:2807-2813. [PMID: 31134425 DOI: 10.1007/s10792-019-01127-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 05/22/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To analyze biometric parameters and patterns of corneal astigmatism in cataract surgery patients using optical low-coherence interferometry in Northern United Arab Emirates (UAE). METHODS Axial length (AL), anterior chamber depth (ACD), horizontal corneal diameter (white to white, WTW) and flat and steep keratometry (K1 and K2, respectively) were optically measured using optical low-coherence interferometry (Aladdin). Ocular datasets acquired between 2015 and 2018 were collected and analyzed. RESULTS This study evaluated 238 eyes of 123 cataract patients with a mean age of 67.1 ± 9.4 years. Mean AL, ACD, WTW, K1, and K2 were 23.22 ± 0.99 mm, 3.05 ± 0.36 mm, 11.19 ± 0.46 mm, 43.72 ± 1.80 diopter (D), and 45.04 ± 1.71 D, respectively. Mean corneal astigmatism was 1.32 ± 0.97 D. Corneal astigmatism of 1.5 D or greater was found in 32.4%. With the rule, against the rule, and oblique astigmatism were found in 29.8%, 57.1%, and 13.0% of eyes, respectively. CONCLUSIONS Results of this study provide normative data for cataract surgery as an informative reference in Northern UAE, the Middle East. This study showed higher corneal astigmatism in Northern UAE than those in other countries.
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Affiliation(s)
- Eui Seok Han
- Department of Ophthalmology, Sheikh Khalifa Specialty Hospital, PO Box 6365, Ras al-Khaimah, United Arab Emirates.,Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Moonjung Kim
- Department of Ophthalmology, Sheikh Khalifa Specialty Hospital, PO Box 6365, Ras al-Khaimah, United Arab Emirates. .,Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
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De Bernardo M, Salerno G, Cornetta P, Rosa N. Axial Length Shortening After Cataract Surgery: New Approach to Solve the Question. Transl Vis Sci Technol 2018; 7:34. [PMID: 30619654 PMCID: PMC6314107 DOI: 10.1167/tvst.7.6.34] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/16/2018] [Indexed: 12/11/2022] Open
Abstract
Purpose To check if optical biometry can detect eventual corneal power (Km) and axial length (AL) cataract surgery-related changes that could influence the refractive outcome. Methods Patients scheduled for sequential bilateral cataract surgery between January and September 2017 were included in the present study. One hundred ninety-six eyes of 98 patients (48 males) were selected. Before surgery of the first eye, patients underwent a complete ophthalmic examination, including IOLMaster biometry; the same evaluations were repeated in both eyes the day before the fellow eye cataract surgery, performed at least 2 months after the first one. The differences in Km and AL in the first operated eyes were evaluated, and the fellow eyes were used as controls. Results Km differences in the operated eyes ranged from −1.97 to +0.98 diopter (D) (mean = −0.02 ± 0.36 D) (P = 0.89); in the nonoperated eyes they ranged from −0.6 to +0.7 D (mean = 0 ± 0.20 D) (P = 0.91). The AL differences (pseudophakic option) in the operated eyes ranged from −0.35 to +0.15 mm (mean = −0.10 ± 0.08 mm) (P < 0.001); with the aphakic option they ranged from −0.24 to + 0.26 mm (mean = 0.01 ± 0.08 mm) (P= 0.38). In the nonoperated eyes, the AL differences ranged from −0.04 to +0.06 mm (mean= 0 ± 0.02 mm) (P = 0.02). Conclusions The modern phaco-technique seems not to induce changes in Km and AL, supporting the hypothesis that the differences in AL are due to an incorrect estimation in pseudophakic eyes. Translational Relevance The results of our study may improve the AL measurements in pseudophakic eyes.
