Prevalence of interocular symmetry in corneal astigmatism and the possible influence of age, sex and refractive error.

Purpose: The aim of this study was to investigate, using a power vector approach, whether corneal astigmatism follows a mirror symmetry pattern considering both the magnitude and axis, and whether age, sex and spherical equivalent refractive error can influence the pattern.

Methods: The IOLMaster 700 optical biometer was used to measure the radii of curvature of the anterior corneal surface. Refractive error was determined by non-cycloplegic subjective refraction. Descriptive statistical analyses and inferential logistic regression were applied over the dichotomous variable of mirror symmetry using J₀ and J₄₅ power vector components. An evaluation was carried out based on the subject's age, sex and spherical equivalent refractive error.

Results: A total of 2974 Caucasian adults were evaluated. This cross-sectional study revealed that axis orientation follows the isorule symmetry pattern, and in terms of both magnitude and axis orientation, mirror symmetry was present in 70.9% of cases. Age, sex and spherical equivalent refractive error were not significant factors and did not contribute to the clinical improvement of the model despite its statistical significance (refractive error, p = 0.001; age and sex, p = 0.23 and 0.36, respectively).

Conclusions: Among an adult Caucasian population, the prevalence of corneal astigmatism mirror symmetry was 70.9% and isorule symmetry was the most common pattern considering axis orientation only. The inclusion of age, sex and spherical equivalent refractive error did not improve the model.