ESCRS - PP17.08 - Using Corneal Wavefront For Astigmatism Prediction In Cataract Surgery

Using Corneal Wavefront For Astigmatism Prediction In Cataract Surgery

Published 2026 - 44th Congress of the ESCRS

Reference: PP17.08 | Type: Free paper | DOI: 10.82333/tej9-9c71

Authors: Dr Bjørn Gjerdrum* 1 , Dr Kjell Gunnar Gundersen 2

1ifocus øyeklinikk,Ifocus øyeklinikk,Haugesund,Norway;Ifocus øyeklinikk,Ifocus øyeklinikk,Haugesund,Norway, 2Ifocus øyeklinikk,Ifocus øyeklinikk,Haugesund,Norway

Purpose

To evaluate astigmatism prediction error using preoperative total corneal wavefront measurements.

Setting

The study included results from two private eye clinics situated in Haugesund and Stavanger in Norway

Methods

This was a retrospective study of successful cataract or refractive lens exchange surgery with toric and non-toric IOLS. Preoperative biometry was performed with an OCT based biometer (Anterion, Heidelberg Engineering. The astigmatism prediction error (APE) was calculated as the magnitude of the vector differences between the achieved and the predicted refractive astigmatism using thre methods: Built-in Barrett toric calclulator (measured posterior astigmatism) (APE-Barrett), total cornea power (APE-TCP) and total wavefront astigmatism (APE-WF). Wavefront astigmatism was converted from Zernike coefficients (microns) of oblique and with-the-rule/against-the-rule astigmatism to diopters of cylinder and axis)

Results

The study included 146 eyes of 146 patients. The mean age was 60 years and 40% were female. Toric IOL´s were implanted in 44% of the eyes. Mean Follow-up time was 100 days (63 - 154). The mean uncorrected VA was -0,01 on the logMAR scale. The mean postoperative refractive spherical equivalent and astigmatism was -0,06 and -0,31, respectively. The mean APE and SD was 0.33±0,20, 0.43±0.25 D and 0.39± 0.24 for
APE-Barrett, APE-TCP, and APE-WF, respectively. APE-Barret was statistically significantly lower than APE-TCP and APE-WF (p<0,01).
The percentages of eyes with APE within 0.5 D was statistically significantly higher for APE-Barrett (83%) compared to APE-TCP (64%) (p<0,001) but not compared to APE-WF (72 %)(p=0,06).

Conclusions

Astigmatism prediction using OCT based total corneal wavefront could not improve astigmatism prediction in this study. The lowest astigmatism prediction error was found with the Barrett toric calculator for measured posterior astigmatism