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Distribution of preoperative corneal astigmatism and postoperative refractive astigmatism in a large population of patients undergoing cataract surgery in the UK

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Session Details

Session Title: Pseudophakic IOLs: Toric

Session Date/Time: Tuesday 10/10/2017 | 08:30-10:30

Paper Time: 08:30

Venue: Room 4.4

First Author: : A.Day UK

Co Author(s): :    M. Dhariwal   M. Keith   F. Ender   C. Perez-Vives   S. Kalson-Ray   D. Anderson     

Abstract Details


Currently, there is a paucity of real-world data on astigmatism prevalence in UK cataract patients and a limited understanding of astigmatism related unmet needs following cataract surgery. This study was conducted to describe the prevalence and degree of astigmatism pre and post cataract surgery in the UK.


Retrospective analysis of electronic medical records from 8 UK NHS ophthalmology clinics.


Data from 110,468 eyes (from patients aged >65 years) undergoing phacoemulsification with in-the-bag IOL placement were analyzed to describe 1) proportions of pre-operative corneal astigmatism using most recent keratometry measures in 2 years prior to surgery; 2) proportions of eyes receiving standard monofocal IOLs during surgery and with post-operative astigmatism, using the most recent subjective and/or auto-refraction measures within 2-12 months post-surgery. For eyes with ≥0.5D of corneal astigmatism, implanted with standard monofocal IOLs and with records of both cylinder and axis of corneal and refractive astigmatism, pre-operative (corneal) and post-operative (refractive) astigmatism were compared using power vector analysis.


Overall, 78% (n=85,650) eyes had pre-existing corneal astigmatism ≥0.5D, 42% (n=46,003) ≥1.0D, 21% (n=22,899) ≥1.5D, and 11% (n=11,651) ≥2.0D. After surgery, refraction cylinder measures were available for 39,744 eyes receiving standard monofocal IOLs, of which 90% (n=35,907) had refractive astigmatism ≥0.5D and 58% (n=22,886) ≥1.0D. Of the 39,744 eyes where both preoperative and postoperative data were available, 28,845 eyes (73%) had both cylinder and axis recorded. Eyes operated off axis had a greater postoperative astigmatism vector magnitude compared with eyes operated on axis (+0.80D vs. +0.35D).


There is a significant burden of pre-operative corneal astigmatism in the UK cataract population. Postoperative refraction data was only available on just over a third of eyes, and in these cases approximately 60% had ≥1D refractive cylinder. Eyes operated on-axis had lower postoperative refractive cylinder than eyes operated off-axis.

Financial Disclosure:

is employed by a forNONEprofit company with an interest in the subject of the presentation, receives consulting fees, retainer, or contract payments from a competing company

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