Prevalence and Age-Related Changes of Corneal Astigmatism in Patients Undergoing Cataract Surgery in Northern China
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Updated: Dec 5, 2025

Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter
Published on: September 16, 2025
Zhizhong Wu1, Caijuan Liu1, Zhimin Chen1
1Department of Ophthalmology, Hebei Eye Hospital, Xingtai, Hebei, China.
Purpose:
To examine the magnitude, orientation, and age-related changes of corneal astigmatism of the eyes before cataract surgery. Setting. Hebei Eye Hospital, Hebei, China.
Design:
A clinical-based retrospective study.
Results:
The study consisted of 5662 eyes of 5662 consecutive cataract surgery patients with a mean age of 68.26 ± 10.39 (mean ± standard deviation (SD)) years (range 40 to 97 years), and 59.86% of the patients were women. Mean corneal astigmatism was 0.98 ± 0.76 diopter (D) (range 0.00-9.61 D). Corneal astigmatism of 0.50-0.99 D was the most common range of values (30.08%), followed by 1.00-1.49 D (22.15%), ≤0.50 D (21.21%), and 1.50-1.99 D (10.28%). There was a strong U-shaped relation between corneal astigmatism and age (p for nonlinearity <.01). With the increase of age, the astigmatism axis gradually changes from with-the-rule (WTR) to against-the-rule (ATR). Moreover, in young patients with age below 65 years, WTR astigmatism was negatively correlated with age, while ATR was positively correlated with age (r = -0.11, p=.001; r = 0.10, p=.010, respectively). However, in the old patients with age above and equal to 65 years, all types of astigmatism were positively correlated with age.
Conclusion:
This study may provide valuable and practical information to surgeons when selecting the appropriate surgical method and toric intraocular lens (IOLs).
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