{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:11:58Z","timestamp":1790881918747,"version":"4.1.0"},"reference-count":47,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: To evaluate the magnitude, axis and age-related changes in corneal astigmatism in patients before cataract surgery. Materials and Methods: In this retrospective, cross-sectional, and observational study, data from 2152 eyes that underwent phacoemulsification were evaluated. Keratometric values were obtained using the IOL Master 500 device. The frequency, magnitude and axis of corneal astigmatism were determined. The astigmatism axis was categorized as with the rule (WTR), against the rule (ATR), and oblique astigmatism. Quantitative analysis was performed using the power vector method (J0 and J45). The distribution and characteristics of corneal astigmatism data according to age were analyzed. Results: The mean age of the patients was 70.56 \u00b1 8.88 years (range 40\u201394 years) and 1010 (46.9%) were males. Mean corneal astigmatism, J0 and J45 values were 0.96 \u00b1 0.72, 0.05 \u00b1 0.51, 0.01 \u00b1 0.30 diopters (D), respectively. The most common range of magnitudes was 0.50\u20130.99 D with 38.8%, followed by &lt;0.50 D (25.3%), 1.00\u20131.49 D (20.3%), and 1.50\u20131.99 D (8.7%). The cubic regression curve showed a U-shaped nonlinear relationship between age and corneal astigmatism (p &lt; 0.001). The most common type of astigmatism was WTR with 43.4%, followed by ATR with 37.5% and oblique astigmatism with 19.1%. With the increase in age, the astigmatism axis gradually changed from WTR to ATR. There was a linear trend in the rate of these types of astigmatism across age groups (p &lt; 0.05). Additionally, in patients under 65 years of age, WTR astigmatism was negatively correlated with age, while in patients 65 years of age and older, ATR astigmatism was positively correlated with age (r = \u22120.217, p &lt; 0.001; r = 0.153, p &lt; 0.001, respectively). Linear regression analyses revealed that the J0 value decreased significantly with age, whereas J45 showed no significant relationship. Specifically, J0 decreased by 0.014 D per year of age (95% confidence interval [CI], 0.011\u20130.016; p &lt; 0.001). Conclusions: The results obtained in this study may provide information to guide surgeons in the management of astigmatism and the choice of toric intraocular lens in cataract surgery.<\/jats:p>","DOI":"10.3390\/medicina62010231","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T13:55:34Z","timestamp":1769176534000},"page":"231","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Frequency and Age-Related Changes in Corneal Astigmatism in Cataract Surgery Candidates at a Training Hospital in Turkey"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7554-0843","authenticated-orcid":false,"given":"Alper Can","family":"Yilmaz","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Gulhane School of Medicine, University of Health Sciences, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3108-6295","authenticated-orcid":false,"given":"Bagim Aycin","family":"Cakir Ince","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ufuk University, Ridvan Ege Hospital, 06520 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2843-0355","authenticated-orcid":false,"given":"Onder","family":"Ayyildiz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Gulhane School of Medicine, University of Health Sciences, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih Mehmet","family":"Mutlu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Gulhane School of Medicine, University of Health Sciences, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/ICU.0000000000001005","article-title":"Refractive cataract surgery","volume":"35","author":"Narang","year":"2024","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Park, R.B., and Aref, A.A. (2024). Astigmatism Management in Modern Cataract Surgery. Vision, 8.","DOI":"10.3390\/vision8010009"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"97","DOI":"10.29271\/jcpsp.2024.01.97","article-title":"Corneal Astigmatism in Cataract","volume":"34","author":"Shoaib","year":"2024","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3219","DOI":"10.1007\/s00417-024-06488-9","article-title":"Prevalence data for total corneal astigmatism in cataract patients","volume":"262","author":"Bian","year":"2024","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/OPX.0000000000001998","article-title":"Epidemiology and Burden of Astigmatism: A Systematic Literature Review","volume":"100","author":"Zhang","year":"2023","journal-title":"Optom. Vis. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"56","DOI":"10.4103\/joco.joco_33_21","article-title":"Ocular Biometric Values and Prevalence of Corneal Astigmatism in Patients Candidate for Cataract Surgery","volume":"34","author":"Hashemian","year":"2022","journal-title":"J. Curr. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jfo.2020.03.025","article-title":"Biometry data and prevalence of corneal astigmatism in caucasian spanish candidates for cataract surgery","volume":"44","year":"2021","journal-title":"J. Fr. Ophtalmol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Abu-Ain, M.S., Al-Latayfeh, M.M., and Khan, M.I. (2022). Do limbal relaxing incisions during cataract surgery still have a role?. