Prediction of distance visual acuity in presbyopic astigmatic subjects

This study was aimed to determine the effect of the amount of astigmatism on distance visual acuity, and to provide a prediction formula of visual acuity according to astigmatism, in a presbyopic population. We comprised 318 eyes of 318 consecutive patients (158 phakic and 160 pseudophakic subjects) without any eye diseases, except for refractive errors with astigmatism of 3 diopter or less. We assessed the relationship of the spherical equivalent visual acuity (SEVA) with astigmatism, and also provided a regression formula of visual acuity according to astigmatism in such subjects. We found a significant correlation between the SEVA and the amount of astigmatism (r = 0.715, p < 0.001) in the entire study population. We obtained similar results, not only in phakic eyes (r = 0.718, p < 0.001), but also in pseudophakic eyes (r = 0.717, p < 0.001). The regression formula was expressed as follows: y = 0.017x² + 0.125x - 0.116 (R² = 0.544), where y = logMAR SEVA, and x = astigmatism. We also found no significant differences in the SEVA for matched comparison among the with-the-rule (WTR), against-the-rule (ATR), and oblique (OBL) astigmatism subgroups (p = 0.922). These regression formulas may be clinically beneficial not only for estimating the visual prognosis after astigmatic correction, but also for determining the surgical indication of astigmatic correction.