Estimating Total Corneal Astigmatism From Anterior Corneal Data

Cornea. 2017 Jul;36(7):828-833. doi: 10.1097/ICO.0000000000001224.


Purpose: To determine keratometric astigmatism (KA), posterior corneal astigmatism (PCA), and total corneal astigmatism (TCA) in 951 normal eyes, to establish a model for estimating TCA from anterior corneal data, and to test this method in a new group of eyes with toric intraocular lenses (TIOLs).

Methods: We used a Pentacam HR (high-resolution) Scheimpflug camera to determine KA, PCA, and TCA in 951 normal eyes. A model to estimate TCA from anterior corneal data was evaluated by the difference (=error) between the measured TCA and the estimated value. The model was tested in 40 eyes with TIOLs.

Results: KA, TCA, and PCA averaged 1.06 (±0.85) D, 1.05 (±0.83) D, and 0.33 (±0.17) D. The error of the model to estimate TCA averaged zero with an SD of ±0.21 D. Application of this model and of direct Pentacam TCA measurements in TIOL calculation gave similar results, namely a slight reduction of overcorrection in with-the-rule astigmatism, but an eradication of undercorrection in against-the-rule astigmatism.

Conclusions: It was possible to estimate TCA accurately from anterior corneal data with a new formula. However, application of both this model on keratometric data and of direct Pentacam measurements in a group of 40 eyes with TIOLs did not completely eradicate the refractive error in TIOL calculation. More studies comparing Pentacam TCA and refractive astigmatism are required.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Astigmatism / diagnosis*
  • Child
  • Cornea / pathology*
  • Female
  • Healthy Volunteers
  • Humans
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Models, Statistical*
  • Phacoemulsification
  • Photography / instrumentation
  • Retrospective Studies