Fluctuations in corneal curvature limit predictability of intraocular lens power calculations.

PURPOSE: To analyze fluctuations in corneal curvature over time.

SETTING

Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.

DESIGN

Case series.

METHODS

A 3-piece IOL was implanted in 1 eye and a 1-piece IOL in the other eye through a 3.2 mm clear corneal temporal incision. Keratometry was performed preoperatively and at several points in time postoperatively. Differences between measurements were analyzed by power vectors. Statistical significance was assessed by monovariate, bivariate, and trivariate paired t tests. Acute angle shifts were determined as differences between meridians at 2 points in time.

RESULTS

Fifty patients were enrolled. From preoperatively to 1 year postoperatively, the changes in vector components (M, J0, J45) were, respectively, -0.02 diopter (D) ± 0.23 (SD) (P=.38), -0.07 ± 0.27 D (P=.02), and +0.04 ± 0.25 D (P=.14). Corresponding changes from 1 year to 2 years postoperatively were +0.01 ± 0.25 D (P=.73), +0.01 ± 0.23 D (P=.83), and +0.01 ± 0.16 D (P=.40). The meridian shift was -5 ± 32 degrees (P=.13) from preoperatively to postoperatively and +3 ± 22 degrees (P=.23) from 1 year to 2 years.

CONCLUSIONS

Surgically induced astigmatism was composed of slight flattening in the horizontal meridian and slight steepening in the oblique meridian but was insignificant in relation to random fluctuations, which were almost equally large between postoperative measurements 1 year apart. The fluctuations were not due to imprecision in measurement.

FINANCIAL DISCLOSURE: Dr. Norrby is a retiree from Abbott Medical Optics, Inc., and holder of a small amount of stock. Dr. Findl is scientific advisor to Abbott Medical Optics, Inc. No other author has a financial or proprietary interest in any material or method mentioned.