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Global prevalence, economic and humanistic burden of astigmatism in cataract patients: a systematic literature review

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Session Details

Session Title: Pseudophakic IOLs: Toric

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

Paper Time: 08:36

Venue: Room 4.4

First Author: : D.Anderson UK

Co Author(s): :    M. Dhariwal   M. Keith   C. Bouchet              

Abstract Details


To systematically evaluate the published scientific evidence regarding prevalence as well as the economic and humanistic burden attributed to astigmatism in Cataract patients


A systematic literature search


This review followed a standard, systematic review methodology endorsed by the Cochrane Collaboration and the National Institute for Health and Care Excellence (NICE), UK HTA body. Findings were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search using MEDLINE and EMBASE databases using a predefined search strategy (search period: 1996-July 2016). In addition, selected conference proceedings and grey literature searches were also performed. In total, 34 publications meeting inclusion criteria were reviewed to collate and critically appraise the evidence on prevalence, and direct and indirect economic and humanistic burden.


The prevalence of ≥1D pre-operative astigmatism in cataractous eyes: 23% in South Korea; 32% in Sweden and Croatia; 34% in Spain; 36% in Japan; 37% in Thailand; 41% in UK, Italy, and Denmark; and 47% in China. Post-operative spectacle costs: In the US, the total cost of spectacles was approximately US$300 per year. In Europe, cost of spectacles ranged from €200 to €500. In Korea, lifetime costs were KRW 2,065,152 (US$1786.4) per patient. In Cataract patients, both pre-operative astigmatism and postoperative residual astigmatism are associated with poor vision related patient satisfaction and QoL, spectacle burden, and increased risk of falls.


Pre-operative astigmatism ≥1D is present in many cataract patients. Although published data are limited, both pre-operative astigmatism and post-operative residual astigmatism affect visual acuity, visual function, and vision-related quality of life, resulting in added humanistic burden. Continuous need for vision correction in the post-operative period due to sub-optimal correction of astigmatism during Cataract surgery could lead to higher spectacle dependence and cost burden. Patients must bear the out of pocket expenses as spectacles are often not reimbursed by payers. More studies are needed to gain a better understanding of the disease burden of astigmatism in Cataract patients.

Financial Disclosure:

is employed by a forNONEprofit company with an interest in the subject of the presentation

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