ESCRS - POCAT623 - Clinical Impact Of Total Keratometry: How Often Does Measured Posterior Corneal Astigmatism Alter Spherical Iol Power Selection In A Croatian Caucasian Population?

Clinical Impact Of Total Keratometry: How Often Does Measured Posterior Corneal Astigmatism Alter Spherical Iol Power Selection In A Croatian Caucasian Population?

Published 2026 - 44th Congress of the ESCRS

Reference: POCAT623 | Type: Poster | DOI: 10.82333/pqsp-3v46

Authors: Dr Lorena Karla Šklebar* 1 , Dr Niko Tomljanović 2 , A/Prof. Sonja Jandroković 3 , Dr Ivan Škegro 3 , Dr Sania Vidas Pauk 1 , Dr Dina Lešin Gaćina 1 , A/Prof. Sanja Masnec 3 , Prof. Dr Miro Kalauz 3

1Department of ophthalmology,University Hospital Centre Zagreb,Zagreb,Croatia, 2Ghetaldus Eye Clinic,Zagreb,Croatia, 3School of medicine, University of Zagreb,Zagreb,Croatia;Department of ophthalmology,University Hospital Centre Zagreb,Zagreb,Croatia

Purpose

To evaluate the clinical impact of incorporating measured posterior corneal astigmatism using Total Keratometry (TK) on spherical intraocular lens (IOL) power selection. While similar data have been reported in other populations, real-world regional analyses remain limited. We specifically assessed how often TK meaningfully alters surgical planning compared with standard keratometry (Barrett Universal II) in a Croatian Caucasian cohort.

Setting

Single-centre retrospective study conducted at a tertiary referral ophthalmology department in Croatia (University Hospital Centre Zagreb)

Methods

Fifty-seven eyes of Caucasian Croatian patients undergoing routine cataract evaluation were analysed. Spherical IOL power was calculated using Barrett Universal II (standard keratometry) and Barrett TK (Total Keratometry). Paired differences (ΔIOL) were analysed using the Wilcoxon signed-rank test due to non-normal distribution. The proportion of eyes in which TK would have resulted in a different spherical IOL selection was assessed. Associations between ΔIOL, anterior chamber depth (ACD), and axial length (AL) were evaluated using Spearman correlation.

Results

A total of 57 eyes were included. Median spherical IOL power was 23.0 D with both calculation methods. The median ΔIOL (TK–K) was 0.085 D, and no statistically significant difference was observed (p = 0.393). TK would have resulted in a different spherical IOL selection in only a small minority of cases. A weak positive correlation was found between ΔIOL and ACD (ρ = 0.295, p = 0.038), while no association was observed with AL (ρ = 0.023, p = 0.872).

Conclusions

In this Croatian Caucasian cohort, incorporation of measured posterior corneal data had minimal impact on spherical IOL power selection. Although TK slightly diverged from standard keratometry in eyes with deeper anterior chambers, these differences were generally below clinically relevant thresholds. These findings suggest that, in routine practice, the decision-impact of TK on spherical power selection is limited, while its value may lie predominantly in astigmatic planning.