{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:12:34Z","timestamp":1793081554544,"version":"4.5.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Projekt DEAL"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Implantation of toric intraocular lenses (IOLs) has become standard in the correction of corneal astigmatism. The IOL selection is based on keratometric measurements of the central cornea. However, mid-peripheral corneal changes may yield suboptimal correction in patients with larger pupils. This study retrospectively analyzed corneal topography data collected using a Scheimpflug device during routine clinical examinations. Of 11,953 patients, 641 met the inclusion criteria. Total corneal astigmatism was compared between five concentric zones (2\u20136\u00a0mm) using vector analysis. The absolute difference between astigmatism at 2\u00a0mm and 6\u00a0mm was 0.30\u2009D (\u2212\u20090.36 to 0.64), which decreased to 0.10\u2009D (0 to 0.20) between the 5- and 6-mm zone. With-the-rule astigmatism was the most prevalent (53%), 34% had against-the-rule (ATR), and 13% had oblique. The decrease of the cylinder power with the diameter differed significantly between the three types, with ATR and oblique astigmatism being associated with the steepest change. Patients with high corneal astigmatism tend to demonstrate larger differences between the center and mid-periphery than those with low and moderate astigmatism. In conclusion, we demonstrated that central corneal astigmatism differs from that measured at the mid-periphery and that a larger difference was found in patients with ATR, oblique and high astigmatism.<\/jats:p>","DOI":"10.1038\/s41598-021-81772-w","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T10:09:07Z","timestamp":1618222147000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Central and mid-peripheral corneal astigmatism in an elderly population: a retrospective analysis of Scheimpflug topography results"],"prefix":"10.1038","volume":"11","author":[{"given":"Grzegorz","family":"\u0141abuz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorottya","family":"Varadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Khoramnia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd U.","family":"Auffarth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"key":"81772_CR1","doi-asserted-by":"publisher","first-page":"619","DOI":"10.3928\/1081597X-20080601-12","volume":"24","author":"ST Awwad","year":"2008","unstructured":"Awwad, S. T. et al. Contrast sensitivity and higher order aberrations in eyes implanted with AcrySof IQ SN60WF and AcrySof SN60AT intraocular lenses. J. Refract. Surg. 24, 619\u2013625 (2008).","journal-title":"J. Refract. Surg."},{"key":"81772_CR2","doi-asserted-by":"publisher","first-page":"1406","DOI":"10.1016\/j.jcrs.2014.10.035","volume":"41","author":"G \u0141abuz","year":"2015","unstructured":"\u0141abuz, G., Reus, N. J. & Van Den Berg, T. J. Ocular straylight in the normal pseudophakic eye. J. Cataract Refract. Surg. 41, 1406\u20131415 (2015).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR3","doi-asserted-by":"publisher","first-page":"1965","DOI":"10.2147\/OPTH.S114890","volume":"10","author":"A Gibbons","year":"2016","unstructured":"Gibbons, A., Ali, T. K., Waren, D. P. & Donaldson, K. E. Causes and correction of dissatisfaction after implantation of presbyopia-correcting intraocular lenses. Clin. Ophthalmol. (Auckland, NZ) 10, 1965 (2016).","journal-title":"Clin. Ophthalmol. (Auckland, NZ)"},{"key":"81772_CR4","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1097\/01.opx.0000177792.62460.58","volume":"82","author":"PB Morgan","year":"2005","unstructured":"Morgan, P. B., Efron, S. E., Efron, N. & Hill, E. A. Inefficacy of aspheric soft contact lenses for the correction of low levels of astigmatism. Optom. Vis. Sci. 82, 823\u2013828 (2005).","journal-title":"Optom. Vis. Sci."},{"key":"81772_CR5","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1016\/j.jcrs.2010.09.022","volume":"37","author":"JS Wolffsohn","year":"2011","unstructured":"Wolffsohn, J. S., Bhogal, G. & Shah, S. Effect of uncorrected astigmatism on vision. J. Cataract Refract. Surg. 37, 454\u2013460 (2011).