Influence of simple myopic against-the-rule and with-the-rule astigmatism on visual acuity in eyes with monofocal intraocular lenses

Abstract

After monofocal IOL implantation, UDVA in eyes with simple myopic ATR astigmatism was worse than in eyes with simple myopic WTR astigmatism. Additionally, UDVA was significantly influenced by cylindrical refractive power in eyes with ATR astigmatism, but not in eyes with WTR astigmatism.

Comparison of corneal irregular astigmatism by the type of corneal regular astigmatism

“…The studies in volunteers reported that oblique astigmatism induced with cylindrical lenses resulted in worse visual functions than ATR astigmatism, and that WTR astigmatism had the least effect [22][23][24] . In eyes after intraocular lens implantation, it was demonstrated that UDVA was worse in eyes with simple myopic ATR astigmatism than in those with simple myopic WTR astigmatism 25 . These studies, however, were about the influence of uncorrected corneal regular astigmatism on visual function.…”

“…With a greater amount of corneal irregular astigmatism, optical quality of eyes with oblique astigmatism may be deteriorated to some extent. The influence of axis orientation of uncorrected astigmatism on visual function has been studied previously in normal eyes of healthy volunteers [22][23][24] and eyes after monofocal intraocular lens www.nature.com/scientificreports/ implantation 25 . The studies in volunteers reported that oblique astigmatism induced with cylindrical lenses resulted in worse visual functions than ATR astigmatism, and that WTR astigmatism had the least effect [22][23][24] .…”

The Effect of Astigmatism Axis on Visual Acuity

“…Previous studies on other populations also reported better UDVA for WTR astigmatism than for ATR astigmatism. Yamamoto et al (3) reported that UDVA was worse in myopic ATR astigmatism than in simple myopic WTR astigmatism in patients after monofocal intraocular lens implantation. Vinas et al (5) reported that in nonastigmatic patients in whom astigmatism was induced, ATR astigmatism led to lower UDVA than oblique or WTR astigmatism.…”

“…Conflicting reports exist regarding the effect of astigmatism axis on UDVA. Yamamoto et al (3) reported that UDVA was worse in myopic ATR astigmatism than in myopic WTR astigmatism while Remon et al (4) reported no significant differences between axes ranging from 0 to 90 degrees. Vinas et al (5) reported that in nonastigmatic patients in whom astigmatism was induced, ATR astigmatism led to lower UDVA than oblique or WTR astigmatism.…”

Apparent accommodation in pseudophakic eyes with refractive against-the-rule, with-the-rule and minimum astigmatism

“…Our results may suggest that some Zernike coefficients of coma aberrations contribute to apparent accommodation in concert with WTR astigmatism. Additionally, we have speculated that movements of the eyelids or the palpebral fissures7 17 22 influence accommodation because narrowing palpebral fissures can reduce apparent pupil diameter in the vertical direction, enhancing depth of focus. However, another study with a large population is required to clarify the exact role of eyelid movement on apparent accommodation.…”