TOPOGRAPHIC DETERMINATION OF CORNEAL ASPHERICITY AND ITS LACK OF EFFECT ON THE REFRACTIVE OUTCOME OF RADIAL KERATOTOMY

PURPOSE: The normal human cornea flattens peripherally. The amount of flattening, or asphericity, has traditionally been calculated from multiple keratometric measurements. We devised a mathematical technique for determining asphericity from computed corneal topography. We then determined whether asphericity affects the refractive outcome of radial keratotomy. METHODS: One eye each of 41 patients who underwent four or eight-incision radial keratotomy and preoperative computed corneal topography was identified retrospectively and analyzed. The asphericity, P, of each cornea was calculated by fitting Baker's equation (y(2) = 2r(o)x - Px(2)) to each meridian of the topographic map. For each patient, we calculated the difference between the refractive outcome in diopters for radial keratotomy and the prediction of a quadratic least-squares best fit model involving optical zone size and age. RESULTS: Asphericity could be calculated from the topographic maps in all 41 patients and ranged from 0.33 to 1.28, with mean +/- S.D. of 0.82 +/- 0.21. Asphericity varied among the meridians of a cornea, with an average standard deviation among meridians of 0.17. No statistical correlation was found between calculated asphericity and refractive outcome. CONCLUSIONS: Corneal asphericity can be calculated from corneal topographic maps. Asphericity is not constant in the different meridians of a normal cornea. Corneal asphericity is not useful in predicting the refractive outcome of radial keratotomy.