The Change in Corneal Astigmatism after Cataract Surgery in Patients with Small Amount of Astigmatism

Hee Jung Yang; Yu Li Park; Hyun Seung Kim

doi:10.3341/jkos.2015.56.11.1712

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Yang, Park, and Kim: The Change in Corneal Astigmatism after Cataract Surgery in Patients with Small Amount of Astigmatism

Original Article

J Korean Ophthalmol Soc 2015;56(11):1712-1719.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.11.1712

The Change in Corneal Astigmatism after Cataract Surgery in Patients with Small Amount of Astigmatism

Hee Jung Yang, M.D, Yu Li Park, M.D, Hyun Seung Kim, M.D, PhD

Department of Ophthalmology and Visual Science, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Hyun Seung Kim, MD, PhD Department of Ophthalmology, Yeouido St. Mary’s Hospital, #10, 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea Tel: 82-2-3779-1243, Fax: 82-2-761-6869 E-mail: sara514@catholic.ac.kr

Received 29 May 201529 July 2015 Accepted 25 September 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze the change in posterior corneal astigmatism and total corneal astigmatism in patients with anterior corneal astigmatism less than 1.0 diopter (D).

Methods

In the present study we evaluated 52 eyes with anterior corneal astigmatism less than 1.0 D. Patients were divided into 2 groups according to steep axis: Group 1 included 33 eyes with within-the-rule (WTR) astigmatism and Group 2 included 19 eyes with against-the-rule (ATR) astigmatism. Anterior, posterior and total corneal astigmatism were measured using Scheimpflug imaging (Pentacam^®).

Results

In Group 1, preoperative anterior astigmatism, posterior astigmatism and total astigmatism were 0.55 ± 0.44 D, 0.31 ±0.14 D and 0.30 ± 0.72 D, respectively. At postoperative 2 months, anterior astigmatism, posterior astigmatism and total astig-matism were 0.51 ± 0.67 D, 0.31 ± 0.15 D and 0.35 ± 0.81 D, respectively. There was no statistically significant difference be-tween preoperative and postoperative anterior, posterior and total corneal astigmatism in Group 1. In Group 2, preoperative an-terior astigmatism, posterior astigmatism and total astigmatism were -0.48 ± 0.46 D, 0.26 ± 0.09 D and -0.51 ± 0.65 D, respectively. At postoperative 2 months, anterior astigmatism, posterior astigmatism and total astigmatism were -0.17 ± 0.68 D, 0.25 ± 0.13 D and -0.30 ± 0.55 D, respectively. There was no statistically significant difference between preoperative and post-operative anterior, posterior and total corneal astigmatism in the 2 groups. There was no statistical correlation between pre-operative posterior corneal astigmatism and postoperative 2 months total corneal astigmatism. After vector analysis, surgically induced astigmatism (SIA) of the anterior and total astigmatism in Group 1 were 0.03 D @ 30° and 0.07 D @ 74°, respectively, and in Group 2 were 0.27 D @ 100° and 0.36 D @ 86°, respectively.

Conclusions

In patients with preoperative total corneal astigmatism less than 1.0 D, posterior corneal astigmatism had a small effect on postoperative total corneal astigmatism.

Keywords: Pentacam, Posterior corneal astigmatism, Total corneal astigmatism

References

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Figure 1.

Double-angle plots of surgically induced astigmatism (SIA) of anterior corneal astigmatism (SIA-A) and total corneal as-tigmatism (SIA-T) in (A) WTR group and (B) ATR group. WTR = within-the-rule; ATR = against-the-rule.

Figure 2.

Correlation analysis between preoperative anterior astigmatism and posterior astigmatism in (A) total group, (B) WTR group and (C) ATR group. WTR = within-the-rule; ATR = against-the-rule.

Figure 3.

Correlation analysis between preoperative posterior astigmatism and postoperative total astigmatism in (A) WTR group and (B) ATR group. WTR = within-the-rule; ATR = against-the-rule.

Table 1.

