Correlation between Refractive, Corneal and Residual astigmatism in refractive surgery candidates

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1 Correlation between Refractive, Corneal and Residual astigmatism in refractive surgery candidates Abstract Zahra Heidari 1, Hossein Mohammad-Rabie 2, Mehrdad Mohammadpour 3, Ebrahim Jafarzadehpur 4, Mehdi Khabazkhoob 5, Mahmoud Jabbarvand 6, Hassan Hashemi 7 1 MSc in Optometry, Farabi Hospital Research Center, Tehran University of Medical Sciences, Tehran, Iran 2 MD, Associate Professor, Imam Hossein Hospital Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 3 MD, Assistant Professor, Farabi Hospital Research Center, Tehran University of Medical Sciences, Tehran, Iran 4 PhD, Department of Optometry, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran 5 MSc in Epidemiology, Department of Epidemiology, Dezful University of Medical Sciences, Dezful, Iran 6 MD, Professor, Department of Ophthalmology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran 7 MD, Professor, Noor Hospital Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran (Received August 26, 2013; Accepted January 8, 2014) Background and purpose: Astigmatism is a common optical dysfunction, effective on various visual outcomes and one of the important criteria of refractive surgery. The aim of present study was to evaluate the correlation between refractive, corneal and residual astigmatism in refractive surgery candidates. Materials and methods: In this cross-sectional descriptive, analytical study, 200 patients referred to the Farabi hospital, Iran, for refractive surgery were enrolled. Refraction survey and topography were done to determine refractive, corneal and residual astigmatism for all of participants and statistical analyses were performed. Results: Overall, 400 eyes of 200 subjects with the average age of 28.2 ± 6.24 participated in this study. 62.7% of cases were women. According to spherical equivalent, 94.2% were myope, 3.3% were hyprope and 78.9% had refractive astigmatism more than 0.75 D. Mean spherical equivalent refractive errors was ± 1.95 D in myopic group and 2.72 ± 0.97 D in hyperopic group; mean refractive astigmatism was 1.97 ± 1.3 D in myopic and 1.3 ± 1.37 D in hyperopic group. The correlation ratio was (r = 0.223) between lenticular and refractive astigmatism (P < 0.001), (r = 0.111) between lenticular and corneal astigmatism (P = 0.027), and (r = 0.942) between refractive and corneal astigmatism (P < 0.001). Conclusion: Significant correlations were found between refractive, corneal, and residual astigmatism; there was a strong correlation between corneal and refractive astigmatism; and 81% of the changes in refractive astigmatism could be justified with corneal astigmatism changes. Separating the type of astigmatism and determining its origin (cornea or lens) could be helpful for refractive surgery. Keywords: Refractive error, correlation, internal, cornea, refractivity, astigmatism J Mazand Univ Med Sci 2014; 23(110): (Persian). 37