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02327-9"},{"key":"ref_9","first-page":"74","article-title":"A prospective study to compare the safety and efficacy of toric intra-ocular lens vs. opposite clear corneal incision in patients undergoing phacoemulsification for age-related cataract with pre-existing corneal astigmatism","volume":"69","author":"Gupta","year":"2025","journal-title":"Rom. J. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1007\/s10792-025-03530-5","article-title":"Effects of toric intraocular lens in cataract patients with axial myopia and regular corneal astigmatism at primary hospitals","volume":"45","author":"Jiang","year":"2025","journal-title":"Int. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Ning, R., Xu, H., Li, Z., Yu, J., Xu, S., Lei, C.S., Wang, Y., Savini, G., Schiano-Lomoriello, D., and Zhou, X. (2024). Agreement between a new fully automatic ocular biometer based on optical low-coherence reflectometry and an optical biometer based on Scheimpflug imaging combined with partial coherence interferometry. BMC Ophthalmol., 24.","DOI":"10.1186\/s12886-024-03716-y"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Kanclerz, P., Hecht, I., and Tuuminen, R. (2023). Technical failure rates for biometry between swept-source and older-generation optical coherence methods: A review and meta-analysis. BMC Ophthalmol., 23.","DOI":"10.1186\/s12886-023-02926-0"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"295","DOI":"10.4103\/ojo.ojo_345_21","article-title":"Pattern of astigmatism using partial coherence interferometry in patients of different age groups undergoing cataract surgery","volume":"15","author":"Vats","year":"2022","journal-title":"Oman J. Ophthalmol."},{"key":"ref_14","first-page":"6385098","article-title":"Prevalence and Age-Related Changes of Corneal Astigmatism in Patients Undergoing Cataract Surgery in Northern China","volume":"2020","author":"Wu","year":"2020","journal-title":"J. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1097\/APO.0000000000000262","article-title":"Frequency of Corneal Astigmatism in Patients Presenting for Senile Cataract Surgery at a Teaching Hospital in Indian Rural Population","volume":"9","author":"Joshi","year":"2020","journal-title":"Asia Pac. J. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1097\/00006324-199706000-00019","article-title":"Power vectors: An application of Fourier analysis to the description and statistical analysis of refractive error","volume":"74","author":"Thibos","year":"1997","journal-title":"Optom. Vis. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1970","DOI":"10.1016\/j.jcrs.2012.07.025","article-title":"Analysis of corneal astigmatism in cataract surgery candidates at a teaching hospital in Shanghai, China","volume":"38","author":"Guan","year":"2012","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1016\/j.jcrs.2018.06.020","article-title":"Sex-related differences in corneal astigmatism and shape with age","volume":"44","author":"Hayashi","year":"2018","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1038\/s41598-022-05311-x","article-title":"Type of residual astigmatism and uncorrected visual acuity in pseudophakic eyes","volume":"12","author":"Hasegawa","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Yoon, Y.C., Ha, M., and Whang, W.J. (2021). Comparison of surgically induced astigmatism between anterior and total cornea in 2.2\u2009mm steep meridian incision cataract surgery. BMC Ophthalmol., 21.","DOI":"10.1186\/s12886-021-02131-x"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1080\/02713683.2022.2052108","article-title":"Surgically Induced Astigmatism after Cataract Surgery\u2014A Vector Analysis","volume":"47","author":"Langenbucher","year":"2022","journal-title":"Curr. Eye Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1016\/j.jcrs.2014.09.043","article-title":"Analysis of anterior corneal astigmatism before cataract surgery using power vector analysis in eyes of Korean patients","volume":"41","author":"Oh","year":"2015","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"617","DOI":"10.2147\/OPTH.S291467","article-title":"Prevalence of Astigmatism in Patients Undergoing Cataract Surgery at a Tertiary Care Center in North India","volume":"15","author":"Sharma","year":"2021","journal-title":"Clin. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.jcrs.2012.08.060","article-title":"Prevalence of corneal astigmatism before cataract surgery in Chinese patients","volume":"39","author":"Chen","year":"2013","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"456","DOI":"10.4103\/njcp.njcp_117_17","article-title":"Analysis of corneal astigmatism with NIDEK axial length scan in caucasian cataract surgery candidates","volume":"21","author":"Duman","year":"2018","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1177\/11206721211030779","article-title":"Comparison of corneal astigmatism characteristics and prevalence of corneal astigmatism between Turkish individuals and Syrian refugees","volume":"32","author":"Guven","year":"2022","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_27","first-page":"3286043","article-title":"Toric Intraocular Lenses for the Management of Corneal Astigmatism at the Time of Cataract Surgery","volume":"2021","author":"McAlinden","year":"2021","journal-title":"J. Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.mjafi.2020.03.014","article-title":"Rotational stability of Toric intraocular lenses","volume":"78","author":"Singh","year":"2022","journal-title":"Med. J. Armed Forces India"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1016\/j.jcrs.2010.02.025","article-title":"Analysis of biometry and prevalence data for corneal astigmatism in 23,239 eyes","volume":"36","author":"Hoffmann","year":"2010","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_30","first-page":"536412","article-title":"Prevalence of corneal astigmatism in patients before cataract surgery in Northern China","volume":"2014","author":"Yuan","year":"2014","journal-title":"J. Ophthalmol."},{"key":"ref_31","first-page":"272","article-title":"Corneal astigmatism in cataract surgery candidates","volume":"77","author":"Milena","year":"2018","journal-title":"Rev. Bras. Oftalmol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"494","DOI":"10.5301\/ejo.5000415","article-title":"Prevalence of corneal astigmatism before cataract surgery in Caucasian patients","volume":"24","author":"Zeppa","year":"2014","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.4103\/0301-4738.146751","article-title":"Preoperative corneal astigmatism among adult patients with cataract in Northern Nigeria","volume":"62","author":"Isyaku","year":"2014","journal-title":"Indian J. Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1007\/s10792-016-0327-z","article-title":"Prevalence of corneal astigmatism before cataract surgery in Indian population","volume":"37","author":"Prasher","year":"2017","journal-title":"Int. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.jcrs.2010.12.038","article-title":"Prevalence of corneal astigmatism in cataract surgery candidates in Bangkok, Thailand","volume":"37","author":"Lekhanont","year":"2011","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s00347-016-0323-8","article-title":"Prevalence and age-related changes of corneal astigmatism in patients before cataract surgery","volume":"114","author":"Michelitsch","year":"2017","journal-title":"Ophthalmologe"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"9651","DOI":"10.1167\/iovs.11-7641","article-title":"Power vector analysis of refractive, corneal, and internal astigmatism in an elderly Chinese population: The Shihpai Eye Study","volume":"52","author":"Liu","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jcrs.2008.09.027","article-title":"Prevalence of corneal astigmatism before cataract surgery","volume":"35","year":"2009","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.jcrs.2017.02.028","article-title":"Changes in corneal astigmatism during 20 years after cataract surgery","volume":"43","author":"Hayashi","year":"2017","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.ajo.2010.11.014","article-title":"Long term change in corneal astigmatism after sutureless cataract surgery","volume":"151","author":"Hayashi","year":"2011","journal-title":"Am. J. Ophthalmol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/j.1444-0938.2007.00112.x","article-title":"A review of astigmatism and its possible genesis","volume":"90","author":"Read","year":"2007","journal-title":"Clin. Exp. Optom."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.jcjo.2014.02.001","article-title":"Changes in corneal astigmatism among patients with visually significant cataract","volume":"49","author":"Lyall","year":"2014","journal-title":"Can. J. Ophthalmol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s00417-021-05406-7","article-title":"Long-term changes in the refractive effect of a toric intraocular lens on astigmatism correction","volume":"260","author":"Hayashi","year":"2022","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1007\/s10792-016-0201-z","article-title":"Prevalence of corneal astigmatism before cataract surgery","volume":"36","author":"Mohammadi","year":"2016","journal-title":"Int. Ophthalmol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1046\/j.1442-9071.2001.d01-27.x","article-title":"The Auckland Cataract Study: Demographic, corneal topographic and ocular biometric parameters","volume":"29","author":"Riley","year":"2001","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e1080","DOI":"10.1111\/aos.15040","article-title":"Prediction of total corneal power from measured anterior corneal power on the IOLMaster 700 using a feedforward shallow neural network","volume":"100","author":"Langenbucher","year":"2022","journal-title":"Acta Ophthalmol."},{"key":"ref_47","first-page":"39","article-title":"The impact of posterior corneal astigmatism on the surgical planning of toric multifocal intraocular lens implantation","volume":"3","author":"Mohammadi","year":"2022","journal-title":"Adv. Ophthalmol. Pract. Res."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/231\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T14:25:31Z","timestamp":1769178331000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,22]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["medicina62010231"],"URL":"https:\/\/doi.org\/10.3390\/medicina62010231","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,22]]}}}