Received: 16 November 2021; Published on-line: 15 March 2022
Study of Prevalence of Preoperative Corneal Astigmatism in Patients with Senile Cataract at a Tertiary Care Institute in South India
C. Kumar Amruth , P. Ramya Deepthi, K. Sushma
Narayana Medical College and Hospitals; Nellore, Andhra Pradesh (India)
TO CITE THIS ARTICLE: Kumar Amruth C., Ramya Deepthi P., Sushma K. Study of Prevalence of Preoperative Corneal Astigmatism in Patients with Senile Cataract at a Tertiary Care Institute in South India. J.ophthalmol.(Ukraine).2022;1:20-3. http://doi.org/10.31288/oftalmolzh202212023
Background. The prevalence of corneal astigmatism in patients with cataract has not been well documented in both rural and urban areas of Indian population.
Purpose. The aim of this study was to assess prevalence of corneal astigmatism before cataract surgery in adult age group population of rural Andhra Pradesh.
Materials and methods. A Prospective, cross-sectional, and observational study was carried out from March 2019 to December 2019 in patients presenting for cataract surgery. Axial length, and intraocular lens power were measured, Keratometric values were measured with an auto refractokeratometer, and astigmatism was calculated. Data was analysed using SPSS software.
Results. This study included 1000 eyes of 1000 patients with a mean age of 61.81 ± 8.94 years. The mean astigmatism was 0.80 ± 0.72 D and the mean keratometry was 44.12D ± 1.71 D. A total of less than 1D astigmatism is seen in 67.5% eyes, 23.3% eyes had astigmatism between 1.00 and 1.99 D, 4.6% eyes had 2-2.99D, and ≥3D in 0.8% eyes and no astigmatism in 3.8% eyes. Against the rule astigmatism was seen in 49.8% cases, with the rule astigmatism is found in 31.8% of eyes and oblique astigmatism in 14.9% of eyes. With the increasing age, the WTR percentage decreased while the ATR percentage increased.
Conclusion. Our study showed that significant numbers of patients have preoperative corneal astigmatism, affecting the quality of vision after cataract surgery. Majority of patients have corneal astigmatism < 1.00D, which can be corrected by low-cost procedures like steep axis phaco, limbal relaxing incisions, and opposite clear corneal incisions, especially in developing countries like India, and less percentage of candidates require expensive toric IOLs.
Кey words: сorneal astigmatism, cataract, keratometry, intraocular lens
1.Lindstrom R. Thoughts on cataract surgery: 2015. Rev Ophthalmol. 2015 Mar 9
2.Olsen T. Improved accuracy of intraocular lens power calculation with the Zeiss IOLMaster. Acta Ophthalmologica Scandinavica. 2007 Feb;85(1):84-7.
3.Narváez J, Zimmerman G, Stulting RD, Chang. DH. Accuracy of intraocular lens power prediction using the Hoffer Q, Holladay 1, Holladay 2, and SRK/T formulas. Journal of Cataract & Refractive Surgery. 2006 Dec 1;32(12):2050-3.
4.Harakuni U, Bubanale S, Smitha KS, Tenagi AL, Kshama KK, Meena A, Kathyayini SV, Biala A. Comparison of surgically induced astigmatism with small incision cataract surgery and phacoemulsification. JEMDS. 2015 Sep 3;4(71):12354-60.
5.Monaco G, Scialdone A. Long-term outcomes of limbal relaxing incisions during cataract surgery: aberrometric analysis. Clinical ophthalmology (Auckland, NZ). 2015; 9:15A81.
6.Qammar A, Mullaney P. Paired opposite clear corneal incisions to correct pre-existing astigmatism in cataract patients. Journal of Cataract & Refractive Surgery. 2005 Jun 1;31(6):1167-70.
7.Norouzi H, Rahmati-Kamel M. Laser in situ keratomileusis for correction of induced astigmatism from cataract surgery. Journal of Refractive Surgery. 2003 Jul 1;19(4):416-24.
8.Kim P, Sutton GL, Rootman DS. Applications of the femtosecond laser in corneal refractive surgery. Current opinion in ophthalmology. 2011 Jul 1;22(4):238-44.
9.Mohammad-Rabei H, Mohammad-Rabei E, Espandar G, Javadi MA, Jafarinasab MR, Hashemian SJ, Feizi S. Three methods for correction of astigmatism during phacoemulsification. Journal of ophthalmic & vision research. 2016 Apr;11(2):162.
10.Lee YC. Astigmatism considerations in cataract surgery. Tzu Chi Medical Journal. 2013 Mar 1;25(1):19-22.
11.Khokhar S, Lohiya P, Murugiesan V, Panda A. Corneal astigmatism correction with opposite clear corneal incisions or single clear corneal incisions: comparative analysis. Journal of Cataract & Refractive Surgery. 2006 Sep 1;32(9):1432-7.
12.Mendicute J, Irigoyen C, Ruiz M, Illarramendi I, Ferrer-Blasco T, Montés-Micó R. Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery. Journal of Cataract & Refractive Surgery. 2009 Mar 1;35(3):451-8.
13.Bachernegg A, Rückl T, Riha W, Grabner G, Dexl AK. Rotational stability and visual outcome after implantation of a new toric intraocular lens for the correction of corneal astigmatism during cataract surgery. Journal of Cataract & Refractive Surgery. 2013 Sep 1;39(9):1390-8.
14.Prasher P, Sandhu JS. Prevalence of corneal astigmatism before cataract surgery in Indian population. International ophthalmology. 2017 Jun 1;37(3):683-9.
15.Venkateswara R.H., Hanumantha R. G., Sivacharan K. J. N., Anitha Devi Boyapati. "Preoperative Corneal Astigmatism in Patients with Cataract". Journal of Evidence based Medicine and Healthcare; Volume 2, Issue 29, July 20, 2015; Page: 4278-4283
16.Moulick PS, Kalra D, Sati A, Gupta S, Khan MA, Singh A. Prevalence of corneal astigmatism before cataract surgery in Western Indian Population. Medical Journal Armed Forces India. 2018 Jan 1;74(1):18-21.
17.Isyaku M, Ali SA, Hassan S. Preoperative corneal astigmatism among adult patients with cataract in Northern Nigeria. Indian J Ophthalmol. 2014; 62:1094-5
18.Yuan X, Song H, Peng G, Hua X, Tang X. Prevalence of corneal astigmatism in patients before cataract surgery in Northern China. Journal of ophthalmology. 2014;2014.
19.Khan MI, Muhtaseb M. Prevalence of corneal astigmatism in patients having routine cataract surgery at a teaching hospital in the United Kingdom. Journal of Cataract & Refractive Surgery. 2011 Oct 1;37(10):1751-5.
20.De Bernardo M., Zeppa L., Cennamo M., Iaccarino S., Rosa N. Prevalence of corneal astigmatism before cataract surgery in Caucasian patients, European Journal of Ophthalmology, 2013
21.Chaudhary M., Dahal HN, Prevalence and types of corneal astigmatism in patients undergoing cataract surgery. Journal of Institute of Medicine. 2017 Apr 1;39(1).
22.Joshi Rajesh Subhash, Jadhav, Sonali Arun. Frequency of Corneal Astigmatism in Patients Presenting for Senile Cataract Surgery at a Teaching Hospital in Indian Rural Population. Asia-Pacific Journal of Ophthalmology: March-April 2020; 9(2):126-129.
The authors declare no conflict of interest