Correlation of Preoperative Keratometry and Corneal Astigmatism on Visual Outcomes in Cataract Patients Receiving Non-Toric IOLs
Abstract
Introduction: Preoperative biometry plays a pivotal role in predicting visual outcomes after cataract surgery. Corneal astigmatism can significantly influence uncorrected visual acuity (UCVA). In clinical settings where only non-toric intraocular lenses (IOLs) are available, understanding the impact of astigmatism becomes even more crucial. This study investigates biometric profiles and visual outcomes in relation to corneal astigmatism severity in patients who received non-toric IOLs. Methods: A retrospective cohort analysis was conducted on 30 eyes from 28 patients undergoing phacoemulsification with non-toric IOL implantation at Nyi Ageng Serang Hospital between September 2021 and February 2022. Biometric parameters including axial length (AL), anterior chamber depth (ACD), and lens thickness (LT) were recorded. Patients were grouped based on corneal astigmatism values (>–1.0 D and ≤–1.0 D), and outcomes were analyzed in terms of postoperative UCVA and best corrected visual acuity (BCVA). Results: The mean age of patients was 66 ± 10.3 years, with 63.3% male. Nearly half (46.7%) of eyes presented with corneal astigmatism greater than –1.0 D. A significant age-related variation in astigmatism was observed (p=0.001), particularly in patients aged 61–70. There was no statistically significant difference in postoperative UCVA or BCVA between astigmatism groups (p=0.438 and p=0.524, respectively). Conclusion: In the absence of toric IOL options, corneal astigmatism showed a weak positive correlation with postoperative UCVA and moderate positive correlation with postoperative BCVA although these results did not lead to significantly different visual outcomes postoperatively. This underscores the importance of individualized preoperative planning and suggests future access to toric IOLs could further enhance postoperative UCVA, particularly in patients with corneal astigmatism >–1.0 D.