Residual astigmatism calculation method in implantation of a monofocal non-toric intraocular lens

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Abstract

BACKGROUND: Nowadays, phacoemulsification with monofocal non-toric intraocular lens (IOL) implantation is a most common procedure in cataract surgery. Residual astigmatism has an important impact on uncorrected visual acuity. Therefore, development of residual astigmatism assessment method is relevant and may expand indications for toric IOL implantation.

AIM: To develop a method for calculating residual astigmatism in cases when non-toric monofocal IOL is implanted.

MATERIALS AND METHODS: The study included 351 patients (391 eyes, 105 men and 246 women, mean age 75.3 ± 8.5 years) who underwent phacoemulsification with non-toric monofocal IOL implantation. Biometry was performed by IOL-Master 500, postoperative refraction was assessed by autorefractometer Topcon-8800.

RESULTS: Using regression analysis, where the depended variable was residual astigmatism, and preoperative corneal astigmatism and steep corneal meridian axis location served as covariates, we revealed a significant relation (p < 0.001) with medium strength (R2 = 0.51) between these parameters, which formed residual astigmatism calculation formula for monofocal non-toric IOL implantation: Ast = KAst · 0.71 – 0.62 · sinKax + 0.73.

CONCLUSIONS: This formula may allow to evaluate the residual astigmatism and justify a decision on the advisability of toric IOL implantation.

About the authors

Dmitrii F. Belov

Saint Petersburg Multifield Hospital No. 2; Saint Petersburg State University

Author for correspondence.
Email: belovd1990@gmail.com
ORCID iD: 0000-0003-0776-4065
SPIN-code: 2380-2273

MD, Cand. Sci. (Med.); Ophthalmologist; Assistant Performing Medical Work, Department of Otorhinolaryngology and Ophthalmology

Russian Federation, Saint Petersburg; Saint Petersburg

Vadim P. Nikolaenko

Saint Petersburg Multifield Hospital No. 2; Saint Petersburg State University

Email: dr.Nikolaenko@mail.ru
ORCID iD: 0000-0002-6393-1289
SPIN-code: 4906-2542

MD, Dr. Sci. (Med.), Deputy Head Doctor of Ophthalmological Center; Professor of the Department of Otorhinolaryngology and Ophthalmology

Russian Federation, Saint Petersburg; Saint Petersburg

Angelina G. Alekseeva

Saint Petersburg State University

Email: angecoon@icloud.com
ORCID iD: 0009-0000-5852-4999

Student

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Uncorrected visual acuity dependance on residual astigmatism (R2 = 0.46, p < 0.001)

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3. Fig. 2. Corneal astigmatism distribution in patients

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4. Fig. 3. Postoperative astigmatism dependance on preoperative steep corneal meridian axis location

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5. Fig. 4. Postoperative astigmatism dependance on preoperative steep corneal meridian axis location and corneal astigmatism; R2 = 0.51, p < 0.001

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