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Distribution of preoperative and postoperative astigmatism in a large population of patients undergoing cataract surgery in the UK

Day, AC; Dhariwal, M; Keith, MS; Ender, F; Perez Vives, C; Miglio, C; Zou, L; (2018) Distribution of preoperative and postoperative astigmatism in a large population of patients undergoing cataract surgery in the UK. British Journal of Ophthalmology , 103 (7) pp. 993-1000. 10.1136/bjophthalmol-2018-312025. Green open access

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Abstract

PURPOSE: To assess the prevalence and severity of preoperative and postoperative astigmatism in patients with cataract in the UK. SETTING: Data from 8 UK National Health Service ophthalmology clinics using MediSoft electronic medical records (EMRs). DESIGN: Retrospective cohort study. METHODS: Eyes from patients aged ≥65 years undergoing cataract surgery were analysed. For all eyes, preoperative (corneal) astigmatism was evaluated using the most recent keratometry measure within 2 years prior to surgery. For eyes receiving standard monofocal intraocular lens (IOLs), postoperative refractive astigmatism was evaluated using the most recent refraction measure within 2-12 months postsurgery. A power vector analysis compared changes in the astigmatic 2-dimensional vector (J0, J45) before and after surgery, for the subgroup of eyes with both preoperative and postoperative astigmatism measurements. Visual acuity was also assessed preoperatively and postoperatively. RESULTS: Eligible eyes included in the analysis were 110 468. Of these, 78% (n=85 650) had preoperative (corneal) astigmatism ≥0.5 dioptres (D), 42% (n=46 003) ≥1.0 D, 21% (n=22 899) ≥1.5 D and 11% (n=11 651) ≥2.0 D. After surgery, the refraction cylinder was available for 39 744 (36%) eyes receiving standard monofocal IOLs, of which 90% (n=35 907) had postoperative astigmatism ≥0.5 D and 58% (n=22 886) ≥1.0 D. Visual acuity tended to worsen postoperatively with increased astigmatism (ρ=-0.44, P<0.01). CONCLUSIONS: There is a significant burden of preoperative astigmatism in the UK cataract population. The available refraction data indicate that this burden is not reduced after surgery with implantation of standard monofocal IOLs. Measures should be taken to improve visual outcomes of patients with astigmatic cataract by simultaneously correcting astigmatism during cataract surgery.

Type: Article
Title: Distribution of preoperative and postoperative astigmatism in a large population of patients undergoing cataract surgery in the UK
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bjophthalmol-2018-312025
Publisher version: http://doi.org/10.1136/bjophthalmol-2018-312025
Language: English
Additional information: © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an Open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:©http://creativecommons.org/licenses/by-nc/4.0/.
Keywords: Angle, epidemiology, treatment other, vision
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/10066398
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