Impact of Total Corneal Astigmatism Estimated With the Abulafia-Koch Formula Versus Measured With a SS-OCT Biometer on the Refractive Outcomes of a Toric Intraocular Lens in Cataract Surgery.

PURPOSE

To compare the impact of total corneal astigmatism (TCA) estimated with the Abulafia-Koch formula (TCA) versus measured by Total Keratometry (TK), swept-source optical coherence tomography (OCT) coupled with telecentric keratometry (TCA) on the refractive outcomes after cataract surgery with toric intraocular lens (IOL) implantation.

METHODS

Two hundred one eyes of 146 patients who underwent cataract surgery with toric IOL implantation (XY1AT; HOYA Corporation) were included in this single-center, retrospective study. For each eye, TCA (estimated from the anterior keratometry values measured with the IOLMaster 700 [Carl Zeiss Meditec AG]) and TCA (measured using TK IOLMaster 700) were entered into the HOYA Toric Calculator. Patients were operated on based on TCA. For each eye, centroid and mean absolute error in predicted residual astigmatism (EPA) were calculated according to TCA used (TCA or TCA). The cylinder power and the axis of the posterior chamber IOL were compared.

RESULTS

The mean uncorrected distance visual acuity was 0.07 ± 0.12 logMAR, the mean spherical equivalent was 0.11 ± 0.40 D, and mean residual astigmatism was 0.35 ± 0.36 D. Mean centroid EPA was 0.28 D at 132° with TCA and 0.35 D at 148° with TCA ((x) < .001; (y) < .01). Mean absolute EPA was 0.46 ± 0.32 D with TCA and 0.50 ± 0.37 D with TCA ( < .01). In the with-the-rule astigmatism subgroup, a deviation from the target of less than 0.50 D was achieved in 68% of eyes with TCA versus 50% of eyes with TCA. The proposed posterior chamber IOL was different depending on the calculation methods used in 86% of cases.

CONCLUSIONS

Both calculation methods showed excellent results. However, the predictability error was significantly reduced when TCA was used compared to TCA measured with the IOLMaster 700 in the whole cohort. Finally, TCA was overestimated by TK in the with-the-rule astigmatism subgroup. .