Measurement of irregular astigmatism using semimeridian data from videokeratographs

Irregular astigmatism is one of the most troublesome side effects of corneal surgery. We attempted to quantify irregular astigmatism in a simple way, using semimeridian data from videokeratographs of corneas with different amounts of irregular astigmatism.

We studied the corneal topography of 30 normal corneas to be used as controls, 30 corneas from patients after radial keratotomy, 30 corneas from patients after nonfreeze myopic keratomileusis, and 30 corneas with clinically apparent keratoconus. We developed two diagnostic formulas, a refractive power symmetry index and an angle symmetry index, using the absolute-scale, color-coded map, and semimeridian data from the EyeSys Corneal Analysis System, and used them to compare the four groups of corneas.

In the corneas with irregular astigmatism, values for the refractive power symmetry index and angle symmetry index were significantly higher than in the normal corneas. The refractive power symmetry index confidence interval set at 95% was 0.58 diopters (D) (range 0.00 D to 0.58 D) in the control group. Using these limits, most values in the radial keratotomy, keratomileusis, and keratoconus groups were abnormal. Spectacle-corrected visual acuity correlated negatively with the refractive power symmetry index (rs = -0.58, p < .001). The refractive power symmetry index sensitivity and specificity were respectively 97% and 66%. Spectacle-corrected visual acuity did not correlate with the angle symmetry index.

Semimeridian data from videokeratographs can be used to quantify irregular astigmatism.