Comparison of Methods to Predict Residual Astigmatism After Intraocular Lens Implantation
Abstract
PURPOSE:
To evaluate and compare the accuracy of three toric intraocular lens (IOL) calculators using keratometry measurements derived from the anterior corneal curvature and direct measurements of the posterior corneal curvature.
METHODS:
Postoperative corneal astigmatism was measured by the IOLMaster (Carl Zeiss Meditec, Jena, Germany) and Pentacam (Oculus Optikgeräte, Wetzlar, Germany). The data were processed by the Alcon, Holladay, and Barrett toric IOL calculators. The error in predicted residual astigmatism (PredRA) was calculated by subtracting the PredRA from the postoperative subjective refraction by vector analysis.
RESULTS:
The centroid errors in PredRA were against-the-rule (ATR) with the Alcon (0.56 diopters [D]) and Holladay (0.55 D) toric calculators using the IOLMaster (Carl Zeiss Meditec, Jena, Germany) measurements. The centroid errors in PredRA were lower when Pentacam (Oculus Optikgeräte, Wetzlar, Germany) measurements were used (0.38 D, ATR). The Barrett toric calculator using the IOLMaster measurements had the lowest centroid errors in PredRA (0.02 D, P < .001) and achieved the most accurate results: 75.8% and 92.9% of eyes were within 0.50 and 0.75 D of the PredRA, respectively.
CONCLUSIONS:
The prediction of the postoperative astigmatic outcome can be improved by using appropriate methods of adjustment for posterior corneal astigmatism.
[J Refract Surg. 2015;31(10):699–706.]
- 1.Holland E, Lane S, Horn JD, Ernest P, Arleo R, Miller KM. The AcrySof Toric intraocular lens in subjects with cataracts and corneal astigmatism: a randomized, subject-masked, parallel-group, 1-year study. Ophthalmology. 2010; 117:2104–2111.
10.1016/j.ophtha.2010.07.033 Crossref MedlineGoogle Scholar - 2.Goggin M, Moore S, Esterman A. Toric intraocular lens outcome using the manufacturer’s prediction of corneal plane equivalent intraocular lens cylinder power. Arch Ophthalmol. 2011; 129:1004–1008.
10.1001/archophthalmol.2011.178 Crossref MedlineGoogle Scholar - 3.Mendicute J, Irigoyen C, Aramberri J, Ondarra A, Montes-Mico R. Foldable toric intraocular lens for astigmatism correction in cataract patients. J Cataract Refract Surg. 2008; 34:601–607.
10.1016/j.jcrs.2007.11.033 Crossref MedlineGoogle Scholar - 4.Potvin R, Gundersen KG, Masket S, Prospective multi-center study of toric IOL outcomes when dual zone automated keratometry is used for astigmatism planning. J Refract Surg. 2013; 29:804–809.
10.3928/1081597X-20131115-03 Crossref MedlineGoogle Scholar - 5.Sun X-Y, Vicary D, Montgomery P, Griffiths M. Toric intraocular lenses for correcting astigmatism in 130 eyes. Ophthalmology. 2000; 107:1776–1781.
10.1016/S0161-6420(00)00266-9 Crossref MedlineGoogle Scholar - 6.Hill W, Potvin R. Monte Carlo simulation of expected outcomes with the AcrySof toric intraocular lens. BMC Ophthalmol. 2008; 8:22.
10.1186/1471-2415-8-22 Crossref MedlineGoogle Scholar - 7.Jin H, Limberger IJ, Ehmer A, Guo H, Auffarth GU. Impact of axis misalignment of toric intraocular lenses on refractive outcomes after cataract surgery. J Cataract Refract Surg. 2010; 36:2061–2072.
10.1016/j.jcrs.2010.06.066 Crossref MedlineGoogle Scholar - 8.Abulafia A, Barrett GD, Kleinmann G, Prediction of refractive outcomes with toric intraocular lens implantation. J Cataract Refract Surg. 2015; 41:936–944.
