Distribution and Repeatability of Corneal Astigmatism Measurements (Magnitude and Axis) Evaluated With Color Light Emitting Diode Reflection Topography

PURPOSE: To evaluate and investigate the distribution and repeatability of anterior corneal surface astigmatism measurements (axis and magnitude) using a novel corneal topographer. METHODS: Anterior corneal surface astigmatism was investigated in a total of 195 eyes using a novel multicolored spot reflection topographer (Cassini; i-Optics). Two patient groups were studied, a younger-age group A and an older-age group B. Three consecutive acquisitions were obtained from each eye. The repeatability of measurement was assessed using Bland–Altman plot analysis and is reported as the coefficient of repeatability. RESULTS: Group A (average age 34.3 years) had on average with-the-rule astigmatism, whereas the older-age group B (average age 72.3 years) had on average against-the-rule astigmatism. Average astigmatism magnitude measurement repeatability in group A was 0.4 diopters (D) and in group B 0.4 D. Average astigmatism axis measurement repeatability in group A was 5.4 degrees and in group B 5.5 degrees. The axis measurement repeatability improved with increasing magnitude of astigmatism: in the subgroups with astigmatism between 3.0 and 6.0 D, the axis repeatability was 1.4 degrees (group A) and 1.2 degrees (group B), whereas in the subgroups with astigmatism larger than 6.0 D, the repeatability was 1.1 and 0.6 degrees, respectively. CONCLUSIONS: This novel corneal topography device seems to offer high precision in reporting corneal astigmatism. This study reaffirms the established trend of a corneal astigmatism shift from an average “with-the-rule” to “against-the-rule” with aging.