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR6","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1055\/s-0034-1396179","volume":"232","author":"R Khoramnia","year":"2015","unstructured":"Khoramnia, R., Fitting, A., Rabsilber, T., Auffarth, G. & Holzer, M. Postoperative results after implantation of a toric, aspheric intraocular lens. Klin Monbl Augenheilkd 232, 867\u2013873 (2015).","journal-title":"Klin Monbl Augenheilkd"},{"key":"81772_CR7","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1136\/bjophthalmol-2017-310386","volume":"102","author":"BC Thomas","year":"2018","unstructured":"Thomas, B. C., Khoramnia, R., Auffarth, G. U. & Holzer, M. P. Clinical outcomes after implantation of a toric intraocular lens with a transitional conic toric surface. Br. J. Ophthalmol. 102, 313\u2013316 (2018).","journal-title":"Br. J. Ophthalmol."},{"key":"81772_CR8","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.jcrs.2008.09.027","volume":"35","author":"T Ferrer-Blasco","year":"2009","unstructured":"Ferrer-Blasco, T., Mont\u00e9s-Mic\u00f3, R., Peixoto-de-Matos, S. C., Gonz\u00e1lez-M\u00e9ijome, J. M. & Cervi\u00f1o, A. Prevalence of corneal astigmatism before cataract surgery. J. Cataract Refract. Surg. 35, 70\u201375 (2009).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR9","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1136\/bjophthalmol-2018-312025","volume":"103","author":"AC Day","year":"2019","unstructured":"Day, A. C. et al. Distribution of preoperative and postoperative astigmatism in a large population of patients undergoing cataract surgery in the UK. Br. J. Ophthalmol. 103, 993\u20131000 (2019).","journal-title":"Br. J. Ophthalmol."},{"key":"81772_CR10","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1038\/eye.2015.274","volume":"30","author":"OC Wakefield","year":"2016","unstructured":"Wakefield, O. C., Annoh, R. & Nanavaty, M. Relationship between age, corneal astigmatism, and ocular dimensions with reference to astigmatism in eyes undergoing routine cataract surgery. Eye 30, 562\u2013569 (2016).","journal-title":"Eye"},{"key":"81772_CR11","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s10384-004-0152-1","volume":"49","author":"K Asano","year":"2005","unstructured":"Asano, K. et al. Relationship between astigmatism and aging in middle-aged and elderly Japanese. Jpn. J. Ophthalmol. 49, 127\u2013133 (2005).","journal-title":"Jpn. J. Ophthalmol."},{"key":"81772_CR12","doi-asserted-by":"publisher","first-page":"2080","DOI":"10.1016\/j.jcrs.2012.08.036","volume":"38","author":"DD Koch","year":"2012","unstructured":"Koch, D. D. et al. Contribution of posterior corneal astigmatism to total corneal astigmatism. J. Cataract Refract. Surg. 38, 2080\u20132087 (2012).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR13","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1167\/iovs.05-1181","volume":"47","author":"SA Read","year":"2006","unstructured":"Read, S. A., Collins, M. J., Carney, L. G. & Franklin, R. J. The topography of the central and peripheral cornea. Invest. Ophthalmol. Vis. Sci. 47, 1404\u20131415 (2006).","journal-title":"Invest. Ophthalmol. Vis. Sci."},{"key":"81772_CR14","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1007\/s10043-018-0427-2","volume":"25","author":"T Kawamorita","year":"2018","unstructured":"Kawamorita, T., Shimizu, K., Hoshikawa, R., Kamiya, K. & Shoji, N. Relationship between central and peripheral corneal astigmatism in elderly patients. Opt. Rev. 25, 336\u2013339 (2018).","journal-title":"Opt. Rev."},{"key":"81772_CR15","doi-asserted-by":"publisher","first-page":"729","DOI":"10.3928\/1081597X-20120911-02","volume":"28","author":"N Visser","year":"2012","unstructured":"Visser, N., Bauer, N. J. & Nuijts, R. M. Residual astigmatism following toric intraocular lens implantation related to pupil size. J. Refract. Surg. 28, 729\u2013732 (2012).","journal-title":"J. Refract. Surg."