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The Pentacam HR was used to measure anterior corneal astigmatism (ACA), posterior corneal astigmatism (PCA), total corneal astigmatism (TCA) and keratometric corneal astigmatism (KCA). With age, the proportion of with-the-rule (WTR) ACA decreased from 65.31% to 23.63%, while the against-the-rule (ATR) ACA increased from 26.53% to 56.20%. PCA exceeded 0.50 D in 9.14% of eyes, while 76.35% of them were ATR. The magnitude of ACA was positively correlated with PCA in the whole sample, with a more significant correlation in WTR eyes (s<jats:sub>r<\/jats:sub>\u2009=\u20090.349, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The vector summation effect of PCA to ACA changed from compensation to augmentation with aging. In 57.53% of WTR eyes, KCA was overestimated by an average of 0.21\u2009\u00b1\u20090.17 D, while it was underestimated by 0.38\u2009\u00b1\u20090.27 D in 87.62% of ATR eyes. In conclusion, among age-related cataract patients, ACA and TCA gradually shifted from WTR to ATR with aging, while most PCA remained as ATR. Ignoring the age-related changes and real PCA might cause overestimation of WTR astigmatism and underestimation of ATR astigmatism.<\/jats:p>","DOI":"10.1038\/s41598-021-91028-2","type":"journal-article","created":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T15:20:18Z","timestamp":1622560818000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Distribution and internal correlations of corneal astigmatism in cataract patients"],"prefix":"10.1038","volume":"11","author":[{"given":"Yuanfeng","family":"Jiang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaochong","family":"Bu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,1]]},"reference":[{"key":"91028_CR1","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., Montes-Mico, R., Peixoto-de-Matos, S. 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