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7 %#M$V Mh! = M )M ) c (;!5) 5 B$!6Ni.(20)! M PM#7 W;\! 5`# r# B XM7# M P#7 *Q#$?.%#$V *6=) cmmm=v! MM! MM% -MM$ 5 MM`!MMM% 1MMH! 5 1M 5 *:;5)M# *!M. XM PM#7 *MQ*)M( 5M6 M =.)M -M *$ = 5`# *QY 5 W;\ MW;\ M$ R.! ^ R%?b/ a/ RW;\ B8 -MM!5) RMMW;\ -MM! *!MM. XMM 1MM = `#MM$. ) Z?.%#$V $! 5 (%#$V 5 - U References 1. Read SA, Collins MJ, Carney LG. A review of astigmatism and its possible genesis. Clin Exp Optom 2007; 90(1): Aghadost D, Zare M, Mousavi SGH. Prevalence of refractive errors among students in kashan ( academic years). Journal of Kermansha University of Medical Sciences 2001; 5(3): (Persian). 3. Yekta A, Fotouhi A, Hashemi H, Dehghani C, Ostadimoghaddam H, Heravian J, et al. Prevalence of refractive errors among schoolchildren in Shiraz, Iran. Clin Experiment Ophthalmol 2010; 38(3): Hashemi H, Khabazkhoob M, Peyman A, Miraftab M, Jafarzadehpur E, Emamian MH, et al. The association between residual astigmatism and refractive errors in a population-based study. J Refract Surg 2013; 29(9): McKendrick AM, Brennan NA. Distribution of astigmatism in the adult population. J Opt Soc Am A Opt Image Sci Vis 1996; 13(2): Kelly JE, Mihashi T, Howland HC. Compensation of corneal horizontal/vertical astigmatism, lateral coma, and spherical aberration by internal optics of the eye. J Vis 2004; 4(4): Zheng GY, Du J, Zhang JS, Liu SB, Nie XL, Zhu XH, et al. Contrast sensitivity and higher-order aberrations in patients with astigmatism. Chin Med J (Engl) 2007; 120(10): Pinero DP, Alio JL, Barraquer RI, Uceda- Montanes A, Murta J. Clinical characterization of corneal ectasia after myopic laser in situ keratomileusis based on anterior corneal aberrations and internal astigmatism. J Cataract Refract Surg 2011; 37(7): Maduka Okafor FC, Okoye OI, Eze BI. Myopia: a review of literature. Niger J Med 2009; 18(2): Ziaei H, Katibeh M, Solaimanizad R, Hosseini S, Gilasi HR, Golbafian F, et al. Prevalence of *RZ %#$V - ) [8! #"! /H J_5 MH5 MT 5 M#"! %#M$V -M -M(~%Q 5 MT 5 5 *RMZ %#M$V M -M *! (W [8! ;5 B M k!m6 um -M! 5.(P < 0/05) ) B" #"! M ) #"! 5 *RZ %#$V - *R"_ 5 [8! Q R RMW;\ rm# M RM (19)!) H5 ( T %#$V H5!M M" 110 Srivannaboon um!.b$ h a/ RMW;\ R#"!! R *!. X R( 5 )(#"6!Z $! M!M%Q 5 Liu u r# -(~%Q. 5`# a/ M#"! %#M$V *5! -$ c" RZ h R refractive errors; the yazd eye study. J Ophthalmic Vis Res 2013; 8(3): Yekta AA, Fotouhi A, Khabazkhoob M, Hashemi H, Ostadimoghaddam H, Heravian J, et al. The prevalence of refractive errors and its determinants in the elderly population of Mashhad, Iran. Ophthalmic Epidemiol 2009; 16(3): Dunne MC, Elawad ME, Barnes DA. A study of the axis of orientation of residual astigmatism. Acta Ophthalmol (Copenh) 1994; 72(4): Shankar S, Bobier WR. Corneal and lenticular components of total astigmatism in a preschool sample. Optom Vis Sci 2004; 81(7): Huynh SC, Kifley A, Rose KA, Morgan I, Heller GZ, Mitchell P. Astigmatism and its components in 6-year-old children. Invest Ophthalmol Vis Sci 2006; 47(1): Baldwin WR, Mills D. A longitudinal study of corneal astigmatism and total astigmatism. Am J Optom Physiol Opt 1981; 58(3): Keller PR, Collins MJ, Carney LG, Davis BA, van Saarloos PP. The relation between corneal and total astigmatism. Optom Vis Sci 1996; 73(2): Remon L, Benlloch J, Furlan WD. Corneal and refractive astigmatism in adults: a power vectors analysis. Optom Vis Sci 2009; 86(10): Grosvenor T, Ratnakaram R. Is the relation between keratometric astigmatism and refractive astigmatism linear? Optom Vis Sci 1990; 67(8): Srivannaboon S. Internal astigmatism and its correlation to corneal and refractive astigmatism. J Med Assoc Thai 2003; 86(2): Liu YC, Chou P, Wojciechowski R, Lin PY, Liu CJ, Chen SJ, et al. Power vector analysis of refractive, corneal, and internal astigmatism in an elderly Chinese population: the Shihpai Eye Study. Invest Ophthalmol Vis Sci 2011; 52(13):

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