Article: Prevalence of Corneal Astigmatism in an NHS Cataract Surgery Practice in Northern Ireland

Purpose: Post-operative corneal astigmatism following cataract surgery can leave the patient with visual impairment. Correcting it at the time of surgery with a toric intraocular lens (TIOL) can give patients a better final visual outcome. The purpose was to determine the prevalence of corneal astigmatism in a cataract population and assess the demand for TIOL.

Methods: Keratometric data was collected and analyzed for all patients who attended for routine cataract surgery under the care of a single surgeon based in Altnagelvin Area Hospital, Northern Ireland (NI). All patients were included between January 2008 and December 2014. Data was collected retrospectively for this observational study.

Results: There were 2080 consecutive eyes of 1788 patients. The mean corneal astigmatism was 1.09 ± 0.83. Corneal astigmatism was 1.50D or less in 1621 eyes (78%). It was more than 2.00 D in 242 eyes (11.6%), more than 2.50 D in 127 eyes (6.1%), more than 3.00D in 68 eyes (3.27%) and more than 3.50 D in 45 eyes (2.16%).

Conclusion: For routine cataract surgery, 41.3% of eyes had more than 1.00 D of corneal astigmatism and 11.6% had more and 2.00D. Females had more astigmatism than males. This shows the potential demand for the TIOL in this population.

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References

1.

MIngo-Botin D, Munoz-Negrete F, Won Kim H, Morcillo-Laiz R, Rebolleda G, Oblanca N . Comparison of toric intraocular lenses and peripheral corneal relaxing incisions to treat astigmatism during cataract surgery. J Cataract Refract Surg. 2010; 36(10):1700-8. DOI: 10.1016/j.jcrs.2010.04.043. View

2.

Ma J, Tseng S . Simple method for accurate alignment in toric phakic and aphakic intraocular lens implantation. J Cataract Refract Surg. 2008; 34(10):1631-6. DOI: 10.1016/j.jcrs.2008.04.041. View

3.

Khokhar S, Lohiya P, Murugiesan V, Panda A . Corneal astigmatism correction with opposite clear corneal incisions or single clear corneal incision: comparative analysis. J Cataract Refract Surg. 2006; 32(9):1432-7. DOI: 10.1016/j.jcrs.2006.04.010. View

4.

Lam A, Chan C, Lee M, Wong K . The aging effect on corneal curvature and the validity of Javal's rule in Hong Kong Chinese. Curr Eye Res. 1999; 18(2):83-90. DOI: 10.1076/ceyr.18.2.83.5384. View

5.

Chayet A, Sandstedt C, Chang S, Rhee P, Tsuchiyama B, Grubbs R . Use of the light-adjustable lens to correct astigmatism after cataract surgery. Br J Ophthalmol. 2010; 94(6):690-2. DOI: 10.1136/bjo.2009.164616. View