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. 2021 Aug 1;47(8):991-998.
doi: 10.1097/j.jcrs.0000000000000560.

Effect of residual astigmatism on uncorrected visual acuity and patient satisfaction in pseudophakic patients

Steven C Schallhorn  1 , Keith A Hettinger, Martina Pelouskova, David Teenan, Jan A Venter, Stephen J Hannan, Julie M Schallhorn
Affiliations

Effect of residual astigmatism on uncorrected visual acuity and patient satisfaction in pseudophakic patients

Steven C Schallhorn et al. J Cataract Refract Surg. .

Abstract

Purpose: To evaluate the effect of residual astigmatism on postoperative visual acuity and satisfaction after intraocular lens (IOL) surgery.

Setting: Private practice, United Kingdom.

Design: Retrospective case series.

Methods: Postoperative data of patients who had previously undergone refractive lens exchange or cataract surgery were used in a multivariate regression model to assess the effect of residual astigmatism on 3 months postoperative monocular uncorrected distance visual acuity (UDVA) and patient satisfaction. The analysis was based on residual refraction in the dominant eye of each patient. Odds ratios were calculated to demonstrate the effect of increasing residual astigmatism on UDVA and satisfaction with separate calculations for monofocal and multifocal IOLs.

Results: Three months postoperative outcomes of 17 152 dominant eyes were used in multivariate regression analysis. Compared with eyes with 0.00 diopter (D) residual astigmatism, the odds of not achieving 20/20 vision in eyes with 0.25 to 0.50 D residual astigmatism increased by a factor of 1.7 and 1.9 (P < .0001) in monofocal and multifocal IOLs, respectively. For the residual astigmatism 0.75 to 1.00 D, the odds ratio for not achieving 20/20 vision compared with eyes with no astigmatism was 6.1 for monofocal and 6.5 for multifocal IOLs (P < .0001). The effect of residual astigmatism on satisfaction was more evident at the 0.75 to 1.00 D level, where the odds of not being satisfied with vision increased by a factor of 2.0 and 1.5 in patients with monofocal and multifocal IOLs, respectively (P < .0001). The orientation of astigmatism was not a significant predictor in multivariate analysis.

Conclusions: Multivariate analysis in a large population of patients demonstrated that low levels of residual astigmatism can degrade visual acuity. Corneal astigmatism of 0.50 D or greater should be included in surgical planning.

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References

    1. Hoffmann PC, Hutz WW. Analysis of biometry and prevalence data for corneal astigmatism in 23,239 eyes. J Cataract Refract Surg 2010;36:1479–1485
    1. Rubenstein JB, Raciti M. Approaches to corneal astigmatism in cataract surgery. Curr Opin Ophthalmol 2013;24:30–34
    1. Gupta PC, Caty JT. Astigmatism evaluation prior to cataract surgery. Curr Opin Ophthalmol 2018;29:9–13
    1. Koch DD, Ali SF, Weikert MP, Shirayama M, Jenkins R, Wang L. Contribution of posterior corneal astigmatism to total corneal astigmatism. J Cataract Refract Surg 2012;38:2080–2087
    1. LaHood BR, Goggin M. Measurement of posterior corneal astigmatism by the IOLMaster 700. J Refract Surg 2018;34:331–336

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