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Affiliation(s)
- Maddalena De Bernardo
- Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy
| | - Giulio Salerno
- Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy
| | - Palmiro Cornetta
- Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy
| | - Nicola Rosa
- Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy
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Zvorničanin J. Corneal astigmatism in cataract surgery patients from Bosnia and Herzegovina. Int Ophthalmol 2018; 39:1753-1760. [PMID: 30051216 DOI: 10.1007/s10792-018-0998-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/21/2018] [Indexed: 01/16/2023]
Abstract
PURPOSE To determine corneal astigmatism prevalence, its correlations with age and symmetry pattern in fellow eyes of patients undergoing cataract surgery. METHODS This is a clinical-based retrospective cross-sectional study. Keratometry measurements of patients undergoing cataract surgery assigned to University Clinical Center Tuzla, Bosnia and Herzegovina, between January 2011 and June 2012 were recorded and analyzed retrospectively. RESULTS The study consisted of 4080 eyes of 2205 consecutive cataract surgery patients with a mean age of 68.24 years ± 9.25 (SD) (range 32-84 years), and 54.0% of the patients were women. Mean corneal astigmatism was 0.72 ± 0.61 D (range 0-6.5 D). The prevalence of corneal astigmatism 1.0 D or more was in 1291 eyes (31.64%), 1.5 D or more in 736 eyes (18.03%), 2.0 D or more in 396 eyes (9.71%) and 3.0 D or more in 108 eyes (2.65%). There was no significant difference in the magnitude of astigmatism between age groups (p = 0.10), male and female (p = 0.29) or right and left (p = 0.75) eyes. The prevalence and amount of astigmatism increased with age (p < 0.05). Gradual shift from with-the-rule astigmatism toward against-the-rule astigmatism was observed (p = 0.03). Patients with higher amount of astigmatism in one eye are more likely to have significant astigmatism in fellow eye (p < 0.01). Symmetry in pairs of eyes is present in eyes with astigmatism greater than 2.5 D (p < 0.01). CONCLUSION This study provides useful reference data for cataract surgeons and patients from Bosnia and Herzegovina.
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Affiliation(s)
- Jasmin Zvorničanin
- Department of Ophthalmology, University Clinical Center Tuzla, Trnovac bb, 75000, Tuzla, Bosnia and Herzegovina.
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Yu JG, Zhong J, Mei ZM, Zhao F, Tao N, Xiang Y. Evaluation of biometry and corneal astigmatism in cataract surgery patients from Central China. BMC Ophthalmol 2017; 17:56. [PMID: 28446167 PMCID: PMC5405481 DOI: 10.1186/s12886-017-0450-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 04/22/2017] [Indexed: 11/10/2022] Open
Abstract
Background To evaluate the distribution of biometric parameters and corneal astigmatism using the IOLMaster device before phacoemulsification in cataract patients in Central China. Methods Consecutive cataract patients were recruited at the Central Hospital of Wuhan between January 2015 and June 2016. Ocular axial length (AL), keratometry values, anterior chamber depth (ACD) and horizontal corneal diameter (white to white [WTW]) of each cataract-affected eye were measured with the IOLMaster device. Results The study evaluated 3209 eyes of 2821 cataract patients. The mean AL, ACD, and WTW were 24.38 ± 2.47 mm, 3.15 ± 0.48 mm, and 11.63 ± 0.43 mm, respectively. Corneal astigmatism of 0.51–1.00 diopters (D) was the most common range of values (34.96%). A total of 10.56% patients exhibited a corneal astigmatism greater than 2.0 D. The flat and steep keratometry values gradually increased with age. The mean ACD and WTW showed increasing trends as the AL increased (P < 0.001). When the AL was shorter than 26.0 mm, the keratometry decreased as AL increased. The against-the-rule (ATR) astigmatism proportion increased with age and the with-the-rule (WTR) astigmatism proportion decreased with age. Conclusions The profile of ocular biometric data and corneal astigmatism may help ophthalmologists improve their surgical procedures and make an appropriate IOL choice to gain a high quality of postoperative vision.
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Affiliation(s)
- Ji-Guo Yu
- Department of Ophthalmology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No, 26 Shengli Street, Wuhan, Hubei Province, 430014, China
| | - Jie Zhong
- Department of Ophthalmology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No, 26 Shengli Street, Wuhan, Hubei Province, 430014, China
| | - Zhong-Ming Mei
- Department of Ophthalmology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No, 26 Shengli Street, Wuhan, Hubei Province, 430014, China
| | - Fang Zhao
- Department of Ophthalmology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No, 26 Shengli Street, Wuhan, Hubei Province, 430014, China
| | - Na Tao
- Department of Ophthalmology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No, 26 Shengli Street, Wuhan, Hubei Province, 430014, China
| | - Yi Xiang
- Department of Ophthalmology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No, 26 Shengli Street, Wuhan, Hubei Province, 430014, China.