Preoperative clinical characteristics of each group

	Group 1 (n = 33)	Group 2 (n = 19)	p-value	Total group
Sex (female:male)	24:9	13:6	0.692	37:15
Age (years)	65.7 ± 12.4	69.1 ± 7.5	0.290^†	66.91 ± 10.93
Laterality (right eye:left eye)	14:19	7:12	0.606^*	21:31
BCVA (log MAR)	0.31 ± 0.23	0.31 ± 0.57	1.000^‡	0.31 ± 0.38
IOP (mm Hg)	13.3 ± 2.8	14.4 ± 2.8	0.153^†	13.6 ± 3.1
Axial length (mm)	24.27 ± 2.06	23.70 ± 1.85	0.324^‡	24.06 ± 1.99
ACD (mm)	2.63 ± 0.60	2.59 ± 0.43	0.822^†	2.62 ± 0.54
Central corneal thickness (μ m)	546 ± 41	545 ± 29	0.923^†	545 ± 37
Corneal endothelium cell density (cells/mm²)	2,706 ± 485	2,880 ± 343	0.174^†	2,768 ± 444
Corneal astigmatism (algebraic value, D)
Anterior	0.55 ± 0.44	-0.48 ± 0.46	0.000^†	0.18 ± 0.67
Posterior	0.31 ± 0.14	0.26 ± 0.09	0.124^‡	0.29 ± 0.13
Total	0.30 ± 0.72	-0.51 ± 0.65	0.000^†	0.04 ± 0.79

Values are presented as mean ± SD unless otherwise indicated. Group 1 is within-the-rule group and Group 2 is against-the-rule group. BCVA = best corrected visual acuity; IOP = intraocular pressure; ACD = anterior chamber depth.

^* Statistically significant differences ( p-value < 0.05) in Pearson's chi-square test

^† Statistically significant differences ( p-value < 0.05) in in-dependent t-test

^‡ Statistically significant differences ( p-value < 0.05) in Mann Whitney U-test.

Table 2.

Preoperative and postoperative corneal astigmatism (algebraic value)

		Pre-op	Post-op 1 day	Post-op 1 month	Post-op 2 months
Group 1	Anterior (D)	0.55 ± 0.44	0.23 ± 0.81	0.39 ± 0.82	0.51 ± 0.67
	Posterior (D)	0.31 ± 0.14	0.41 ± 0.21	0.29 ± 0.17	0.31 ± 0.15
	Total (D)	0.30 ± 0.72	0.18 ± 1.15	0.17 ± 0.96	0.35 ± 0.81
Group 2	Anterior (D)	-0.48 ± 0.46	-0.10 ± 0.70	-0.13 ± 0.69	-0.17 ± 0.68
	Posterior (D)	0.26 ± 0.09	0.33 ± 0.19	0.21 ± 0.11	0.25 ± 0.13
	Total (D)	-0.51 ± 0.65	-0.06 ± 0.80	-0.51 ± 0.47	-0.30 ± 0.55
Total group	Anterior (D)	0.18 ± 0.67	0.11 ± 0.77	0.20 ± 0.80	0.26 ± 0.75
	Posterior (D)	0.29 ± 0.13	0.38 ± 0.21	0.26 ± 0.16	0.29 ± 0.14
	Total (D)	-0.01 ± 0.80	0.09 ± 1.03	-0.08 ± 0.87	0.11 ± 0.78

Values are presented as mean ± SD unless otherwise indicated. Group 1 is within-the-rule group and group 2 is against-the-rule group. Pre-op = preoperative; Post-op = postoperative.

Table 3.

Comparison of preoperative and postoperative 2 month corneal astigmatism (algebraic value)

		Pre-op	Post-op 2 months	p-value
Group 1	Anterior (D)	0.55 ± 0.44	0.51 ± 0.67	0.706^*
Posterior (D)	0.31 ± 0.14	0.31 ± 0.15	1.000^†
Total (D)	0.30 ± 0.72	0.35 ± 0.81	0.701^*
Group 2	Anterior (D)	-0.48 ± 0.46	-0.17 ± 0.68	0.036^†
Posterior (D)	0.26 ± 0.09	0.25 ± 0.13	0.867^*
Total (D)	-0.51 ± 0.65	-0.30 ± 0.55	0.216^*
Total group	Anterior (D)	0.18 ± 0.67	0.26 ± 0.75	0.335^*
Posterior (D)	0.29 ± 0.13	0.29 ± 0.14	0.926^*
Total (D)	-0.01 ± 0.80	0.11 ± 0.78	0.293^*

Values are presented as mean ± SD unless otherwise indicated. Group 1 is within-the-rule group and Group 2 is against-the-rule group. Pre-op = preoperative; Post-op = postoperative.

^* Statistically significant differences ( p-value < 0.05) in paired t-test

^† Statistically significant differences ( p-value < 0.05) in Wilcoxon sign-ed-rank test.

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