},{"key":"81772_CR16","doi-asserted-by":"publisher","first-page":"803","DOI":"10.3928\/1081597X-20160629-01","volume":"32","author":"R Vinciguerra","year":"2016","unstructured":"Vinciguerra, R. et al. Detection of keratoconus with a new biomechanical index. J. Refract. Surg. 32, 803\u2013810 (2016).","journal-title":"J. Refract. Surg."},{"key":"81772_CR17","doi-asserted-by":"publisher","first-page":"1707","DOI":"10.1016\/j.jcrs.2013.05.042","volume":"39","author":"F Gilani","year":"2013","unstructured":"Gilani, F. et al. Comprehensive anterior segment normal values generated by rotating Scheimpflug tomography. J. Cataract Refract. Surg. 39, 1707\u20131712 (2013).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR18","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.jcrs.2006.11.008","volume":"33","author":"D Chen","year":"2007","unstructured":"Chen, D. & Lam, A. K. Intrasession and intersession repeatability of the Pentacam system on posterior corneal assessment in the normal human eye. J. Cataract Refract. Surg. 33, 448\u2013454 (2007).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR19","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1111\/j.1444-0938.2008.00336.x","volume":"92","author":"D Chen","year":"2009","unstructured":"Chen, D. & Lam, A. K. Reliability and repeatability of the Pentacam on corneal curvatures. Clin. Exp. Optom. 92, 110\u2013118 (2009).","journal-title":"Clin. Exp. Optom."},{"key":"81772_CR20","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1016\/j.jcrs.2014.10.044","volume":"41","author":"I Conrad-Hengerer","year":"2015","unstructured":"Conrad-Hengerer, I., Al Sheikh, M., Hengerer, F. H., Schultz, T. & Dick, H. B. Comparison of visual recovery and refractive stability between femtosecond laser\u2013assisted cataract surgery and standard phacoemulsification: six-month follow-up. J. Cataract Refract. Surg. 41, 1356\u20131364 (2015).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR21","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/S0886-3350(99)00360-0","volume":"26","author":"RC Drews","year":"2000","unstructured":"Drews, R. C. Five year study of astigmatic stability after cataract surgery with intraocular lens implantation: Comparison of wound sizes. J. Cataract Refract. Surg. 26, 250\u2013253 (2000).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR22","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1016\/s0886-3350(00)00486-7","volume":"26","author":"EM Schnitzler","year":"2000","unstructured":"Schnitzler, E. M., Baumeister, M. & Kohnen, T. Scotopic measurement of normal pupils: Colvard versus Video Vision Analyzer infrared pupillometer. J. Cataract Refract. Surg. 26, 859\u2013866. https:\/\/doi.org\/10.1016\/s0886-3350(00)00486-7 (2000).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR23","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1136\/bjo.85.9.1127","volume":"85","author":"N Morlet","year":"2001","unstructured":"Morlet, N., Minassian, D. & Dart, J. Astigmatism and the analysis of its surgical correction. Br. J. Ophthalmol. 85, 1127\u20131138 (2001).","journal-title":"Br. J. Ophthalmol."},{"key":"81772_CR24","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1016\/s0161-6420(98)94014-3","volume":"105","author":"D Zadok","year":"1998","unstructured":"Zadok, D. et al. Excimer laser photoastigmatic refractive keratectomy: Eighteen-month follow-up. Ophthalmology 105, 620\u2013623. https:\/\/doi.org\/10.1016\/s0161-6420(98)94014-3 (1998).","journal-title":"Ophthalmology"},{"key":"81772_CR25","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1097\/00006324-199706000-00019","volume":"74","author":"LN Thibos","year":"1997","unstructured":"Thibos, L. N., Wheeler, W. & Horner, D. Power vectors: an application of Fourier analysis to the description and statistical analysis of refractive error. Optom. Vis. Sci. 74, 367\u2013375 (1997).","journal-title":"Optom. Vis. Sci."},{"key":"81772_CR26","doi-asserted-by":"crossref","unstructured":"Zhang, Y. et al. Corneal astigmatism measurements comparison among ray-tracing aberrometry, partial coherence interferometry, and scheimpflug imaging system. J. Ophthalmol. 