10.1016/j.jcrs.2014.08.036 Crossref MedlineGoogle Scholar - 9.Koch DD, Jenkins RB, Weikert MP, Yeu E, Wang L. Correcting astigmatism with toric intraocular lenses: effect of posterior corneal astigmatism. J Cataract Refract Surg. 2013; 39:1803–1809.
10.1016/j.jcrs.2013.06.027 Crossref MedlineGoogle Scholar - 10.Barrett GD. An improved universal theoretical formula for intraocular lens power prediction. J Cataract Refract Surg. 1993; 19:713–720.
10.1016/S0886-3350(13)80339-2 Crossref MedlineGoogle Scholar - 11.Holladay JT, Hill WE, Steinmueller A. Corneal power measurements using Scheimpflug imaging in eyes with prior corneal refractive surgery. J Refract Surg. 2009; 25:862–868.
10.3928/1081597X-20090917-07 LinkGoogle Scholar - 12.Ton YAA, Reitblat O, Assia EI. Posterior corneal astigmatism contribution to residual astigmatism following cataract surgery.
Presented at the ESCRS 2013 Symposium ;October 5, 2013 ;Amsterdam, Netherlands . Google Scholar - 13.Holladay JT, Moran JR, Kezirian GM. Analysis of aggregate surgically induced refractive change, prediction error, and intraocular astigmatism. J Cataract Refract Surg. 2001; 27:61–79.
10.1016/S0886-3350(00)00796-3 Crossref MedlineGoogle Scholar - 14.Naeser K, Knudsen EB, Hansen MK. Bivariate polar value analysis of surgically induced astigmatism. J Refract Surg. 2002; 18:72–78. LinkGoogle Scholar
- 15.Javal E. Mémoires d’ophtalmométrie: annotés et précédés d’une introduction. Paris: G. Masson; 1890. Google Scholar
- 16.Grosvenor T, Quintero S, Perrigin DM. Predicting refractive astigmatism: a suggested simplification of Javal’s rule. Am J Optom Physiol Opt. 1988; 65:292–297.
10.1097/00006324-198804000-00009 Crossref MedlineGoogle Scholar - 17.Remon L, Benlloch J, Furlan WD. Corneal and refractive astigmatism in adults: a power vectors analysis. Optom Vis Sci. 2009; 86:1182–1186.
10.1097/OPX.0b013e3181baac2c Crossref MedlineGoogle Scholar - 18.Tong L, Carkeet A, Saw SM, Tan DT. Corneal and refractive error astigmatism in Singaporean schoolchildren: a vector-based Javal’s rule. Optom Vis Sci. 2001; 78:881–887.
10.1097/00006324-200112000-00010 Crossref MedlineGoogle Scholar - 19.Alpins NA. New method of targeting vectors to treat astigmatism. J Cataract Refract Surg. 1997; 23:65–75.
10.1016/S0886-3350(97)80153-8 Crossref MedlineGoogle Scholar - 20.Auger P. Confirmation of the simplified Javal’s rule. Am J Optom Physiol Opt. 1988; 65:915.
10.1097/00006324-198811000-00010 Crossref MedlineGoogle Scholar - 21.Lam AK, Chan CC, Lee MH, Wong KM. The aging effect on corneal curvature and the validity of Javal’s rule in Hong Kong Chinese. Curr Eye Res. 1999; 18:83–90.
10.1076/ceyr.18.2.83.5384 Crossref MedlineGoogle Scholar - 22.Teus MA, Arruabarrena C, Hernández-Verdejo JL, Sales-Sanz A, Sales-Sanz M. Correlation between keratometric and refractive astigmatism in pseudophakic eyes. J Cataract Refract Surg. 2010; 36:1671–1675.
10.1016/j.jcrs.2010.05.010 Crossref MedlineGoogle Scholar - 23.Bae JG, Kim SJ, Choi YI. Pseudophakic residual astigmatism. Korean J Ophthalmol. 2004; 18:116–120.
10.3341/kjo.2004.18.2.116 Crossref MedlineGoogle Scholar - 24.Koch D. Corneal optics for IOL selection: cracking the code.
Presented at the ASCRS annual meeting ;April 20–24, 2012 ;Chicago, IL . Google Scholar
