Relationship between age, corneal astigmatism, and ocular dimensions with reference to astigmatism in eyes undergoing routine cataract surgery

Purpose. To clarify the distribution of corneal spherical aberrations (SAs) in cataract patients with different corneal astigmatism and axial length. Setting. Department of Ophthalmology and Vision Science of the Eye and ENT Hospital of Fudan University, Shanghai, China. Design. Retrospective case series. Methods. The axial length, corneal SAs, and other corneal biometrics were collected in cataract patients with Pentacam HR and IOLMaster 500. The statistical analysis of the corneal SAs was based on the stratification of axial length and anterior corneal astigmatism. Results. In total, 6747 eyes of 6747 patients were recruited, with 2416 eyes (58.17 ± 16.81 years old) in the astigmatism group (anterior corneal astigmatism ≥1 D) and others (61.82 ± 12.64 years old) in the control group. In patients with astigmatism <2 D, the total and anterior SAs decreased as the axial length increased (P<0.001). The total corneal SAs of patients with astigmatism of 2-3 D stabilized at around 0.29 μm, whereas those of patients with anterior corneal astigmatism ≥3 D tended to be variable. Age and anterior corneal astigmatism had positive and negative effects, respectively, on SA in the regression model. Conclusions. Axial length has a negative effect on the anterior and total corneal SAs, which stabled around 0.33 μm and 0.30 μm in patients with axial length of ≥26 mm, respectively. Individualized SA adjustments are essential for patients undergoing aspheric toric IOL implantation with preoperative anterior corneal astigmatism of 1-2 D or ≥3 D. Toric IOLs with a negative SA of −0.20 μm are recommended for patients with anterior corneal astigmatism of 2-3 D if no customized therapy is warranted.

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“…A shift from ATR to WTR with age was also detected (Supplementary Material Table 5), which is consistent with previous findings [15, 16].…”

Section: Resultssupporting

confidence: 92%

Correlations of Corneal Spherical Aberration with Astigmatism and Axial Length in Cataract Patients

Zhang

Qian

Jing

et al. 2019

Journal of Ophthalmology

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“…More and more studies have begun to pay attention to the relationship between age and corneal astigmatism. Similar findings showed that the magnitude of corneal astigmatism increased with increasing age [ 6 , 25 ]. In current study, interestingly, we found a stronger U-shaped association between corneal astigmatism and age ( Figure 3 ), which was not reported in most of the previous studies.…”

Section: Discussionsupporting

confidence: 75%

Prevalence and Age-Related Changes of Corneal Astigmatism in Patients Undergoing Cataract Surgery in Northern China

Liu

Chen

et al. 2020

Journal of Ophthalmology

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Purpose. To examine the magnitude, orientation, and age-related changes of corneal astigmatism of the eyes before cataract surgery. Setting. Hebei Eye Hospital, Hebei, China. Design. A clinical-based retrospective study. Results. The study consisted of 5662 eyes of 5662 consecutive cataract surgery patients with a mean age of 68.26 ± 10.39 (mean ± standard deviation (SD)) years (range 40 to 97 years), and 59.86% of the patients were women. Mean corneal astigmatism was 0.98 ± 0.76 diopter (D) (range 0.00–9.61 D). Corneal astigmatism of 0.50–0.99 D was the most common range of values (30.08%), followed by 1.00–1.49 D (22.15%), ≤0.50 D (21.21%), and 1.50–1.99 D (10.28%). There was a strong U-shaped relation between corneal astigmatism and age ( p for nonlinearity <.01). With the increase of age, the astigmatism axis gradually changes from with-the-rule (WTR) to against-the-rule (ATR). Moreover, in young patients with age below 65 years, WTR astigmatism was negatively correlated with age, while ATR was positively correlated with age (r = −0.11, p = .001 ; r = 0.10, p = .010 , respectively). However, in the old patients with age above and equal to 65 years, all types of astigmatism were positively correlated with age. Conclusion. This study may provide valuable and practical information to surgeons when selecting the appropriate surgical method and toric intraocular lens (IOLs).

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“…Although PL had the deepest ACD among our subgroups, it was still shallow when compared to the ACD in PL measured in prior studies (2.80–3.14 mm) [ 18 – 20 ]. This surprising finding may be explained firstly by the frequent mixed mechanisms that often underlie AAC.…”

Section: Discussioncontrasting

confidence: 69%

Qualitative and quantitative evaluation of acute angle-closure mechanisms

et al. 2017

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BackgroundTo evaluate ocular biometric parameters in different subtypes of acute angle closure and compared to fellow eyes of AAC and PACS eyes.MethodsThis is a retrospective chart review study. A total of 167 eyes (96 patients) consisting of 71 AAC eyes, 71 fellow eyes of AAC, and 25 PACS eyes were recruited. All patients underwent ocular examination and biometry. The mechanism of AAC was confirmed by ultrasound biomicroscopy. We then subdivided AAC eyes into four subgroups: crowded-angle (CR), lens subluxation (LS) pupillary block (PB), and plateau iris syndrome (PL). Outcome variables included anterior chamber depth (ACD), lens thickness (LT), vitreal length (VL), axial length (AL), lens position and relative lens position (LP and RLP, respectively), and lens axial length factor (LAF).ResultsAmong the three groups, ACD was shallower in AAC eyes than fellow eyes of AAC and PACS eyes (p < 0.01 for both) and AAC eyes demonstrated a lesser LP and RLP. The LT, VL, AL, and LAF were not significantly different among the three groups. Among the four subgroups, LS displayed the most shallow ACD (p = 0.01). The lens position in PL was greater than in CR and LS (p < 0.05 and <0.01, respectively).ConclusionsAAC eyes had a more anterior lens position than fellow eyes and PACS eyes, though lens thickness did not differ among the groups. As such, an anterior lens position may offer more sensitive prognostication regarding future development of AAC compared to lens thickness.

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Relationship between age, corneal astigmatism, and ocular dimensions with reference to astigmatism in eyes undergoing routine cataract surgery

Cited by 44 publications

References 26 publications

Correlations of Corneal Spherical Aberration with Astigmatism and Axial Length in Cataract Patients

Correlations of Corneal Spherical Aberration with Astigmatism and Axial Length in Cataract Patients

Prevalence and Age-Related Changes of Corneal Astigmatism in Patients Undergoing Cataract Surgery in Northern China

Qualitative and quantitative evaluation of acute angle-closure mechanisms

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