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Moulick PS, Kalra D, Sati A, Gupta S, Khan MA, Singh A. Prevalence of corneal astigmatism before cataract surgery in Western Indian Population. Med J Armed Forces India 2017; 74:18-21. [PMID: 29386726 DOI: 10.1016/j.mjafi.2017.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 02/03/2017] [Indexed: 11/30/2022] Open
Abstract
Background The prevalence and nature of corneal astigmatism among cataract surgery candidates has not been well-documented in Indian population. The purpose of the study is to analyse prevalence and presentation patterns of corneal astigmatism (CA) in cataract surgery candidates. Methods Keratometric values were measured in patients before cataract extraction. Descriptive statistics of CA were analysed including the assessment with age ranges. Results Mean CA of 223 eyes of 223 patients [mean age 61 ± 10 years (range, 29-90 years)] was 0.88 ± 0.61 (95% CI, 0.80-0.96) with 27.8%, 51.1% and 21.1% having with the rule (WTR), against the rule (ATR) and oblique astigmatism (OBL) respectively. Between 40 and 50 years, ATR exceeds WTR and reaches 100% by 80 years. A trend of less negative CA was seen up to 60 years and then increases up to 90 years. CA was below 0.25 dioptre (D) in 17.5% of eyes, between 0.25 and 1.25 D in 63.7% and ≥1.50 D in 18.8% of eyes. Conclusions Considering CA < 1.25 D in majority of cataract surgery candidates, it is preferable to perform inexpensive keratorefractive procedures rather expensive toric IOLs, especially in developing world.
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Affiliation(s)
- P S Moulick
- Professor & Head, Dept of Ophthalmology, Armed Forces Medical College, Pune 40, India
| | - Deepak Kalra
- MG (Med), Medical Branch, HQ (Southern Command), C/o 56 APO, India
| | - Alok Sati
- Assistant Professor, Dept of Ophthalmology, Armed Forces Medical College, Pune 40, India
| | - Sandeep Gupta
- Associate Professor, Dept of Ophthalmology, Armed Forces Medical College, Pune 40, India
| | - M A Khan
- Associate Professor, Dept of Ophthalmology, Armed Forces Medical College, Pune 40, India
| | - Archana Singh
- Resident, Dept of Ophthalmology, Armed Forces Medical College, Pune 40, India
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Feizi S, Naderan M, Ownagh V, Sadeghpour F. Distribution of the anterior, posterior, and total corneal astigmatism in healthy eyes. Int Ophthalmol 2017; 38:481-491. [PMID: 28289951 DOI: 10.1007/s10792-017-0483-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 02/24/2017] [Indexed: 12/26/2022]
Abstract
PURPOSE To evaluate the magnitude and axis orientation of the anterior, posterior, and total corneal astigmatism in normal healthy eyes of an Iranian population. METHODS In a prospective cross-sectional study, ophthalmic and anterior segment parameters of 153 healthy eyes of 153 subjects were evaluated by Galilei dual Scheimpflug analyzer. The magnitude and axis orientation [with-the-rule (WTR), against-the-rule (ATR), and oblique] of the anterior, posterior, and total corneal astigmatism measurements (ACA, PCA, and TCA) were compared according to the age, sex, and other ophthalmic parameters. RESULTS The mean ± SD age of the study population was 30 ± 5.9 years. The mean magnitude was 1.09 ± 0.76 diopters (D) for ACA, 0.30 ± 0.13 D for PCA, and 1.08 ± 0.77 D for TCA. Males had a significantly higher magnitude of PCA than females (p = 0.041). Most eyes had a WTR anterior astigmatism and an ATR posterior astigmatism. The WTR astigmatism had a higher mean magnitude compared to the ATR and oblique astigmatism in all the astigmatism groups, with a significant difference in the ACA and TCA groups (p < 0.05). PCA magnitude exceeded 0.50 D in only 7.8% of the subjects. ACA, PCA, and TCA were significantly correlated with each other and also had a significant correlation with the anterior and posterior maximum corneal elevation measurements (p < 0.001). CONCLUSION The results of this study although are limited due to the small number of participants and confined to our demographics, provided information regarding a population that was not described before and may be helpful in obtaining optimum results in astigmatism correction in refractive surgery or designing new intraocular lenses.
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Affiliation(s)
- Sepehr Feizi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Naderan
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran.
| | - Vahid Ownagh
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadeghpour
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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