Effects of error in radius of curvature on the corneal power measurement before and after laser refractive surgery for myopia

Abstract

Purpose: To investigate the sources of error in corneal power measurement before and after corneal refractive surgery for myopia.

Methods: The study comprised 28 eyes of six males and eight females with a mean age of 26 (range 18-39 years). The radius of curvature of anterior and posterior corneal surface, Q-Values of anterior and posterior corneal surface and corneal central thickness were measured by rotating Scheimpflug imaging (Pentacam). The true net power F(g), back vertex power F(v), and keratometric power SimK, were calculated respectively at the apex and at a paracentral area on the 3 mm ring.

Results: For virgin eyes, the overestimation (0.53 ± 0.11 D) of the corneal power by using a keratometric index of 1.3375 was balanced by the underestimation (-0.21 ± 0.09 D) of the corneal power by the error in the radius of curvature, resulting in a relatively small corneal power error with a mean value of 0.33 ± 0.11 D. With the Q-value changing from -0.09 to -0.41, the percentage balanced by the error in radius of curvature increased from 16% to 73%. However, for eyes after laser refractive surgery, the radius of curvature error lead to an overestimation (0.54 ± 0.16 D) of the corneal power and the keratometric index of 1.3375 again overestimated (1.59 ± 0.26 D) the corneal power, resulting in a large measurement error with a mean value of 2.12 ± 0.40 D. With the Q-value changing from 0.35 to 1.89, the percentage added by the error in radius of curvature increased from 14% to 32%.

Conclusions: For virgin eyes, the overestimation of the corneal power by using a keratometric index of 1.3375 is balanced by the underestimation of the corneal power by the error in the radius of curvature, resulting in a relatively small corneal power error. However, for eyes after laser refractive surgery, the flatter anterior corneal surface means that the use of a keratometric index of 1.3375 significantly overestimates the corneal power and the radius of curvature error now adds to this overestimation and results in a large measurement error.