Impact of preoperative mean keratometry on corneal higher-order aberrations and optical quality following cataract surgery.
- 1Department of Ophthalmology, Peking University Third Hospital, Beijing, China.
Abstract
Purpose
To evaluate how different corneal meridian characteristics influence visual outcomes, surgically induced astigmatism (SIA), and higher-order aberrations (HOAs) following phacoemulsification with intraocular lens implantation in cataract patients.Methods
Patients were divided into three groups according to preoperative mean keratometry (Kmean): flat (≤ 43.0 D), regular (43.0-46.0 D), and steep (≥ 46.0 D). Outcomes included corrected distance visual acuity (CDVA), anterior and posterior corneal astigmatism, SIA measured with the Pentacam, and HOAs assessed using both Pentacam and iTrace at 1 and 3 months postoperatively.Results
CDVA, corneal astigmatism, and SIA parameters showed no significant between-group differences (all p > 0.05), with the primary clinically relevant differences lying in intrinsic HOAs and aberration changes. Preoperatively, Pentacam measurements revealed that the steep group had significantly higher anterior and posterior corneal HOAs than the flat group (p = 0.006 and <0.001, respectively). At 3 months postoperatively, the steep group maintained higher HOAs (p = 0.006 and 0.013), while changes from baseline were comparable among groups. iTrace analysis showed that the flat group had the lowest preoperative spherical aberration (SA) (p = 0.003), but exhibited a significant postoperative increase in trefoil aberration compared with the regular group (mean difference, 0.10 μm; 95% CI, 0.02 to 0.18; Padj=0.042), alongside a non-significant trend toward higher SA.Conclusion
Cataract surgery provides effective and consistent refractive and visual outcomes in eyes across different Kmean profiles. Steeper corneas consistently show higher intrinsic HOAs, whereas flatter corneas demonstrate a statistically significant increase in trefoil and a non-significant trend toward higher SA compared with regular corneas.
Related
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- Age-Related Differences in Corneal Higher-Order Aberrations Among School-Aged Children Referred After Vision Screening
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BibTeX
@article{shen2026impact,
title = {{Impact of preoperative mean keratometry on corneal higher-order aberrations and optical quality following cataract surgery.}},
author = {Zhan Shen and Kaiyue Du and Bowei Yuan and Yinan Liu and Xiaoyong Chen and Jing Hong},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1934290},
url = {https://europepmc.org/article/MED/42948064},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of preoperative mean keratometry on corneal higher-order aberrations and optical quality following cataract surgery.
AU - Zhan Shen
AU - Kaiyue Du
AU - Bowei Yuan
AU - Yinan Liu
AU - Xiaoyong Chen
AU - Jing Hong
PY - 2026
DA - 2026/10/13
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1934290
UR - https://europepmc.org/article/MED/42948064
AB - Purpose To evaluate how different corneal meridian characteristics influence visual outcomes, surgically induced astigmatism (SIA), and higher-order aberrations (HOAs) following phacoemulsification with intraocular lens implantation in cataract patients.Methods Patients were divided into three groups according to preoperative mean keratometry (Kmean): flat (≤ 43.0 D), regular (43.0-46.0 D), and steep (≥ 46.0 D). Outcomes included corrected distance visual acuity (CDVA), anterior and posterior corneal astigmatism, SIA measured with the Pentacam, and HOAs assessed using both Pentacam and iTrace at 1 and 3 months postoperatively.Results CDVA, corneal astigmatism, and SIA parameters showed no significant between-group differences (all p > 0.05), with the primary clinically relevant differences lying in intrinsic HOAs and aberration changes. Preoperatively, Pentacam measurements revealed that the steep group had significantly higher anterior and posterior corneal HOAs than the flat group (p = 0.006 and <0.001, respectively). At 3 months postoperatively, the steep group maintained higher HOAs (p = 0.006 and 0.013), while changes from baseline were comparable among groups. iTrace analysis showed that the flat group had the lowest preoperative spherical aberration (SA) (p = 0.003), but exhibited a significant postoperative increase in trefoil aberration compared with the regular group (mean difference, 0.10 μm; 95% CI, 0.02 to 0.18; Padj=0.042), alongside a non-significant trend toward higher SA.Conclusion Cataract surgery provides effective and consistent refractive and visual outcomes in eyes across different Kmean profiles. Steeper corneas consistently show higher intrinsic HOAs, whereas flatter corneas demonstrate a statistically significant increase in trefoil and a non-significant trend toward higher SA compared with regular corneas.
SN - 2296-858X
ER -