2020 (2020).","DOI":"10.1155\/2020\/3012748"},{"key":"81772_CR27","doi-asserted-by":"publisher","first-page":"1396","DOI":"10.1097\/OPX.0000000000000413","volume":"91","author":"S Hickson-Curran","year":"2014","unstructured":"Hickson-Curran, S., Brennan, N. A., Igarashi, Y. & Young, G. Comparative evaluation of Asian and white ocular topography. Optom. Vis. Sci. 91, 1396\u20131405 (2014).","journal-title":"Optom. Vis. Sci."},{"key":"81772_CR28","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.1016\/j.jcrs.2010.02.025","volume":"36","author":"PC Hoffmann","year":"2010","unstructured":"Hoffmann, P. C. & H\u00fctz, W. W. Analysis of biometry and prevalence data for corneal astigmatism in 23 239 eyes. J. Cataract Refract. Surg. 36, 1479\u20131485 (2010).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR29","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1097\/00003226-200104000-00007","volume":"20","author":"T Goto","year":"2001","unstructured":"Goto, T. et al. Gender-and age-related differences in corneal topography. Cornea 20, 270\u2013276 (2001).","journal-title":"Cornea"},{"key":"81772_CR30","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1016\/j.jcrs.2018.06.020","volume":"44","author":"K Hayashi","year":"2018","unstructured":"Hayashi, K., Sato, T., Sasaki, H., Hirata, A. & Yoshimura, K. Sex-related differences in corneal astigmatism and shape with age. J. Cataract Refract. Surg. 44, 1130\u20131139 (2018).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR31","doi-asserted-by":"publisher","first-page":"1846","DOI":"10.1016\/j.jcrs.2013.06.019","volume":"39","author":"Y Hasegawa","year":"2013","unstructured":"Hasegawa, Y., Okamoto, F., Nakano, S., Hiraoka, T. & Oshika, T. Effect of preoperative corneal astigmatism orientation on results with a toric intraocular lens. J. Cataract Refract. Surg. 39, 1846\u20131851. https:\/\/doi.org\/10.1016\/j.jcrs.2013.06.019 (2013).","journal-title":"J. Cataract Refract. Surg."},{"key":"81772_CR32","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/1471-2415-12-41","volume":"12","author":"B Agresta","year":"2012","unstructured":"Agresta, B., Knorz, M. C., Donatti, C. & Jackson, D. Visual acuity improvements after implantation of toric intraocular lenses in cataract patients with astigmatism: a systematic review. BMC Ophthalmol. 12, 41. https:\/\/doi.org\/10.1186\/1471-2415-12-41 (2012).","journal-title":"BMC Ophthalmol."},{"key":"81772_CR33","doi-asserted-by":"publisher","first-page":"e121","DOI":"10.1097\/OPX.0000000000000592","volume":"92","author":"R Blendowske","year":"2015","unstructured":"Blendowske, R. Unaided visual acuity and blur: a simple model. Optom. Vis. Sci. 92, e121\u2013e125 (2015).","journal-title":"Optom. Vis. Sci."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-81772-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-81772-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-81772-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T06:37:47Z","timestamp":1670049467000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-81772-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,12]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["81772"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-81772-w","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,12]]},"assertion":[{"value":"6 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"G.U. Auffarth and R. Khoramnia report grants, lecture fees and non-financial support from Rayner, grants, lecture fees and non-financial support from Oculentis, grants from Carl Zeiss Meditec, grants, lecture fees and non-financial support from Hoya, grants and non-financial support from Kowa, grants and non-financial support from Ophtec, grants from Physiol, grants, lecture fees and non-financial support from Alcon, grants, lecture fees and non-financial support from SIFI, grants, lecture fees and non-financial support from Johnson&Johnson, grants from Acufocus, lecture fees and non-financial support from Polytech. G. \u0141abuz and D. Varadi have nothing to disclose.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"7968"}}